Case Study: Mr. C. |
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.
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Expert Solution Preview
Introduction:
The presented case study revolves around a 32-year-old man, Mr. C., who seeks information regarding possible bariatric surgery for his obesity. He reports shortness of breath with activity, swollen ankles, and pruritus over the last 6 months, and previous medical evaluations have not indicated any metabolic diseases, except for his high blood pressure, which he tries to control by restricting dietary sodium. In this assignment, we will critically evaluate Mr. C.’s potential diagnosis and intervention(s) based on the presented health history and medical information.
1. Describe the clinical manifestations present in Mr. C.
Mr. C. presents symptoms of obesity, including shortness of breath with activity and swollen ankles, which may suggest underlying heart problems. Additionally, pruritus may be an indication of liver or kidney problems. High blood pressure is also a concerning clinical manifestation as it may lead to further complications such as stroke, heart attack, or renal failure.
2. Describe the potential health risks for obesity that are of concern for Mr. C. Discuss whether bariatric surgery is an appropriate intervention.
Obesity puts individuals at significant risk for various health problems such as heart disease, stroke, type 2 diabetes, and cancer. Bariatric surgery is a recommended intervention for individuals with obesity who have not been successful with other methods of weight loss. Based on Mr. C.’s BMI and health problems, bariatric surgery may be an appropriate intervention. However, he needs to undergo thorough evaluation and risk assessment before the procedure.
3. 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.)
Health-Perception: Mr. C. perceives that he is obese and seeks intervention. Rationale: This may indicate that Mr. C. values his health and is willing to make necessary changes to improve it.
Health-Management: Mr. C. struggles to manage his high blood pressure and attempts to control it by restricting dietary sodium. Rationale: This may indicate that Mr. C. needs additional guidance and education on hypertension management.
Nutritional: Mr. C.’s high BMI, high total cholesterol, and high triglycerides indicate poor nutritional choices. Rationale: This may suggest that Mr. C. needs nutritional counseling and guidance to make healthier choices.
Metabolic: Mr. C.’s fasting blood glucose levels, serum creatinine, and BUN levels are elevated, indicating metabolic problems. Rationale: This may indicate he has an underlying metabolic problem, such as diabetes or renal failure, which needs proper evaluation and management.
Activity-Exercise: Mr. C. reports shortness of breath with activity, indicating a decreased tolerance for physical activity. Rationale: This may suggest underlying respiratory or cardiac problems that need evaluation and management.
4. Explain the staging of end-stage renal disease (ESRD) and contributing factors to consider.
End-stage renal disease (ESRD) refers to the final stage of chronic kidney disease where the kidneys no longer function adequately to meet the body’s needs. Contributing factors that may lead to ESRD include hypertension, diabetes, and glomerulonephritis. ESRD is divided into five stages based on the glomerular filtration rate (GFR), and each stage requires different treatments and management.
5. 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.
ESRD prevention and health promotion can include regular monitoring of blood pressure and blood glucose levels, maintaining a healthy weight, and following a renal-friendly diet. Mr. C. should receive patient education on kidney disease, its management, and how to maintain good kidney health, including proper hydration and avoiding nephrotoxic medications and substances.
6. 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.
ESRD patients may require nonacute care such as long-term dialysis or kidney transplant. Resources available for such patients include support groups, social workers, financial advisors, and specialized clinics. A multidisciplinary approach involving nurses, physicians, dieticians, and social workers can provide integrated care to ESRD patients and help them manage their health conditions effectively. Other aspects such as transportation, living conditions, and employment issues need to be addressed through proper planning and resources.
