It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.
Evaluate the Health History and Medical Information for Mr. C., presented below.
Based on this information, formulate a conclusion based on your evaluation, 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 evaluations 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 clinical manifestations present in Mr. C.
- Describe the potential health risks for obesity that are of concern for Mr. C. Discuss 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 can you 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 staging of end-stage renal disease (ESRD) and contributing factors to consider.
- Consider ESRD prevention and health promotion opportunities. Describe what type of patient education 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. Consider aspects such as devices, transportation, living conditions, return-to-employment issues.
You are required to cite to a minimum of two 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.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Expert Solution Preview
Introduction:
In this critical thinking essay, we will evaluate the health history and medical information for Mr. C, a 32-year-old single male seeking information about possible bariatric surgery for his obesity. We will analyze the provided objective data and formulate a conclusion based on our evaluation. Additionally, we will address various aspects related to Mr. C’s potential diagnosis, intervention, health risks, functional health patterns, end-stage renal disease (ESRD), prevention and health promotion opportunities, and available resources for ESRD patients.
Answers to the Content:
1. Clinical Manifestations Present in Mr. C:
Based on the provided information, Mr. C presents with clinical manifestations of obesity-related complications. These include increasing shortness of breath with activity, swollen ankles, and pruritus over the last 6 months. Additionally, objective data reveals 3+ pitting edema in bilateral feet and ankles, high blood pressure (172/98), elevated heart rate (88 beats per minute), and increased respiratory rate (26 breaths per minute). Furthermore, laboratory results indicate elevated levels of fasting blood glucose (146 mg/dL), total cholesterol (250 mg/dL), triglycerides (312 mg/dL), and reduced HDL (30 mg/dL). Mr. C’s height and weight measurements suggest that he has a body mass index (BMI) in the obese range.
2. Potential Health Risks for Mr. C. and Appropriateness of Bariatric Surgery:
Obesity poses several health risks for individuals, and Mr. C is likely to be facing these risks. Elevated blood pressure and abnormal lipid profiles increase the likelihood of cardiovascular diseases such as hypertension, coronary artery disease, and stroke. Mr. C’s shortness of breath with activity suggests impaired lung function, possibly due to obesity-related restrictive lung disease. His increasing weight gain and elevated blood sugar levels indicate the presence of metabolic disturbances, raising concerns about the development of type 2 diabetes. Given Mr. C’s obesity-related health risks and significant weight gain, bariatric surgery may be an appropriate intervention to help him lose weight and improve his long-term health outcomes.
3. Assessment of Mr. C’s Functional Health Patterns and Identification of Problems:
Using the provided information, we can assess Mr. C’s functional health patterns and identify potential problems. These include:
– Health-perception: Mr. C may have a distorted perception of his health since he attributes his obesity-related symptoms to other causes while overlooking the potential impact of his weight.
– Health-management: Mr. C’s attempts at managing his high blood pressure through dietary sodium restriction may not be effective due to other contributing factors such as obesity.
– Nutritional: Mr. C’s significant weight gain and elevated blood sugar levels indicate poor nutritional choices and potential overconsumption of calorie-dense foods.
– Metabolic: Mr. C’s abnormal lipid profile and elevated blood glucose levels suggest metabolic dysregulation, which may be exacerbated by his obesity.
– Activity-exercise: Mr. C’s increasing shortness of breath suggests a reduced ability to engage in physical activity, potentially due to his excess weight.
4. Staging of End-Stage Renal Disease (ESRD) and Contributing Factors:
The staging of ESRD is typically based on the glomerular filtration rate (GFR) and the presence of kidney damage. Commonly used staging systems include the Kidney Disease Improving Global Outcomes (KDIGO) classification or the five-stage National Kidney Foundation (NKF) classification. Factors contributing to the progression of ESRD include uncontrolled hypertension, diabetes mellitus, glomerulonephritis, polycystic kidney disease, and chronic urinary tract obstruction.
5. ESRD Prevention, Health Promotion, and Patient Education:
To prevent future events and promote health restoration in ESRD, Mr. C should receive patient education aimed at improving his renal status. This education should include information on maintaining a healthy lifestyle, including a balanced diet low in sodium, sugar, and saturated fats. Promoting regular exercise and weight management are also crucial in preventing further deterioration of renal function. Additionally, providing information about medication management, symptom recognition, and the importance of regular follow-ups with healthcare providers is essential for Mr. C’s health promotion and prevention of further renal complications.
6. Resources for ESRD Patients and Multidisciplinary Approach:
ESRD patients have several resources available for nonacute care. These include renal dietitians, renal nurses, social workers, and support groups. Medical devices such as dialysis machines and equipment for peritoneal dialysis can be provided. Transportation services for attending dialysis sessions and support for living conditions, such as home modifications, may also be available. A multidisciplinary approach involving healthcare professionals from various specialties such as nephrology, nutrition, psychology, and social work can provide comprehensive care and support for ESRD patients.
In conclusion, based on the evaluation of Mr. C’s health history and medical information, it is evident that he is experiencing obesity-related complications and is at risk for various health conditions such as cardiovascular diseases and metabolic disturbances. Bariatric surgery may be an appropriate intervention for weight management. Mr. C’s functional health patterns indicate potential problems in his health perception, health management, nutrition, metabolism, and ability to engage in physical activity. Implementation of preventive measures, health promotion strategies, patient education, and the provision of resources and multidisciplinary support can contribute to the prevention of further complications and improved outcomes for ESRD patients like Mr. C.
