Question

The registered nurse prepares to conduct a nutritional assessment on Mrs. Varner, a 52-year-old Caucasian female who describes herself as “overweight most of my adult life.” The client states that her health is good. She works part time as a receptionist and volunteers about 10 hours per week in her church. The nurse obtains Mrs. Varner’s height as 64 inches and her weight as 165 pounds. (Learning Objective 8) What is the rationale for computing body mass index? What is Mrs. Varner’s BMI? Calculate her ideal body weight. What is your assessment of her BMI and weight? Based on Mrs. Varner’s BMI and weight, the nurse measures her waist circumference. Describe the proper procedure for this assessment. Mrs. Varner’s waist circumference is 38 inches. What is your assessment? What laboratory values would the nurse review to evaluate Mrs. Varner’s protein levels?

Answer 1

• What is the rationale for computing body mass index?

Body mass index is considered as a reliable way to determine whether a person has too much body fat by calculating the ratio of their weight to their height squared.

• What is Mrs. Varner’s BMI?

BMI is your weight (in kilograms) over your height squared (in centimeters).

1. Multiply the weight in pounds by 0.45 (the metric conversion factor)

165 X 0.45 = 74.25 kg

2. Multiply the height in inches by 0.025 (the metric conversion factor)

64 X 0.025 = 1.6 m

3. Square the answer from step 2

1.6 x 1.6 = 2.56

4.Divide the answer from step 1 by the answer from step 3

74.25 / 2.56 = 29.0039

Mrs. Varner's BMI is 29.

• Calculate her ideal body weight.

Ideal Body Weight (IBW)

Formula for estimated ideal body weight in (kg)
Females: IBW = 45.5 kg + 2.3 kg for each inch over 5 feet.

IBW = 45.5 kg + 2.3 x each inch over 5 feet (60inches)
IBW = 45.5 kg + 2.3 x 4 inches
IBW = 45.5 kg + 9.2
IBW = 54.7 kg

Mrs. Varner's ideal body weight is 54.7 kg.

• What is your assessment of her BMI and weight?

-The World Health Organization (WHO) states that for adults, the healthy range for BMI is between 18.5 and 24.9. Overweight is defined as a body mass index of 25 to 29.9, and obesity is defined as a body mass index of 30 or higher.These BMI cut points in adults are the same for men and women, regardless of their age.

?- Mrs. Varner falls in overweight category as her BMI is 29 and also her ideal weight should be 54.7 kg as per her height but she has been measured to have 74kg which is again over weight.

• Describe the proper procedure for this assessment.

Body fat location is also important-and could be a better indicator of disease risk than the amount body fat. Fat that accumulates around the waist and chest (what’s called abdominal adiposity) may be more dangerous for long-term health than fat that accumulates around the hips and thighs. In adults, measuring both BMI and waist circumference may actually be a better way to predict someone’s weight-related risk.

Procedure to measure waist circumference

1. Start at the top of your hip bone, then bring the tape measure all the way around your body, level with your belly button.
2. Make sure it's not too tight and that it's straight, even at the back. Don't hold your breath while measuring.
Check the number on the tape measure right after you exhale.

In women who are overweight with a body mass index of 25 or higher, a waist size greater than 35 inches is considered high risk and unhealthy. Mrs. Varner's waist measurement is 38 which is considered as unhealthy.