Describe the clinical manifestations present in Mr C
1.Describe the clinical manifestations present in Mr. C.
-Mr. C has a history of obesity since childhood and has gained approximately 100 pounds over the last 2-3 years. He reports experiencing sleep apnea and high blood pressure. He also reports increasing exertional dyspnea, swollen ankles, and pruritus over the last six months. Objective findings include a height of 68 inches and a weight of 134.5 kg, a BMI of 46.4 classified under morbid obesity. Vital signs indicate an elevated blood pressure of 172/98 and tachypnea of 26b/min. Positive physical findings include 3+ pitting edema on bilateral feet and ankles. Lab results reveal an elevated levels of fasting blood glucose- 146 mg/dL, Total cholesterol-250 mg/dL Triglycerides-312 mg/dL and low HDL of 30 mg/dL. In addition, his comprehensive metabolic panel reveals elevated levels of serum creatinine at 1.8 mg/dL and BUN at 32 mg/dl, which suggests impaired kidney function.
2.Describe the potential health risks for obesity that are of concern for Mr. C. Discuss whether bariatric surgery is an appropriate intervention.
-Base on clinical signs of MR. C, there are many potential risk. He is already hypertensive. Additionally, inflammation, low density lipoprotein, cholesterol and blood sugar are risk for developing obesity.
Mr. C has the higher risk in developing cardiovascular diseases, stroke and even coronary heart disease.
Bariatric surgery is an appropriate intervention for Mr. C because it helps in the solution of severe obesity which Mr. C manifest.
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.)
1. Health management
-Mr. C is aware that he is overweight and wants to solve it thats why he was thinking of a bariatric surgery. He is hypertensive too which needs to be controlled by modifying his diet.
2. Cognitive-Perceptual
-Mr. C’s perceives his health as big risks for him thats why he was trying to seek help amd solution about it.
3.Activity-exercise
-Mr.C is having trouble with activity that causes him to have shortness of breath.
4.Nutritional
-Mr C is moifying his diet into controlling dietary sodium intake which can worsen hypertension.
5.Coping stress tolerance
-although it wasn’t said that he was stressed out but this is kne of the problem of Mr. C, stress on his weight.
Support system will play a big role throughout the management of his obesity and also the bariatric surgery.
4. Explain the staging of end-stage renal disease (ESRD) and contributing factors to consider.
-End-stage renal disease, also called end-stage kidney disease, occurs when chronic kidney disease — the gradual loss of kidney function — reaches an advanced state. In end-stage renal disease, your kidneys are no longer able to work as they should to meet your body’s needs.
With end-stage renal disease, you need dialysis or a kidney transplant to stay alive. But you may also choose to forgo dialysis or transplant and opt for conservative care to manage your symptoms — aiming for the best quality of life possible during your remaining time.
Risk factors
Certain factors increase the risk that chronic kidney disease will progress more quickly to end-stage renal disease, including:
- Diabetes with poor blood sugar control
- Kidney disease that affects the glomeruli, the structures in the kidneys that filter wastes from the blood
- Polycystic kidney disease
- Kidney disease after a kidney transplant
- High blood pressure
- Tobacco use
- African-American descent
- Male sex
- Older age
- Lower level of kidney function when your doctor first begins regular measurements of kidney function
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.
If Mr. C have kidney disease, he may be able to slow its progress by making healthy lifestyle choices:
- Lose weight
- Be active most days
- Eat a balanced diet of nutritious, low-sodium foods
- Control your blood pressure
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