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Medical History

Mr. C., a 32-year-old single man, is seeking information about possible bariatric surgery for his obesity at the outpatient center. He is currently employed at a catalog phone center. He claims that he has always been overweight, even as a child, and that he has gained approximately 100 pounds in the last 2-3 years. Previous medical exams revealed no metabolic diseases, but he claims to have sleep apnea and high blood pressure, which he manages by limiting his sodium intake. Over the last 6 months, Mr. C. has experienced increasing shortness of breath with activity, swollen ankles, and pruritus.

Data that is objective:

Weight: 134.5 kg; height: 68 inches
BP: 172/98, HR: 88, RR: 26 3+ bilateral pitting edema of the feet and ankles
146 mg/dL fasting blood glucose
250 mg/dL total cholesterol
312 mg/dL triglycerides
30 mg/dL HDL
BUN 32 mg/dl Serum creatinine 1.8 mg/dL
Essay on Critical Thinking

Critically evaluate Mr. C.’s potential diagnosis and intervention in 750-1,000 words (s). Include the following items:

Describe the clinical manifestations that Mr. C is experiencing.
Describe the potential health risks associated with obesity that concern Mr. C. Discuss whether bariatric surgery is a viable option.
Using the information provided, evaluate each of Mr. C.’s functional health patterns. Discuss at least five actual or potential problems identified by the functional health patterns, as well as the rationale for each. (Health-perception, health-management, nutritional, metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception/self-concept, role-relationship, sexuality/reproductive, and coping-stress tolerance are examples of functional health patterns.)
Explain end-stage renal disease (ESRD) staging and the factors to consider.
Consider the possibilities for ESRD prevention and health promotion. Describe the type of patient education that should be provided to Mr. C. in order to prevent future events, restore his health, and avoid deterioration of his renal status.
Explain the nonacute care resources available to ESRD patients and the type of multidisciplinary approach that would be beneficial to these patients. Consider devices, transportation, living conditions, and return-to-work issues.