NRS-410V Mr. C: Case Study

NRS-410V Mr. C: Case Study

NRS-410V Mr. C: Case Study

Case Study: Mr. C
Nurses and other healthcare providers play a crucial role in the promotion of optimum health outcomes for the populations they serve. They adopt evidence-based interventions to make informed decisions that enhance safety, quality, and efficiency. An understanding of the pathophysiological processes of different conditions is crucial for nurses to provide appropriate care to their patients. Therefore, this paper examines Mr. C’s case study to determine appropriate interventions and identification of his predisposed health risks.

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Subjective and Objective Clinical Manifestations
Mr. C has several subjective and objective clinical manifestations. Subjective clinical manifestations refer to the information the patient providers about their experiences with a disease. The subjective clinical manifestations in the case study include Mr. C being always heavy even as a small child, gaining about 100 pounds in the last 2-3 years, and absence of any metabolic diseases. It also includes his complaints of sleep apnea, reports of high blood pressure, increasing shortness of breath with activity, pruritus over the last six months, and swollen ankles.
Objective data refers to that obtained by the healthcare provider through physical examination. It entails the use of methods such as inspection, palpation, percussion, and auscultation. Mr. C’s case study has objective clinical manifestations that include height, blood pressure, 3+ pitting edema bilateral feet and ankles, and fasting blood glucose of 146 mg/dl. The additional objective data includes those on total cholesterol, triglyceride, high-density lipoproteins, high-density lipoproteins, serum creatinine, and blood urea nitrogen. The objective data validates the patient’s subjective clinical manifestations.
Potential Health Risks for Obesity
Mr. C has several potential health risks attributed to obesity. One of them is diabetes mellitus type 2. The client’s fasting blood glucose level is currently elevated, which shows his increased risk of developing diabetes mellitus type 2. The other health risk is hypertension. This can be seen from the elevated blood pressure in the objective data. Mr. C is also at a risk of developing renal disease. This can be seen from the elevated BUN and serum creatinine levels. The patient is also at a risk of developing cancer (Blüher, 2019). Obesity and overweight are crucial predictors of malignancy.
Bariatric surgery is appropriate for Mr. C. According to evidence, bariatric surgery is appropriate for patients that have a BMI or more than 40 kg/M (cubed). It may also be considered with those of BMI of between 35 and 40 with other comorbidities due to obesity. A patient for bariatric surgery should have also tried other interventions for weight management but have been unsuccessful (Courcoulas, 2023). Mr. C has BMI of 45.1 and other comorbidities such as sleep apnea and diabetes mellitus type 2. Therefore, bariatric surgery is appropriate for him.
Functional Health Patterns
The assessment of Mr. C’s functional health patterns is important to identify the his actual and potential health problems. One of the patient’s actual health problems identified from the functional health patterns is altered ability to engage in activity and exercise. Mr. C is currently activity intolerant. He reports that he experiences increasing shortness of breath with activity. He also has swollen ankles, which affect his ability to engage in active physical activities. The patient is also currently obese, which hinders him from engaging in active physical activities.
The other patient’s actual health problem is altered sleep-rest pattern. Mr. C reports that he experiences sleep apnea because of his excessive weight gain. Sleep apnea affects quality of sleep, life, and productivity. As a result, it is among his actual health problems. In terms of health perception pattern, Mr. C is aware that is he is currently obese and is seeking for a treatment intervention to help him loose the excess weight (Lv & Zhang, 2019). This implies that he has a positive health-perception, which should be used as an opportunity to encourage healthy and lifestyle interventions to reduce risks.
The other actual problem is the negative health management behaviors. Mr. C reports gaining more than 100 pounds in the last 2-3 years. However, he did not take the initiative to implement strategies to promote healthy weight gain, hence, poor health management. The last potential health problem is the client’s risk of poor self-perception. Obesity increases the risk of negative self-image among some patients(Lv & Zhang, 2019). The society’s perception of the ideal body weight may predispose him to stigma and social isolation, hence, negative self-image and identity.
Stages of Renal Disease
End stage renal disease occurs in five stages. In stage 1, the glomerular filtration rate is more than 90%. In stage two, the GFR ranges between 60 and 89%. In stage three, the GFR ranges between 45 and 59%, translating into moderate to severe loss of renal function. In stage four, the GFR ranges between 15 and 29%, translating into severe loss of kidney function. Lastly, stage 5 has GFR of less than 15%. Some factors contributed to the development of end stage renal disease by Mr. C. One of them is obesity. Obesity is a risk factor that causes cascades associated with end stage renal disease. The other factor is type 2 diabetes mellitus. Type 2 diabetes mellitus cause diabetic nephropathy, which is associated with end-stage kidney disease(Lv & Zhang, 2019). The last factor is hypertension, which causes progressive failure of other body organs.
ESRD Prevention and Health Promotion Opportunities
Individualized education should be provided to Mr. C. The education should focus on the prevention of end stage renal disease progression and obesity-associated comorbidities. The health education should entail topics that include healthy dietary habits, engaging in active physical activities, and regular screening for early detection and management of potential complications(Lv & Zhang, 2019). Mr. C should also be educated about the importance of avoiding stress, medication adherence, and utilization of the existing social support services for his optimum health and wellbeing.
Resources for ESRD Patients
Patients with end stage renal disease patients have access to a range of resources. They include social support groups for patients with chronic conditions, religious institutions, friends and families, and healthcare providers. They also have access to online information that can help them learn best approaches to promoting their health. The multidisciplinary approach needed by these patients should encompass all the healthcare providers needed to develop a plan of care that would optimize treatment outcomes(Sousa et al., 2019). A multidisciplinary approach would ensure patient-centeredness, safety, quality, and patient empowerment for the effective disease management.
Conclusion
Overall, Mr. C’s has subjective and objective clinical manifestations. Mr. C is predisposed to obesity-related health problems such as diabetes mellitus type 2 and hypertension. Mr. C has actual and potential health problems that should be addressed. End stage renal disease occurs in five stages. Health education focusing on disease prevention and health promotion should be offered to Mr. C. He should also be linked with the available resources for effective disease management.
 
References
Blüher, M. (2019). Obesity: Global epidemiology and pathogenesis. Nature Reviews Endocrinology, 15(5), Article 5. https://doi.org/10.1038/s41574-019-0176-8
Courcoulas, A. P. (2023). New indications for metabolic and bariatric surgery. The Lancet Diabetes & Endocrinology, 11(3), 151–153. https://doi.org/10.1016/S2213-8587(23)00035-9
Lv, J.-C., & Zhang, L.-X. (2019). Prevalence and Disease Burden of Chronic Kidney Disease. In B.-C. Liu, H.-Y. Lan, & L.-L. Lv (Eds.), Renal Fibrosis: Mechanisms and Therapies (pp. 3–15). Springer. https://doi.org/10.1007/978-981-13-8871-2_1
Sousa, H., Ribeiro, O., Paúl, C., Costa, E., Miranda, V., Ribeiro, F., & Figueiredo, D. (2019). Social support and treatment adherence in patients with end-stage renal disease: A systematic review. Seminars in Dialysis, 32(6), 562–574. https://doi.org/10.1111/sdi.12831

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Topic 3:

Assessment Description

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 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.