Potential Health Risks for Obesity

Obesity is basically an imbalance that occurs between energy intake and energy expenditure. The condition is associated with excessive calorie intake, and leading a sedentary lifestyle. Such unhealthy habits result in being overweight due to accumulation of body fat. The current essay is based on the analysis of a 32-year-old patient known as Mr. C. The patient has obesity.

Clinical Manifestations Present

From the information provided by Mr. C., it is evident that he is an individual with a history of obesity. He has been having excess weight since childhood. The patient reports gaining about 100 pounds for the last 2 to 3 years. He also says that he experiences high blood pressure and sleep apnea. The patient as well reports having swollen ankles, pruritus (itchy skin), and shortness of breath associated with involvement in physical activity (exertional dyspnea) in the last 6 months. The objective findings reveal that Mr. C. has weight of 134.5 kg, and height of 68 inches. This leads to a body mass index (BMI) of 46.4 kg/m2. This is a case of morbid obesity.

Examination of vital signs indicates that the patient has tachypnea of 26b per minute and elevated blood pressure (BP) that stands at 172/98. Physical examination findings reveal a 3 plus pitting edema experienced on both ankles and feet. Results of laboratory examination show that Mr. C is having a high level of fasting blood glucose (146mg/dL), and low high-density lipoprotein (HDL) (30 mg/dL). He has high triglycerides of 312 mg/dL, and his total cholesterol is 250 mg/dL. Moreover, examination of this patient’s metabolic panel indicates elevated serum creatinine levels (1.8 mg/dL), and blood urea nitrogen (BUN) of 32 mg/Dl. These conditions suggest the possibility of having an impaired kidney function.

Potential Health Risks for Obesity that are of Concern, and Whether Bariatric Surgery is an Appropriate Intervention

Obesity is associated with a number of health risks. These include high blood pressure, diabetes, heart disease, stroke, kidney diseases, certain cancers, breathing problems such as asthma, and mental health problems (Gill, 2016; Moini, 2020). Some of these health risks are of concern to Mr. C. For instance, the patient has already been diagnosed with sleep apnea and hypertension. He also experiences breathing difficulties. Since the patient’s fasting blood glucose is high, he might be having type 2 diabetes. Pruritus can be one of the signs for development of cancer. Mr. C also has high blood cholesterol level. This increases his vulnerability to heart disease. Additionally, elevated levels of BUN and serum creatinine indicate that the patient has kidney problems.

Bariatric surgery involves operations that help an individual to lose excessive weight through making certain changes to the digestive system (Angrisani et al., 2017). This medical procedure is recommendable in cases where individuals are experiencing serious health problems as a result of their weight. It can be the last resort if exercise and diet remedies fail to work. In order for one to become a candidate of bariatric surgery, he or she must have a BMI of over 35 kg/m2, and should be between 14 and 75 years of age. Mr. C meets these qualifications. Although it seems that the patient is ready for the procedure, it is necessary to conduct a mental evaluation in order to ensure that he has the required motivation. It is also important to let the patient understand all potential risks associated with the surgery.

Assessment of Functional Health Patterns, and Identification of Actual or Potential Problems

Gordon’s functional health patterns model enables nurses to gather comprehensive health information pertaining to functional status and general wellbeing of their patients (Khatiban et al., 2019; Silva & Jones, 2021).There theory proposes eleven functional health patterns: health perception and health management, activity and exercise, nutrition and metabolism, sleep and rest, self-perception and self-concept, elimination, coping and stress tolerance, sexuality and reproduction, roles and relationships, cognitive and perceptual, and values and beliefs. Gordon’s model can be used as follows to assess the condition of Mr. C.

Health Perception and Management Pattern

This pattern describes an individual’s perceived health pattern and health management practices (Silva & Jones, 2021). Mr. C feels that he is not healthy. He says that he has been overweight. The last 2 to 3 years have seen him gaining about 100 pounds. In order to manage his health, Mr. C. is using dietary sodium restriction to control high blood pressure. He has also visited the outpatient center to seek more health information.

Activity and Exercise Pattern

The pattern describes one’s level of involvement in physical activities, exercise, recreation, and leisure (Khatiban et al., 2019). Physical inactivity is one of the major risk factors for obesity and overweight. Mr. C spends most of his time working in a telephone catalog center. There is also no information that he gets involved in physical activities. It is reported that whenever he engages in such activities, he experiences shortness of breath. All these conditions suggest that he might be leading a sedentary life. This makes him vulnerable to obesity and its various complications.

Nutrition and Metabolism Pattern

The pattern describes fluid and food consumption habits in relation to metabolic need (Silva & Jones, 2021). Excessive consumption of unhealthy food leads to obesity and other chronic conditions such as diabetes and high blood pressure. Since Mr. C has gained a lot of weigh in the recent years, it means that he does not take a heathy diet. There is also evidence to show that his blood glucose and cholesterol levels are high. It is as well important to note that pruritus can be an indicator of food related allergies.

Sleep and Rest Pattern

This particular pattern describes an individual’s sleep and rest patterns (Khatiban et al., 2019). Mr. C says he often experiences sleep apnea. He might also be lacking enough time for rest since he works. These conditions make him prone to obesity and other conditions.

Self-Perception and Self-Concept Pattern

The self-concept and self-perception pattern describes one’s perceptions about the self. It involves body image and state of feeling (Khatiban et al., 2019). Mr. C considers himself to be an overweight individual. According to him, this problem has been there since childhood.

Elimination Pattern

The elimination pattern describes the excretory function (Silva & Jones, 2021). It gives details about the functioning of the bladder and bowel. The objective data of Mr. C reveals high levels of BUN and serum creatinine. The conditions imply that he might be having problems with his kidneys.

Coping and Stress Tolerance Pattern

This pattern describes an individual’s stress tolerance and coping strategies (Khatiban et al., 2019). From his explanations, it is clear that Mr. C is highly stressed by his health condition. In order to combat this problem, he is seeking bariatric surgery. He thinks that this can help him to cope with the situation.

Sexuality and Reproduction Pattern

This pattern describes people’s sexuality and reproduction (Khatiban et al., 2019). It is stated that Mr. C is single in terms of marital status. Nothing is mentioned about his children. Being single without a family is associated with loneliness. Lonely people are at high risk for health problems.

Roles and Relationships Pattern

The pattern describes relationship patterns and role engagement (Silva & Jones, 2021). There is nothing mentioned about Mr. C’s relationships and roles at the family level since he is not married. However, he must be enjoying some good social relationships at his workplace since he serves as a catalog telephone worker. Social relationships are good for his personal health.

Cognitive and Perceptual Pattern

The current pattern describes perceptual, sensory, and cognitive sensory patterns (Silva & Jones, 2021). For Mr. C, no sensory deficits can be detected.  For example, he uses his senses of touch and vision to comprehend that he has swollen ankles. The patient’s cognitive functions are also normal. For example, he has a good memory of how his overweight has been an issue since the time of his childhood. Mr. C’s decision making ability is also good. For instance, he has decided to restrict his dietary sodium in order to control high blood pressure.

Values and Beliefs Pattern

This pattern describes one’s beliefs and values that guide decisions and choices (Khatiban et al., 2019). Mr. C values good health. He believes that bariatric surgery can help to restore his health.

From the above assessment of Mr. C, some potential or actual health problems can be identified. While the actual problems are obesity, high blood pressure and sleep apnea, the potential ones include type 2 diabetes, end-stage renal disease (ESRD), cardiovascular diseases, and allergies. The health perception and health management pattern reveals that Mr. C is overweight or obese. The nutrition and metabolism pattern shows that he has high blood pressure. The sleep and rest pattern indicates that he is suffering from sleep apnea. Mr. C’s overweight condition predisposes him to type 2 diabetes. This is revealed by the self-perception or self-concept pattern. The elimination pattern shows that the patient has elevated levels of serum creatinine and BUN. This suggests that perhaps he has ESRD. The activity and exercise pattern suggests that Mr. C. has dyspnea. This may imply that a cardiovascular disease is present. The nutrition or metabolism pattern indicates that Mr. C has pruritus. This can be a sign of having an allergy.

Staging of End-Stage Renal Disease (ESRD) and Contributing Factors

ESRD is a health problem characterized by an irreversible decline of the function of the kidney. The condition occurs when the kidney disease has reached an advanced stage (Yoong et al., 2017; Thomas, 2018). The kidneys of ESRD patients lose their functional capabilities of filtering fluids and wastes from the blood. There is a possibility that Mr. C is suffering from this disease. Some of the common symptoms of ESRD include swollen feet and ankles, itching, breath shortness, hypertension, sleep problems, changes in urination process, fatigue, and chest pains (Yoong et al., 2017). The patient exhibits most of these signs. The major risk factors for ESRD include diabetes, high blood pressure, male gender, old age, decreased kidney function, and use of tobacco (Abbasi et al., 2010). The patient in the case under consideration is male, and has high blood pressure. His level of serum creatinine shows that he might be having some kidney problems.

ESRD Prevention, Health Promotion Opportunities, and Patient Education

There are many ways through which ESRD can be prevented. These include being involved in physical activities, eating a healthy diet, avoiding tobacco products, and going for regular checkups (Vanholder et al., 2017; Thomas, 2018). Some of the health promotion strategies that Mr. C. can embrace include doing exercises on a regular basis, taking a balanced diet, and making an effort to control blood sugar, and blood pressure. The patient also needs health education on the importance of weight loss, and management of chronic disease. This education can help to prevent further deterioration of his health.

Type of Resources Available for ESRD Patients, and Multidisciplinary Approach to Care

ESRD is a serious condition that necessitates either regular kidney dialysis or kidney transplant. Thus, it calls for regular visits to healthcare facilities. The condition lowers the affected person’s quality of life, and interferes with his or her productivity. Yet a lot of money is required for kidney transplant or dialysis, and transportation to hospital.A number of resources are available for non-acute care of ESRD patients. Examples include Dialysis Patient Citizens, National Kidney Foundation (NKF), American Kidney Fund, and Kidney Smart (Vanholder et al., 2017). Mr. C may find these resources important for his condition of health. The care of ESRD requires a multidisciplinary approach in order to ensure that treatment is well coordinated among various healthcare experts for better outcomes. Some of the healthcare professionals that may be involved in the care of Mr. C include nurses, physicians, nutritionists, dieticians, and physiotherapists.

References:

Abbasi, S. H., Aftab, R. A., & Chua, S. S. (2020). Risk factors associated with nosocomial infections among end stage renal disease patients undergoing hemodialysis: A systematic review. PLoS ONE, 15 (6): e0234376. https://doi.org/10.1371/journal.pone.0234376

Angrisani, L., Santonicola, A., Iovino, P., Vitiello, A., Zundel, N., Buchwald, H., &Scopinaro, N. (2017). Bariatric Surgery and Endoluminal Procedures: IFSO Worldwide Survey 2014. ObesSurg 27: 2279–2289. https://doi.org/10.1007/s11695-017-2666-x

Gill, T. (2016). Managing and preventing obesity: Behavioural factors and dietary interventions. Oxford: Woodhead Publishing.

Khatiban, M., Tohidi, S., & Shahdoust, M. (2019). The effects of applying an assessment form based on the health functional patterns on nursing student’s attitude and skills in developing the nursing process. International Journal of Nursing Sciences, 6 (3): 329-333.https://doi.org/10.1016/j.ijnss.2019.06.004

Moini, J. (2020). Global health complications of obesity. Amsterdam: Elsevier.

Silva, R. C. G. E. & Jones, D. A. (2021). An integrative review of comprehensive nursing assessment tools developed based on Gordon’s Eleven Functional Health Patterns. Int J NursKnowl.doi: 10.1111/2047-3095.12321.

Thomas, R. (2018). Chronic Kidney Disease – from Pathophysiology to Clinical Improvements.IntechOpen.

Vanholder, R., Annemans, L., Brown, E. Gansevoort, R., Gout-Zwart, J. J., Lameire, N., Morton, R. L., Oberbauer, R., Postma, M. J., Tonelli, M., Van Biesen, W., &Zoccali, C. (2017). Reducing the costs of chronic kidney disease while delivering quality health care: a call to action.Nat Rev Nephrol, 13: 393–409. https://doi.org/10.1038/nrneph.2017.63

Yoong, R. K. L., Mooppil, N., Khoo, E. Y. H., Newman, S. P., Lee, V. Y. W., Kang, A. W. C., &Griva, K. (2017). Prevalence and determinants of anxiety and depression in end stage renal disease (ESRD). A comparison between ESRD patients with and without coexisting diabetes mellitus.Journal of Psychosomatic Research, 94: 68-72. https://doi.org/10.1016/j.jpsychores.2017.01.009

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