End-Stage Renal Disease: Clinical Manifestations, Prevention, and Health Promotions
It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.
Evaluate the Health History and Medical Information for Mr. C., presented below.
Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.
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:
Height: 68 inches; weight 134.5 kg
BP: 172/98, HR 88, RR 26
3+ pitting edema bilateral feet and ankles
Fasting blood glucose: 146 mg/dL
Total cholesterol: 250 mg/dL
Triglycerides: 312 mg/dL
HDL: 30 mg/dL
Serum creatinine 1.8 mg/dL
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:
Describe the clinical manifestations present in Mr. C.
Describe the potential health risks for obesity that are of concern for Mr. C. Discuss whether bariatric surgery is an appropriate intervention.
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.)
Explain the staging of end-stage renal disease (ESRD) and contributing factors to consider.
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.
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.
Mr. C. End-Stage Renal Disease (ESRD) Case Study
Name
Professor
Institution Affiliation
Date
Mr. C. End-Stage Renal Disease (ESRD) Case Study
Patient history
The client, Mr. C., is a 32-year-old obese single male. He has visited the outpatient center about bariatric surgery. Mr. C is working at a catalog telephone center. The client notes that he has been heavy since childhood. He also notes that he has gained 100 pounds within the past 2 to 3 years. Mr. C highlighted his high-blood pressure situation and sleep apnea. The client has no metabolic disease based on previous medical evaluations. In the last six months, he has manifested pruritus, swollen ankles, and shortness of breath.
Clinical manifestations
Mr. C. is overweight, indicating that he is obese. At the age of 32-years, he has a height of 68 inches and weighs 134.5 kg. Notably, he is also concerned about the 100lbs he has gained over the past three years. Obesity is associated with ESRD, which makes Mr. C highly susceptible to advanced stages of ESRD (Rhee et al., 2016). The client also has a blood pressure of 172/98, which is above the normal rate of 140/90 (Lin et al., 2016). People have varied heart rates and respiratory rates. However, Mr. C’s rates are concerning. An individuals’ resting heart rate should range between 50-90 beats every minute (Nanchen, 2018). Variations can occur to accommodate outliers. Nanchen observes a rise in HR results in a high mortality rate. Therefore, a patient with high blood pressure and a faster HR and RR rate is likely to die sooner. Nanchen also notes that the standard RHR for men should be approximately 70. Therefore, Mr. C is at a higher risk of early death. The client has a rapid RR. A normal RR should be between 12-20 (Sapra et al., 2020). The client’s RR is 26 signifying rapid lung expansion and contraction, which could interfere with its structural integrity and longevity.
The client also manifests high blood chemicals saturations. The normal blood glucose range is between 72 to 108 mg/dl. while the client has 146 mg/dl (Mathew & Tadi, 2020). The total cholesterol level is 250mg/dL, higher than the optimum range of 100-129 (Lee, & Siddiqui, 2019). An ideal Triglycerides level is less than 150 while he has 312 mg/dL; the serum creatinine should be 0.6 to 1.2 mg/dl while he has 1.8 (Karanchi et al., 2020; Shahbaz, & Gupta, 2019). Moreover, the client has other critical readings like an HDL of 30 mg/dL and BUN of 32 mg/dl, approximately 60mg/dl and 7-20, respectively. Besides, the client has 3+ pitting edema bilateral feet and ankles. These symptoms indicate a threatening kidney failure and a growing ESRD. Moreover, the rate at which he is gaining weight is concerning. Becoming more obese will worsen kidney failure and ESRD development.
Bariatric Surgery
Bariatric surgery is recommended for weight loss. The justification of this approach is based on the evidence that obesity is a leading cause of other health conditions (Wolfe et al., 2016). The surgery is also critical in solving cardiovascular problems associated with weight gain. Therefore, patients can regain their quality of life and experience fewer effects from comorbid conditions associated with weight gain. Mr. C. should have the surgery as his health trajectory is worsening. A radical weight loss strategy is necessary as he cannot sustain a normal weight loss procedure.
Functional Health Patterns
Mr. C manifests Sleep-rest, sexuality/reproductive, health-management, activity-exercise, and nutritional, functional health patterns problems. He has poor sleep rest, as noted in the development of apnea. He is single, suggesting challenges in sexuality and reproduction functionality. Mr. C has failed to manage his health, as observed in the weight gain. That is a sign of failure to take weight gain precautions. Moreover, health management is also manifested in activity-exercise failures to manage the weight...