Based on this information, formulate a conclusion based on your Assessment, and complete the Critical Thinking Essay assignment, as instructed below.
Health History and Medical Information
Health History
Mr. C., a 32-year-old single male, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He currently works at a catalog telephone center. He reports that he has always been heavy, even as a small child, gaining approximately 100 pounds in the last 2-3 years. Previous medical Assessments have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control by restricting dietary sodium. Mr. C. reports increasing shortness of breath with activity, swollen ankles, and pruritus over the last 6 months.
Objective Data:
Height: 68 inches; weight 134.5 kg
BP: 172/98, HR 88, RR 26
3+ pitting edema bilateral feet and ankles
Fasting blood glucose: 146 mg/dL
Total cholesterol: 250 mg/dL
Triglycerides: 312 mg/dL
HDL: 30 mg/dL
Serum creatinine 1.8 mg/dL
BUN 32 mg/dl
Critical Thinking Essay
In 750-1,000 words, critically evaluate Mr. C.’s potential diagnosis and intervention(s). Include the following:
Describe the subjective and objective clinical manifestations present in Mr. C.
Describe the potential health risks for obesity that are of concern for Mr. C. Explain whether bariatric surgery is an appropriate intervention.
Assess each of Mr. C.’s functional health patterns using the information given. Discuss at least five actual or potential problems you can identify from the functional health patterns and provide the rationale for each. (Functional health patterns include health-perception, health-management, nutritional, metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception/self-concept, role-relationship, sexuality/reproductive, coping-stress tolerance.)
Explain the stages of renal disease that leads to end-stage renal disease (ESRD). What factors contributed to Mr. C’s ESRD?
Consider ESRD prevention and health promotion opportunities. Describe what type of patient education for ESRD should be provided to Mr. C. for prevention of future events, health restoration, and avoidance of deterioration of renal status.
Explain the type of resources available for ESRD patients for nonacute care and the type of multidisciplinary approach that would be beneficial for these patients. Include aspects such as devices, transportation, living conditions, return-to-employment issues.
You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
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Mr. C. is a 32-year-old male who is seeking information about possible bariatric surgery for his obesity. He has a history of being overweight, gaining 100 pounds in the last 2-3 years, and reports symptoms of sleep apnea, high blood pressure, shortness of breath, swollen ankles, and pruritus. Objective data shows that he has a height of 68 inches, a weight of 134.5 kg, blood pressure of 172/98, heart rate of 88, respiratory rate of 26, 3+ pitting edema in both feet and ankles, fasting blood glucose of 146 mg/dL, total cholesterol of 250 mg/dL, triglycerides of 312 mg/dL, HDL of 30 mg/dL, serum creatinine of 1.8 mg/dL, and BUN of 32 mg/dL.
Obesity is a major health concern and is associated with a number of risks including, but not limited to, diabetes, heart disease, sleep apnea, high blood pressure, and certain types of cancer. Bariatric surgery is an appropriate intervention for individuals who have a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with comorbidities. Mr. C’s BMI is calculated by his weight in kilograms divided by his height in meters squared, which is 48.8, that is considered severe obesity.
Using the information provided, it is possible to identify several actual or potential problems for Mr. C. based on the functional health patterns.
Health Perception/Health Management: Mr. C. reports that he tries to control his high blood pressure and sleep apnea by restricting dietary sodium, indicating a lack of understanding of the underlying causes and appropriate management of these conditions.
Nutritional: Mr. C.’s weight and BMI suggest that he is consuming more calories than he is able to burn, which is contributing to his obesity.
Metabolic: Mr. C.’s fasting blood glucose of 146 mg/dL, total cholesterol of 250 mg/dL, triglycerides of 312 mg/dL, and HDL of 30 mg/dL indicate that he is at risk for diabetes and heart disease.
Elimination: Mr. C.’s serum creatinine of 1.8 mg/dL and BUN of 32 mg/dL suggest that he is experiencing renal failure, which is a serious complication of obesity.
Activity/Exercise: Mr. C. reports increasing shortness of breath with activity, indicating that he is likely experiencing difficulty with physical activity due to his obesity.
Self-Perception/Self-Concept: Mr. C.’s obesity may be negatively impacting his self-esteem and self-perception.
Renal failure is a progressive disease that can lead to end-stage renal disease (ESRD). Factors that contribute to ESRD include hypertension, diabetes, and obesity, all of which Mr. C. is experiencing. To prevent ESRD, Mr. C. should be provided with patient education on the importance of maintaining a healthy diet and weight, controlling blood pressure and glucose levels, and regular monitoring of his renal function.
There are a number of resources available for ESRD patients for nonacute care, including dialysis and transplantation. A multidisciplinary approach that includes a dietitian, social worker, and nephrologist would be beneficial for Mr. C. to ensure that he receives the appropriate care and support. Other considerations include devices such as a dialysis machine, transportation, living conditions, and return-to-employment issues.
References:
American Society for Metabolic and Bariatric Surgery. (2021). Bariatric Surgery Elig
