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Health, Medicine, Nursing
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Case Study
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English (U.S.)
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Mandatory Discussion Question (Case Study Sample)

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The case scenario provided will be used to answer the discussion questions that follow. Case Scenario Mr. C., a 32-year-old single man, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He reports that he has always been heavy, even as a small child, but he has gained about 100 pounds in the last 2–3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has high blood pressure, which he tries to control with sodium restriction and sleep apnea. He current works at a catalog telephone center. Objective Data •Height: 68 inches; Weight 134.5 kg •BP: 172/96, HR 88, RR 26 •Fasting Blood Glucose: 146/mg/dL •Total Cholesterol: 250mg/dL •Triglycerides: 312 mg/dL •HDL: 30 mg/dL Critical Thinking Questions 1.What health risks associated with obesity does Mr. C. have? Is bariatric surgery an appropriate intervention? Why or why not? 2.Mr. C. has been diagnosed with peptic ulcer disease and the following medications have been ordered: (a) Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL PO 1 hour before bedtime and 3 hours after mealtime and at bedtime; (b) Ranitidine (Zantac) 300 mg PO at bedtime; and (c) Sucralfate / Carafate 1 g or 10ml suspension (500mg / 5mL) 1 hour before meals and at bedtime. The patient reports eating meals at 7 a.m., noon, and 6 p.m., and a bedtime snack at 10 p.m. Plan an administration schedule that will be most therapeutic and acceptable to the patient. 1.Assess each of Mr. C.'s functional health patterns using the information given (Hint: 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). 2.What actual or potential problems can you identify? Describe at least five problems and provide the rationale for each.

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Content:

Mandatory Discussion Question
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Obesity health risks and bariatric surgery
A middle aged 32 years old man suffering from obesity has increased risk of other diseases. Mr. C has been obese since childhood, while also suffering from high blood pressure. Mr. C is at risk of hypertension, obstructive sleep apnea and cardiovascular diseases. Bariatric surgery has the potential to improve the patient’s health condition. Patients need to be well informed, and hence patient education is critical for patients to understand risks and benefits of surgery (Benotti, 2013). When performed within accepted international and national guidelines the surgery is an appropriate intervention. Behavioral adjustments are at times ineffective in reducing surgery highlighting the need for bariatric surgery (Xu, 2012).
2. Administration schedule most therapeutic and acceptable to Mr. C
Magnesium hydroxide/aluminum hydroxide 3 p.m.,9p.m., and 10 p.m.(Mylanta) 15 mL PO Ranitidine (Zantac) 300 mg PO Before 10 p.m.Sucralfate / Carafate 1 g or 10ml suspension (500mg / 5mL) 6a.m.,11a.m.., 5p.m., and 10 p.m.
Reliving pain, healing and preventing further complications associated are the main goals when treating peptic ulcers. Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL PO is an antacid that should ideally be taken 30 minutes before Sucralfate. At the same time Ranidine (Zantac), which is one of the H-2 blockers, should also be taken before Sucraflate.
3. Functional health patterns
Functional health patterns are relevant to formulating nursing diagnoses, whereby related behaviors are used in nursing assessment. Health workers are able to collect data necessary for identifying and validating nursing diagnoses (Weber, 2009).
Health perception and health management- in this health pattern, there is a need to collect data related to past medical history and practices of maintaining health, and how his personal choices may have increased the risks of obesity.
Nutrition and metabolism- This focuses on adequacy of food nutrients food consumption as well as problems associated with the gastrointestinal system (Weber, 2009).
Roles and relationship- Mr. C is living alone and there is a need to focus on his views and social relations and how they affect living. This includes satisfaction with roles as well role in the world.
Sleep and rest- This assessment takes into account sleep and relaxation practices, and since Mr. C has sleep apnea there is a need to focus on the history of the condition.
Elimination- this is related to excretory patterns and obesity may interfere with the excretory system more than peptic ulcers
Activity- exercise- This health pattern assesses role of activities and required energy expenditure. Major body systems are affected by activities including cardiovascular, respiratory and mucoskeletal systems. Mr. C cannot participate in rigorous activities because of his weight problems, while working at a catalog telephone center means that he may continue to live a sedentary lifestyle.
Cognitive-behavioral- This concept describes and explains interplay of cognitive, perpetual and sensory patterns (Weber, 2009). Mr. C should be sensitized to use available information.
Self perception-self concept- This assesses a person’s attitudes and perceptions about image and their self-worth. There is risk that social isolation might lead to anxiety and low self-worth.
Sexuality- reproduction- This assesses sexuality patterns and reproductive functions, and there is no concern that Mr. C is dissatisfied with sexual patterns.
Coping with stress tolerance- This assesses coping strategies and perceptions about stress, Mr. C lives alone and support systems may be lacking.
b. Actual or potential problems
Stroke- people who are overweight and obese are at a risk of stroke since plaque buildups in the arteries and, the plaque can also cause ruptures and fatal clots as the BMI increases so does the risk of stroke (NIH, 2012).
Insomnia- there is potential difficulty in sleeping patt...
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