case study

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:

  1. Height: 68 inches; weight 134.5 kg
  2. BP: 172/98, HR 88, RR 26
  3. 3+ pitting edema bilateral feet and ankles
  4. Fasting blood glucose: 146 mg/dL
  5. Total cholesterol: 250 mg/dL
  6. Triglycerides: 312 mg/dL
  7. HDL: 30 mg/dL
  8. Serum creatinine 1.8 mg/dL
  9. 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:

  1. Describe the clinical manifestations present in Mr. C.
  2. Describe the potential health risks for obesity that are of concern for Mr. C. Discuss whether bariatric surgery is an appropriate intervention.
  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.)
  4. Explain the staging of end-stage renal disease (ESRD) and contributing factors to consider.
  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.
  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.

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. 

Case study

Select one of the following case studies to address. Della is a 52-year-old female with no medical history who has had difficulty sleeping for the past several months and is experiencing menopausal symptoms. She refuses any type of prescription medication and states, “I don’t trust them at all.” What options should you recommend for her to help alleviate her symptoms and why? Bridget is a 22-year-old female with a history of controlled asthma. She takes Advair daily. She comes to you for advice on taking vitamin D supplementation. She is considering a vegan diet. She wants to know how much OTC vitamin D she should take, the food sources she should consider, and if she should have a blood test to check her vitamin D levels? Valerie is a 38-year-old female with a history of adult cystic acne. She has been taking tetracycline 500 mg BID for the past five months with no improvement in symptoms. Further assessment reveals that she has been taking her tetracycline with breakfast and dinner and has recently (three months) started taking daily OTC antacids for her heartburn. Discuss the possible reasons for the failed response of tetracycline. What changes in her medication regimen do you recommend and why? Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas.