Subjective and Objective Clinical Manifestations
Concerning subjective and objective clinical signs are also evident in Mr. C. He has seen a 100-pound weight gain over the previous several years, increased difficulty breathing while active, swelling in his ankles, and pruritus during the past six months. These symptoms might be signs of more severe conditions, including heart failure or renal illness. Mr. C. also has high blood pressure and sleep apnea, increasing the likelihood of cardiovascular disease likelihood. Based on the objective data gathered during the evaluation, Mr. C. has a body mass index of 64,2. This places him in the third class of obesity. He also has 3+ pitting edema in both feet and ankles, tachycardia, and tachypnea. His HDL level is low, and his fasting blood glucose, total cholesterol, and triglyceride levels are all increased. His blood’s elevated creatinine and urea nitrogen amounts also point to end-stage renal failure (ESRD).
Potential Health Risks for Obesity
Cardiovascular disease, type 2 diabetes, sleep apnea, and musculoskeletal diseases are some health problems that may develop due to obesity. Several of these dangers, such as sleep apnea, hypertension, and diabetes, are already present in Mr. C. He now has the end-stage renal disease (ESRD) because of his weight, which is a dangerous medical condition that may severely reduce his quality of life and needs constant medical attention (Schoenberg et al., 2020).
Appropriateness of Bariatric Surgery as an Intervention
Bariatric surgery is an intervention for weight reduction that has been shown to assist people who are very obese to lose much weight and keep it off. While many people see improvement in health concerns connected to obesity after undergoing bariatric surgery, it is not the best option for everyone. Given the severity of Mr. C.’s obesity and related health concerns, bariatric surgery may be an appropriate choice. However, he would need to be evaluated extensively to determine whether the treatment is safe and what kind of surgery would be best for him. Bariatric surgery is not a quick fix and involves a commitment to a healthier lifestyle and continued medical attention to keep the weight off and control any complications (Paul et al., 2020).
Functional Health Patterns Assessment
Mr. C. is seeking medical advice about having bariatric surgery since he is overweight and has health problems. He may not know how the operation would affect his long-term health and what dangers he will face. Mr. C. has high blood pressure and has been told to reduce his salt intake. The management of his obesity and its accompanying health issues, however, may need extra instruction on lifestyle adjustments such as food and exercise. Mr. C. has poor dietary habits, as evidenced by his high fasting blood glucose, total cholesterol, and triglyceride readings. He might enhance his nutritional condition with the help of counseling and close monitoring of his food. Evidence of metabolic dysfunction, such as insulin resistance and dyslipidemia, which are linked to obesity and end-stage renal disease, may be seen in Mr. C.’s metabolic profile (Schoenberg et al., 2020). He will require long-term medical care and behavioral adjustments to avoid additional metabolic issues.
Reduced renal function necessitating dialysis or kidney transplantation has eliminated Mr. C. Because of his kidney condition; he requires constant medical attention. Physical Activity Mr. C.’s extreme obesity and accompanying health concerns severely restrict his ability to engage in physical exercise. Physical therapy and exercise counseling might help him feel better and live better. Mr. C. has reported experiencing sleep apnea, which may result from his overweight condition. He may benefit from sleep hygiene education and therapies like CPAP or BiPAP (bi-level positive airway pressure) to enhance his sleeping breathing. Sleep apnea symptoms may be reduced, and general health can be improved by losing weight via healthy lifestyle changes, including eating less junk and exercising regularly. Mr. C. has sleep apnea and high blood pressure, which he tries to manage by reducing his salt intake. Mr. C. is at risk for cardiovascular disease, stroke, and renal disease due to his high blood pressure and other medical issues (Cao et al., 2020).
Due to his obesity and associated health problems, Mr. C may benefit from bariatric surgery. It is possible, but it should be carefully evaluated only after other failed treatments. Infection, hemorrhage, and intestinal blockage are just some of the dangers associated with bariatric surgery, which may aid with weight reduction and improve overall health. Bariatric surgery is not a fast remedy; it takes significant adjustments to one’s way of life before it can be successful (Strain et al., 2014).
Functional Health Patterns
Mr.. C. has many possible health issues, as shown by an analysis of his functional health patterns. Cognitive-perceptual, self-perception/self-concept, role-relationship, sexuality/reproduction, coping/stress tolerance, and other patterns contribute to one’s overall well-being. Regarding his health, Mr. C. may not accurately grasp the gravity of his obesity, hypertension, and other medical concerns. A lack of drive to make positive adjustments in one’s lifestyle may result from this. It is unclear if Mr. C. regularly treats his other medical issues via medication and other treatments, despite his indication of trying to control his blood pressure by dietary salt restriction. Mr. C. needs to enhance his dietary intake because of his obesity, high blood sugar, and high cholesterol levels (Cao et al., 2020). It is unknown what his current diet consists of or whether he has been taught about the need to maintain a healthy diet.
High glucose and triglyceride levels in Mr.. C.’s blood indicate a possible problem with glucose and lipid metabolism, which, if left untreated, might cause significant health issues. Exclusion: Mr. C presents with pruritus and has increased blood creatinine and BUN levels, which point to renal failure. Further testing and care may be necessary. Mr.. C. might benefit from an activity-based fitness program that considers his unique requirements and skill level since he experiences growing shortness of breath with exertion. Mr.. C. may need to be evaluated for sleep apnea since it likely contributes to his weariness (Docherty & Roux, 2020). The cognitive and perceptual abilities of Mr.. C. may be negatively impacted by his weight and its associated health problems.
Mr.. C.’s self-perception and -concept may take a hit due to his weight and associated health problems. The effects of Mr.. C.’s weight and accompanying health conditions on his capacity to perform his office function and relationships are unknown. Sexuality/Reproductive: Mr. C may benefit from information and treatments about how obesity and associated health conditions might affect sexual function and fertility. Tolerance for stress and coping: Mr.. C. may be under considerable stress because of his health problems and might benefit from coping skills and emotional support (Strain et al., 2014).
Renal Disease and Prevention
Mr. C is likely in the early stages of renal illness due to his increased blood creatinine and BUN values, which indicate kidney failure. A steady deterioration in kidney and nephron function characterizes the phases of renal disease leading to end-stage renal disease (ESRD). Proteinuria, hematuria, and electrolyte abnormalities are possible throughout stages 1 and 2; the kidneys can still filter blood and keep creatinine and BUN levels regular. The kidneys’ filtration capacity further declines in stage 3, with the GFR falling to 30-59 mL/min. Patients are at increased risk for anemia, bone disease, and hypertension. Patients in stage 4 may feel weakness, nausea, vomiting, and uremic symptoms, and their GFR ranges from 15 to 29 mL/min. With ESRD stage 5, the GFR is less than 15 mL/min, and dialysis or a kidney transplant is needed to prolong life (Docherty & Roux, 2020).
Mr. C has a low GFR (glomerular filtration rate) of less than 30 mL/min due to his elevated blood creatinine and BUN levels. Obesity, which may promote chronic inflammation and oxidative stress in the kidneys, may have contributed to the loss of renal function with high blood pressure and blood glucose levels. Low HDL cholesterol and high triglyceride levels may contribute to developing renal disease.
Methods for preventing end-stage renal disease (ESRD) include avoiding nephrotoxic drugs and chemicals and controlling risk factors such as high blood pressure and obesity. A healthy lifestyle, which includes eating well, exercising regularly, not smoking, and managing stress, should be the primary emphasis of patient education (Paul et al., 2020). Other services that may help patients with ESRD include referrals to nephrologists and transplant centers, support groups, and counseling.
Patients with ESRD have access to resources such as dialysis centers, home dialysis kits, transportation services, and charity grants. Patients with ESRD may benefit from the expertise of a multidisciplinary care team consisting of nephrologists, nurses, social workers, nutritionists, and pharmacists. Patients in need of non-acute care may also be able to receive services in the comfort of their own homes (Docherty & Roux, 2020). To ensure that patients have access to the resources and services they need, it is necessary to evaluate their living situation, social support system, and work status.
Conclusion:
Mr. C has many obesity-related symptoms, including high blood pressure, sleep apnea, and metabolic abnormalities. He also exhibits renal failure symptoms, including high creatinine and BUN values and ankle edema. Careful examination and consideration of Mr. C’s overall health state are required to determine whether bariatric surgery is acceptable for weight reduction and improving his metabolic profile. Mr. C’s functional health patterns indicate that he has or may soon have issues with his outlook on health, diet, metabolism, physical activity, and coping mechanisms. Comprehensive treatment for ESRD patients is best provided via a multidisciplinary approach that emphasizes education and assistance for patients to avoid and manage problems.
References
Cao, Y., Raoof, M., Szabo, E., Ottosson, J., & Näslund, I. (2020b). Using Bayesian networks to predict long-Term health-Related quality of life and comorbidity after bariatric surgery: A study based on the Scandinavian obesity surgery registry. Journal of Clinical Medicine, 9(6), 1895. https://doi.org/10.3390/jcm9061895
Docherty, N. G., & Roux, C. W. L. (2020). Bariatric surgery for the treatment of chronic kidney disease in obesity and type 2 diabetes mellitus. Nature Reviews Nephrology, 16(12), 709–720. https://doi.org/10.1038/s41581-020-0323-4
Paul, R., Andersson, E., Wirén, M., & Frisk, J. (2020). Health-Related quality of life, sexuality and hormone status after laparoscopic Roux-En-Y gastric bypass in women. Obesity Surgery, 30(2), 493–500. https://doi.org/10.1007/s11695-019-04197-5
Schoenberg, N. C., Argula, R. G., Klings, E. S., Wilson, K. R., & Farber, H. W. (2020). Prevalence and mortality of pulmonary hypertension in ESRD: A systematic review and meta-Analysis. Lung, 198(3), 535–545. https://doi.org/10.1007/s00408-020-00355-0
Strain, G. W., Kolotkin, R. L., Dakin, G., Gagner, M., Inabnet, W. B., Christos, P. J., Saif, T., Crosby, R. D., & Pomp, A. (2014). The effects of weight loss after bariatric surgery on health-Related quality of life and depression. Nutrition & Diabetes, 4(9), e132. https://doi.org/10.1038/nutd.2014.29
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