Please respond with a paragraph to the following question, add citations and references:
A. Health risks associated with obesity that Mr. C has are hypertension, diabetes, hyperlipidemia, and sleep apnea. His BMI is 45.8 so he is morbid obese (University of Rochester Medical Center, 2019). His fasting blood sugar (146 mg/dL) places him as a diabetic (Mayo Clinic, 2018). His total cholesterol is 250 mg/dL when it should be 200 which shows he has hyperlipidemia (National Cholesterol Education Program, 2005). Additionally, his high triglycerides which are 312 mg/dL when the normal is 150 add to his hyperlipidemia. These are all comorbidities which make him a good candidate for bariatric surgery. Bariatric surgery is an appropriate intervention in Mr. C’s condition since candidates for a bariatric surgical procedure are usually adults with a BMI over 40 kg without comorbid illness, adults with a BMI 35.0 to 39.9 kg with at least one serious comorbidity like obstructive sleep apnea, hypertension, and hyperlipidemia. Mr. C’s high blood pressure (172/96) along with his other conditions make him a good candidate for bariatric surgery (Obeid, Megill, Schmidt, Wootan, Greco, Alsulaim, Schweitzer, Magnuson, & Steele, 2016). His age also places him in range of acceptable age range to have surgery since bariatric is usually recommended from 18-65.
B. An administration schedule that will be most therapeutic and acceptable for the patient would be that he could keep his main three meals but must get rid of his 10 PM snack. He should not eat within 2 hours before bedtime. He should avoid coffee, chocolate, citrus fruits, sodas, fatty foods, fried foods, tomato products, and peppermint. Along with his medications, his schedule should look like this:
Bedtime– Zantac, Sucralfate/Carafate
- Functional Health Patterns :
Health perception: Mr. C is aware of his conditions and that he is overweight. He is cognizant that this has been a lifelong issue for him and is now seeking weight loss surgery. He is aware that he has high blood pressure and sought to remedy that by eating a low sodium diet but he needs more interventions. Mr. C is also aware he has sleep apnea but does not inform staff if he uses a CPAP machine.
Nutritional: Mr. C is eating too many calories in a day as evidenced by his 100lb increase in 2-3 years. He eats foods high in carbohydrates, sugars, and saturated fat as proven by his high triglycerides, high fasting glucose, and high cholesterol. In addition, Mr. C eats a 10 pm snack which is late is contributing to his weight gain.
Activity: Patient works as a telephone catalog center which shows he leads a sedentary lifestyle. This in turn can lead to him gaining weight. More information is needed on his exercise habits.
Elimination: No information is given about Mr. C’s elimination habits but it is important to know if he has diarrhea or constipation. More information on whether he has problems with controlling bm or urine is needed.
Sleep/Rest: Patient has sleep apnea so he is not getting adequate enough rest.
Cognitive/Perceptual: Not much information given around this area but Mr. C shows a willing readiness to learn about weight loss options as evidenced by him asking about bariatric surgery.
Self perception/self concept: Mr. C is aware that he is overweight and has struggled with it his whole life. He is uncomfortable with his weight and trying to correct it as evidenced by him seeking out information about weight loss information.
Role relationship: No information is given about this but more information is needed on whether the patient has a support system. He will need a good support system if he decides to go with bariatric surgery.
Sexuality/Reproductive: No information was given about this area in Mr. C’s life. More information is to know if he is happy in this part of his life. In addition, he could be self-conscious of his weight which could lead to unfulfillment in this part of his weight.
Coping/Stress tolerance: No information given in this area but more information is needed to know how he reacts to stressors in his life and how he handles them. He can be taught other coping methods as well.
2. Five potential problems are sleep apnea, coronary artery disease, obesity, high
blood pressure, and potential for diabetes. He is already diagnosed with sleep apnea which could lead to respiratory distress or sudden death. He already has a high respiratory rate, which is 26. Coronary artery disease is a potential problem with his high blood pressure (250), hyperlipidemia (312), and low HDL (13) which are risk factor for CAD. Mr. C does exhibit morbid obesity presently because his BMI is above 45. The last problem is high blood pressure which is 172/96 which shows he is uncontrolled. He has already been diagnosed with this problem which can lead to a hypertensive crisis or stroke. Diabetes is a potential problem because his fasting blood glucose which 146 mg/dL which is above the normal limit. A1c should be administered to Mr. C if he has the potential for diabetes.
Mayo Clinic. (2018). Diabetes. Retrieved March 25, 2019, from https://www.mayoclinic.org/diseases-conditions/dia…
National Cholesterol Education Program. (2005). High Blood Cholesterol. Retrieved March 25, 2019, from https://www.nhlbi.nih.gov/files/docs/public/heart/wyntk.pdf
Obeid, T., Megill, R., Schmidt, E., Wootan, M., Greco, D. J., Alsulaim, H., Schweitzer, M., Magnuson, T., & Steele, K. (2016). “Factors that Influence Blood Pressure Following Bariatric Surgery”. Surgery for Obesity and Related Diseases, 12(7), 76-232. doi:10.1016/j.soard.2016.08.129
University of Rochester Medical Center. (2019). What is Morbid Obesity? Retrieved March 25, 2019, from https://www.urmc.rochester.edu/highland/bariatric-…