Even with the efforts of healthcare experts all over the world, obesity still remains one of the foundational sources of health issues on a global scale. Apart from being a major risk in itself due to the increased pressure that extra weight puts on patients, obesity also serves as the breeding ground for a plethora of health issues. Therefore, when managing the case at hand, it is critical to focus on the signs of possible comorbidities prior to introducing the patient to a possible treatment and a change in lifestyle. Due to the sign such as swollen legs and pruritus, the patient may have developed diabetes along with the current health condition, which is why a change in dieting and lifestyle, as well as undergoing appropriate diagnostic tests, such as A1C and the Random Blood Sugar Test, will be required.
Apart from the imminent threat of diabetes type II, it is also crucial to pay attention to other concerns associated with obesity. Namely, the likelihood of increased blood pressure, increased levels of LDL cholesterol, and greater probability of the coronary heart disease (CVD) deserve to be brought up in the dialogue with the patient as some of the most likely conditions. Moreover, the risk of developing a CVD Also entails higher probability of a stroke with the resulting threat of immobility or, in the worst-case scenario, death (Araque et al., 2020). Therefore, it is crucial to keep the patient informed about the major risks and the consequences of failing to accept a more balanced diet, as well as undergo the required tests to detect the possible presence of diabetes type II.
In addition, performing the functional assessment of the patient’s health, one will notice the lack of adequate health perception and the proper nutrition and metabolic processes. In addition, the activity-exercise pattern displayed by the patient is virtually nonexistent. However, the patient shows rather good scores in the cognitive-perceptional and sleep-rest domains, which shows that the disease has not progressed far enough to affect his well-being drastically. Therefore, introducing a timely intervention is vital for keeping the patient’s health status high and preventing it from deteriorating. Likewise, Mr. C’s self-concept could use quite a lot of improvements.
Although the patient does not have a negative image of himself, he lacks perception in regard to the assessment of his body weight. As a result, Mr. C has failed to recognize developing obesity. As a result, he has been maintaining the same eating patterns and unwilling to address a dietitian or another relevant healthcare expert. Finally, Mr. C’s role-relationship, sexually-reproductive, coping/stress tolerance, and value-relief health patterns appear to be in line with the existing standards.
Apart from the described health concerns, Mr. C is presently exposed to the risk of developing the end-stage renal disease (ESRD). ESRD implies complete kidney failure, which results in the necessity to perform an urgent kidney transplant (Lassalle et al., 2017). In its nature, ESRD is closely linked to diabetes since the latter implies very poor blood sugar control and the resulting increase in workload for kidneys (Kaballo et al., 2018). ESRD is typically divided into five stages, the first one representing perfectly functioning kidneys, and the fifth one being the renal failure (Bakris et al., 2019). In order to determine the extent of risk to which Mr. C is currently exposed, one should look at his serum creatinine level, or BUN. According to the results of the patient exam, the BUN rate sits at 32 mg/dl.
Although the identified BUN rate is not indicative of a kidney failure, the current standard for BUN is at 23 mg/dl maximum, which shows that there are strong reasons for concern (Seki et al., 2019). Therefore, the threat of a kidney failure remains probable in Mr. C’s case, which is why an appropriate intervention, particularly, the reconsideration of the patient’s diet to include unsaturated fat to reduce cholesterol is crucial.
In addition to a more elaborate and healthier diet, a therapist should consider patient education as a critical step toward building premises for disorder management and avoidance of further health complications. Namely, counseling should be seen as one of the main tools for providing Mr. C with the necessary data concerning the symptoms, their management, and the selection of the best food options. In addition, the patient will be provided with a range of trustworthy sources for self-education and search for further information regarding his condition and the answers to questions that he may possibly have in the future.
Finally, to avoid the deterioration of Mr. C’s renal status, the patient must be provided with detailed instructions concerning regular health checks and the opportunity to communicate with nurse educators and other healthcare experts. Additionally, resources such as official websites of state facilities, booklets issued by healthcare services, and information presented in the profiles of relevant health services on social media will have to be considered as critical information sources of the patient. Once being provided with an opportunity to navigate the process of health literacy development and personal care, Mr. C will be able to develop an appropriate strategy and attitude for managing his condition while retaining his usual quality of life.
References
Araque, A. F., Delgado, M. M., Rello, Z. V., & González, V. V. (2020). Charcot neuroarthropathy in a diabetic patient. The need for a multidisciplinary intervention. Global Journal of Medical and Clinical Case Reports, 7(1), 1-4.
Bakris, G. L., Agarwal, R., Anker, S. D., Pitt, B., Ruilope, L. M., Nowack, C.,… & FIDELIO-DKD study investigators. (2019). Design and baseline characteristics of the finerenone in reducing kidney failure and disease progression in diabetic kidney disease trial. American Journal of Nephrology, 50(5), 333-344. Web.
Kaballo, M. A., Canney, M., O’Kelly, P., Williams, Y., O’Seaghdha, C. M., & Conlon, P. J. (2018). A comparative analysis of survival of patients on dialysis and after kidney transplantation. Clinical Kidney Journal, 11(3), 389-393. Web.
Lassalle, M., Fezeu, L. K., Couchoud, C., Hannedouche, T., Massy, Z. A., & Czernichow, S. (2017). Obesity and access to kidney transplantation in patients starting dialysis: A prospective cohort study. PloS One, 12(5), 1-14. Web.
Seki, M., Nakayama, M., Sakoh, T., Yoshitomi, R., Fukui, A., Katafuchi, E.,… Kitazono, T. (2019). Blood urea nitrogen is independently associated with renal outcomes in Japanese patients with stage 3–5 chronic kidney disease: a prospective observational study. BMC Nephrology, 20(1), 1-10. Web.