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
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.
- 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.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
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. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Expert Solution Preview
Based on the provided health history and medical information of Mr. C., a 32-year-old single male seeking information about possible bariatric surgery for his obesity, this critical thinking essay aims to evaluate his potential diagnosis and interventions. The essay will include an analysis of subjective and objective clinical manifestations present in Mr. C., discussion of potential health risks associated with obesity, assessment of Mr. C.’s functional health patterns, exploration of the stages of renal disease that lead to end-stage renal disease (ESRD), consideration of ESRD prevention and health promotion opportunities, and an explanation of available resources for ESRD patients.
Subjective and objective clinical manifestations present in Mr. C. include increasing shortness of breath with activity, swollen ankles, and pruritus over the last 6 months. Objective data reveals a height of 68 inches and weight of 134.5 kg, high blood pressure (172/98), increased heart rate (88), elevated respiratory rate (26), pitting edema in bilateral 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.
The potential health risks for obesity that are of concern for Mr. C. include sleep apnea, high blood pressure, shortness of breath, swollen ankles, pruritus, increased fasting blood glucose, elevated total cholesterol and triglycerides, and reduced HDL levels. Bariatric surgery may be considered an appropriate intervention in this case to address the severe obesity and associated health risks, as it can lead to significant weight loss and improvement in metabolic parameters. However, a thorough evaluation and assessment of the patient’s overall health, including psychological factors, should be conducted before deciding on bariatric surgery.
Assessing Mr. C.’s functional health patterns, several actual or potential problems can be identified. In the health-perception pattern, Mr. C.’s perception of his health may be distorted due to his denial of underlying metabolic diseases. In the health-management pattern, his lack of effective management strategies for obesity-related health issues, such as sleep apnea and high blood pressure, can be a concern. In the nutritional pattern, his excessive weight gain and high blood glucose levels indicate poor dietary habits. In the metabolic pattern, his elevated cholesterol and triglyceride levels reflect an impaired metabolism. In the activity-exercise pattern, his shortness of breath and limited physical activity suggest decreased exercise tolerance.
The stages of renal disease that lead to end-stage renal disease (ESRD) include the initial renal insult phase, the oliguric/anuric phase, diuretic phase, and recovery phase. Factors that may have contributed to Mr. C.’s ESRD could be his obesity, high blood pressure, and metabolic abnormalities, such as elevated blood glucose and cholesterol levels. These factors can lead to chronic kidney disease and progressive renal damage.
ESRD prevention and health promotion opportunities for Mr. C. may involve patient education regarding lifestyle modifications, including a healthy diet low in sodium, saturated fats, and sugar. He should be educated about the importance of regular exercise, weight loss, smoking cessation, and adherence to prescribed medications, particularly to control blood pressure and blood glucose levels. Regular monitoring of renal function and early intervention can also help in preventing further renal deterioration.
Resources available for ESRD patients for nonacute care include access to nephrologists, dietitians, and renal nurse specialists for ongoing management. Dialysis centers provide hemodialysis and peritoneal dialysis services. Home care services and support groups can assist in improving the quality of life for ESRD patients. Transport services, financial assistance, and employment support may be available for patients to address logistical and financial challenges. A multidisciplinary approach involving healthcare professionals from different specialties, including social workers and psychologists, can be beneficial in providing comprehensive care to ESRD patients.