Case Study: Mr. C.

Case Study: Mr. C.

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Case Study: Mr. C.

The case involves a Mr. C who has high blood pressure and is currently experiencing difficulties in breathing. Furthermore, the patient is likely to develop end stage renal disease. The purpose of this assignment is to explore the clinical manifestation, the health risks for obesity and importance of the bariatric surgery, the functional health patterns, staging of the end stage renal disease, prevention and health promotion programs and finally, the types of resources available for the ESRD patients.

Clinical Manifestation

The case involves a 32 years old male patient with increased shortness of breath with activity. Also, the patient has swollen ankles and pruritis over the last 6 months. He experiences sleeping apnea with high blood pressure which he controls through the dietary sodium intake restriction. The patient has had a bariatric surgery before for his obesity.

Health Risks for Obesity and Importance of Bariatric Surgery

According to Kinlen et al. (2018), obesity causes law state inflammation influenced by the metabolic cells in response to the excess nutrients. The inflammatory state is linked to the brain, pancreases and liver and is associated with immuno-metabolic diseases. The dysregulation of the immune system results in lowered body protection that exposes one to pathogens and cancer. Besides, the study indicates that obesity results in the increased microbiome complications which affects the insulin sensitivity and thus exposing the patients to high risk of developing diabetes. In addition, the patient was vulnerable to cardiovascular diseases due to the accumulation of the low density lipoproteins in the blood vessels that increases the resistance to the blood flow and could result in cerebrovascular and haemorrhagic accidents or stroke and heart failure.

The bariatric surgery was appropriate for the patient since it would reduce the risks for cardiovascular complications which could be fatal. The decision on whether to undergo the surgery or not was based on the patient’s health condition and risks. According to Arterburn et al. (2020), the bariatric procedures have high efficacy and safety impact on the patients with severe obesity and so the intervention was appropriate.

Mr. C Functional Health Patterns

The assessment of the patient’s past medical history and the social life provides significant information on the health risks. First, the patient experiences sleeping apnea and this could increase the risk for hypertension and other complications such as atrial fibrillation. Secondly, Mr. C indicates that he has always been heavy since childhood and gaining about 100 pounds in the last 2-3 years. The obese status exposes the patient to many health risks including low immunity and cardiovascular diseases. Thirdly, the patient is seeking information about bariatric surgery for his obesity and this is a positive perception about health. Though, he does not consider alternative options such as checking on his diet and engaging in regular physical exercise. He may not achieve the desired outcomes even after undergoing the bariatric surgery and failing to check on his lifestyle. The other functional health pattern is the undesirable nutritional intake. While the patient is limiting sodium intake, his fasting blood sugar level is high and this indicates high intake of refined sugar and fatty meals (Nobile et al., 2022). In terms of role relationship, the patient is taking an active role about his life; but, there is need to take a more active role and engaging in healthy lifestyle to reduce the risks for cardiovascular and renal function disorders.

Staging for End Stage Renal Disease

The end-stage renal disease is staged based on the glomerular filtration rates. There are five stages including the stage 1 which is classified based on having a GFR or 90ml/min and above. People in stage 1 are considered healthy (Nobile et al., 2022). Stage 2 involves people with GFR between 60 and 89. People in this category have mild loss of the kidney function. Thirdly, stage 3a involves people with GFR between 45 and 59 and this people have mild to moderate loss of the kidney function. Subsequently, stage 3b refers to individuals with GFR between 30 and 44 and they are classified as moderate to having severe kidney functioning loss. At stage 4, the patients GFR is reduced to between 15 and 29 and this means severe loss in the kidney function. Finally, people in stage 5 have a GFR of less than 15mL/min and they are considered to have kidney failure. Some of the contributing factors to ESRD include diabetes, heart diseases, hypertension and urinary tract blockage among others (Nobile et al., 2022). Therefore, such cases should be considered for testing the renal functions.

ESRD Prevention and Health Promotion Opportunities

The patient can engage in various health promoting activities and reduce the risk for end stage renal disease. First, the patient should control his blood sugar level. The current fasting blood sugar level is high and this can be managed through the medical interventions and proper dietary intake. Secondly, the patient should manage his weight by reducing the calories taken in a day and engage more into the physical exercise (Nobile et al., 2022). Proper adherence to the medication is important and should be emphasized in the care plan for the patient. Taking the medications as per the prescription will help reduce the disease progression and promote better health outcomes. The patient can also be initiated on rehabilitation programs that involves clinical physiotherapy. The measures will reduce the progression of the renal disease to the ESRD (Nobile et al., 2022). The surgical intervention is also important since it will help the patient achieve a reduction in the body weight and bad cholesterol fast and so improve his health outcomes.

Type of Resources Available for ESRD Patients

Fluck & Taal (2018) emphasizes the importance of the multidisciplinary collaboration when managing ESRD. Patients with ESRD tend to suffer from physical, emotional, psychological and financial implications. As they spend more money on the dialysis and other medical interventions, they are likely to be fatigued and stressed. Therefore, various resources such as counselling and financial aids are required for better treatment outcomes. The interdisciplinary team are able to link up and coordinate to ensure that the patient receives seamless care transition. Some of the available resources for the ESRD include Dialysis Patient Citizens which is an organization working to ensure that the lives of the patients with ESRD improves (ESRD Additional resources, n.d.). The National Kidney Foundation is also an important resource helping in providing clinical guidelines for treating ESRD. Also, the Life Option Rehabilitation Program works to help the people with kidney diseases to live well and recover fully (ESRD Additional resources, n.d.). The organization encourages the patients to live active and engage in regular physical exercise.

Conclusion

End stage renal disease (ESRD) affects the patient’s lives in many aspects. Therefore, the risks of the patients having the complications should be identified as early as possible and the right interventions developed. The various outlined resources are critical in addressing the patients’ emotional and physical needs. The patient in this case is at risk of developing ESRD because of the diabetic, hypertensive and obese status.

 

 

 

Reference

Arterburn, D. E., Telem, D. A., Kushner, R. F., & Courcoulas, A. P. (2020). Benefits and risks of bariatric surgery in adults. JAMA324(9), 879. https://doi.org/10.1001/jama.2020.12567

ESRD Additional resources. (n.d.). Kidney disease and dialysis information – DaVita. https://www.davita.com/education/resources

Fluck, R. J., & Taal, M. W. (2018). What is the value of multidisciplinary care for chronic kidney disease? PLOS Medicine15(3), e1002533. https://doi.org/10.1371/journal.pmed.1002533

Kinlen, D., Cody, D., & O’Shea, D. (2018). Complications of obesity. QJM: An International Journal of Medicine111(7), 437-443. https://doi.org/10.1093/qjmed/hcx152

Nobile, S., Di Sipio Morgia, C., & Vento, G. (2022). Perinatal origins of adult disease and opportunities for health promotion: A narrative review. Journal of Personalized Medicine12(2), 157. https://doi.org/10.3390/jpm12020157

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