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.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.
Expert Solution Preview
Introduction:
Mr. C, a 32-year-old man, is seeking information about the possibility of bariatric surgery due to his obesity. He has a history of sleep apnea, high blood pressure and other clinical manifestations that have increased over the last 6 months. In this critical thinking essay, we will evaluate Mr. C’s potential diagnosis and interventions based on his health history, medical information and other functional health patterns.
1. Clinical Manifestations Present in Mr. C:
Mr. C is clinically diagnosed with obesity and reports increasing shortness of breath with activity, swollen ankles, and pruritus over the last 6 months. His objective data shows he has pitting edema bilateral feet and ankles, BP of 172/98, HR 88, RR 26, 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, and BUN 32 mg/dL.
2. Potential Health Risks for Obesity:
Obesity is a serious health risk and can lead to several other medical conditions such as type 2 diabetes, cardiovascular disease, hypertension, and sleep apnea. In Mr. C’s case, he already has sleep apnea and high blood pressure. Bariatric surgery might be an appropriate intervention if Mr. C’s BMI is higher than 40 kg/m2 or if he has a BMI of 35 kg/m2 with other obesity-related diseases.
3. Functional Health Patterns and Problems:
Mr. C’s functional health pattern includes health-perception, health-management, nutritional, metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception/self-concept, role-relationship, sexuality/reproductive, and coping-stress tolerance. Some actual or potential problems that can be identified from these patterns include inadequate physical activity leading to obesity, poor nutritional intake leading to high blood glucose levels, and inadequate stress management leading to high blood pressure. Mr. C may also have issues with self-esteem and self-concept leading to limited social interactions and relationships.
4. Staging of End-Stage Renal Disease (ESRD) and Contributing Factors:
ESRD is the final stage of chronic kidney disease and is characterized by the irreversible loss of kidney function. Stage 5 ESRD is defined by a GFR of less than 15 ml/min. Contributing factors include uncontrolled hypertension, diabetes, glomerulonephritis, polycystic kidney disease and other genetic and environmental factors.
5. ESRD Prevention and Health Promotion Opportunities:
Prevention of ESRD includes managing contributing factors such as hypertension and diabetes, promoting healthy lifestyle choices such as regular exercise and a balanced diet and addressing any potential genetic or environmental factors. Patient education is also crucial in preventing ESRD and managing the disease if it occurs. Mr. C should be educated on the importance of regular follow-up and monitoring of his kidney function, regular exercise, balanced diet, and managing his diabetes and hypertension.
6. Resources Available for ESRD Patients:
ESRD patients require comprehensive multidisciplinary care that involves multiple healthcare providers and care settings. Resources available for ESRD patients include dialysis clinics, rehabilitation centers, social workers, and transportation services. A multidisciplinary approach that involves care coordination and collaboration with these providers can provide comprehensive care and improve patient outcomes.
