bariatric case study
The case study presents Mr. C, a single male patient who needs guidance on seeking bariatric surgery in an outpatient center due to his obesity. The 32-year-old patient informs that since his young age, he has had overweight issues, though, for the last two or three years, he has gained approximately 100 pounds. The patient workplace is within the telephone catalog center, making the most probable reason for his obesity. From the subjective data, Mr. C has hypertension and sleep apnea, with their main intervention being sodium intake reduction. Currently, Mr. C requires guidance on whether to go for bariatric surgery to intervene for his weight gain. The paper will evaluate Mr. C’s clinical manifestations, functional health patterns, end-stage renal disease probability, and the most effective health promotion strategies.
Mr. C’s Clinical Manifestations
Mr. C seeks healthcare practitioners’ direction at the outpatient center concerning his weight gain, which is currently at approximately 100 pounds within the last two to three years. Mr. C also reports sleep apnea, which is a severe sleep disorder that disrupts a patient’s breathing system. The patient also experiences high blood pressure, which he intervenes by sodium intake reduction. When evaluating the patient’s fasting glucose and blood pressure levels, they are high at 146 mg/dL and 172/98, respectively, proving the patient’s fasting glucose impairment. According to Monfared et al. (2020), the fasting glucose impairment may act as prediabetes that may lead the patient to develop type 2 diabetes. Also, Mr. C’s cholesterol levels are higher since it amounts to 250 mg/dL, which may expose the patient to cardiovascular disease risks. Lastly, after evaluating the patient’s metabolic panel, it is clear that the patient has increased serum creatinine levels projected at 1.8 mg/dL with BUN ranging at 32 mg/dl, proving a possible kidney functioning impairment.
Mr. C’s Obesity Potential Health Risks
The patients portray various factors that may result in obesity and its potential health risks. These factors include the possibility of Type 2 Diabetes, Cardiovascular, fatty liver diseases, increased blood sugar levels, high cholesterol levels, and gall bladder disease (McGlone et al., 2020). However, these risks will depend on the interventions and early management of Mr. C’s health. Regarding bariatric surgery, it will be crucial for Mr. C since it will enable him to lose weight but should be an option after the healthcare provider proves that exercise and healthy diet interventions are unsuccessful (McGlone et al., 2020). For Mr. C, the patient meets the bariatric surgery requirements since his body mass index is over 40, his weight is below 450 pounds, and he has hypertension.
Mr. C’s Functional Health Patterns Assessment
Health Perception – Mr. C admits to having had overweight issues since childhood even though lately he has added approximately 100 pounds. He is concerned about his health conditions by seeking more information concerning bariatric surgery since he already acknowledges his health status.
Health Management – Mr. C reduces his sodium intake to manage hypertension.
Nutrition – By Mr. C projecting high-cholesterol levels, there is a high possibility that the patient engages in a high intake of saturated fats. However, the patient’s diet involves low-sodium intake.
Metabolism – The objective data proves the patient to have metabolic-related diseases.
Elimination – The objective data does not provide any information concerning the patient’s elimination status though factors like increased serum creatinine levels project a possible kidney impairment.
Exercise/ Activity – The patient is an employee at the telephone catalog center, which exposes him to spending more hours sitting.
Sleep/Rest – The patient experiences sleep apnea.
Cognitive/Perceptual – There is no identification of any cognitive implications.
Self-Perception – Mr. C already acknowledges that he has a problem with his weight and is ready to seek its intervention.
Role Relationship – Mr. C is single.
Sexuality/ Reproductive – There are no sexual patterns indicated for Mr. C.
Stress/ Coping – The data does not indicate how the patient deals with stress.
In that case, the most probable health issues that may arise from the patient’s functional health patterns include obesity, hypertension, sleep apnea, cardiovascular diseases, and end-stage renal disease.
End-Stage Renal Disease Staging
The end-stage renal disease occurs when the patient experiences kidney functioning loss after the kidney disease reaches an advanced stage. The factors leading to end-stage renal disease include glomerulonephritis, hypertension, diabetes, and obesity. Hence, when staging the disease, the most important factors to consider include levels of glomerular filtration rates (GFR) and albuminuria severity.
These stages include;
Stage one: Damaged kidneys where GFR is normal (over 90ml/min).
Stage two: Mild GFR reduction (between 60 and 89 ml/min).
Stage three: Moderate GFR reduction (between 59 and 30 ml/min).
Stage four: Severe GFR levels reduction (between 15 and 29 ml/min).
Stage five: Renal failure when GFR levels are low than 15ml/min.
The Most Effective Health Promotion Strategies
Healthcare providers should carry out end-stage renal disease prevention. The first strategy will include blood pressure control, weight regulation, a healthy diet, and physical exercise (McGlone et al., 2020). The patient’s cholesterol levels will also need to be monitored regularly. All these interventions will be through patient education especially using the teach-back method. The teach-back strategy will help the healthcare provider assess if the patient understands how to prevent his health status from deteriorating (Yen & Leasure, 2019).
End-Stage Renal Disease (ESRD) Available Resource
The main resources for ESRD patients include rehabilitation services that will help enhance their quality of life and social functioning. The patients also need to be provided with transport services to help them attend their medical appointments, especially those with limited financial constraints (Monfared et al., 2020).
The paper evaluates Mr. C’s conditions which include overweight and obesity issues. The functional health patterns issues for Mr. C include sleep apnea, diabetes, cardiovascular, renal, and diabetes diseases that may be responsible for developing ESRD. However, the main interventions include blood pressure control, weight regulation, a healthy diet, and physical exercise. As the patient seeks help with knowledge about bariatric surgery, it turns out to be the most effective intervention for his weight loss.
Monfared, Y. K., Honardoost, M., Sarookhani, M. R., & Farzam, S. A. (2020). Circulating miR-135 may serve as a novel co-biomarker of HbA1c in type 2 diabetes. Applied Biochemistry and Biotechnology, 191(2), 623-630. https://doi.org/10.1007/s12010-019-03163-2
McGlone, E. R., Carey, I., Veličković, V., Chana, P., Mahawar, K., Batterham, R. L., … & Khan, O. A. (2020). Bariatric surgery for patients with type 2 diabetes mellitus requiring insulin: Clinical outcome and cost-effectiveness analyses. PLoS medicine, 17(12), e1003228. https://doi.org/10.1371/journal.pmed.1003228
Yen, P. H., & Leasure, A. R. (2019). Use and effectiveness of the teach-back method in patient education and health outcomes. Federal practitioner, 36(6), 284. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6590951/
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 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.