Assessing Mr. McKinley for vitamin and mineral deficiencies such as zinc (sparse, dry and dull hair; folliculitis, leukonychia), vitamin A (eye roughness, dryness, or foamy spots), calcium (brittle nails) iron (pale conjunctiva, cracks on lips, pale and/or ridging nailbeds), folate (pale conjunctiva, sore, reddened tongue) and/or a B12 deficiciency (sore, reddened tongue) is also essential. Anthropometrics, including weight, body fat percentage and circumference differences over time will help determine Mr. McKinley’s progress and whether an adequate and appropriate amount of weight is being lost. Mr. McKinley’s laboratory values also need to be monitored to determine whether or not he is making biochemical improvements over time. Blood lipids, cholesterol and glucose should improve with weight loss and diet improvements. Lastly, Mr. McKinley’s diet should be evaluated by visiting his room during or after his meals, analyzing his food journal, and/or a dietary recall. Amount, frequency, and types of foods and vitamin-mineral supplements that Mr. McKinley is consuming will help assess adherence to phases of the bariatric surgery diet. Total protein, fluid and caloric intake will be calculated. In addition, Mr. …show more content…
Some facilities will not perform bariatric surgery on patients under 18 years of age so that normal growth is accomplished. AND states that bariatric surgery for adolescents aged 12-18 years is safe.7 If Mr. McKinley’s cousin meets this criteria, I would tell him that his cousin and the parents should discuss options with a pediatrician, or address dietary behaviors with a pediatric dietitian, since bariatric surgery at 10 years old is