Clinical Presentation
Mr. C has several clinical presentations of an underlying disease condition seen from the subjective and the objective data. The client is obese, as evidenced by the patient’s reports of gaining more than 100 pounds in the last 2-3 years (Ansari et al., 2020). The objective evaluation of his weight and height shows that his basal metabolic index is high, indicating obesity. Moreover, the client has problems with fat metabolism, evidenced by the high cholesterol levels, elevated triglyceride levels, and decreased high-density lipoprotein levels. Furthermore, the patient has an ineffective circulatory mechanism due to the increased blood pressure of 170/98 mmHg, shortness of breath, pitting edema, and raised heart rates of 98 beats per minute. The client has problems with glucose metabolism due to elevated fasting blood glucose levels of 146mg/Dl. Finally, the patient has difficulties with the excretion of wastes in the kidneys. This is seen by the increased serum creatinine and blood urea nitrogen (BUN) levels, pruritus, and swollen ankles.
Potential Obesity Health Risks
Mr. C has numerous probable health risks due to his disease state. First, the patient is at risk of dyslipidemia due to the high cholesterol and triglyceride levels with a decreased amount of high-density lipoproteins (HDL) in the body. Obesity results in impaired metabolism of fats in the liver, resulting in elevated fatty acids and reduced HDLs in the patient’s system (Ansari et al., 2020). The high-fat levels in the blood also predispose the patient to the possibility of suffering from clogging of the blood vessels by fat tissues (atherosclerosis). Disruptions in the blood flow by fat embolus can cause a stroke in the patient. Moreover, the patient is at risk of suffering from type 2 diabetes mellitus. According to Ansari et al. (2020), obesity impairs the functioning of the body to regulate heightened blood sugar levels. According to Nazzal et al. (2020), the patient qualifies to undergo bariatric surgery due to his high BMI, continued weight gain of 100 pounds in the past 2-3 years, sleep apnea, and hypertension, which are complications of obesity. The awareness of the potential risk factors in obese clients enhances their time management.
Functional Health Patterns
The functional health patterns are eleven guidelines by Gordon that outline the holistic management of the patient. An evaluation of the patient’s signs and symptoms shows several disruptions in these functional elements. First, the nutritional-metabolic pattern indicates that the client has had difficulties in consuming fluids and foods (Silva & Jones, 2021). This is evidenced by the significant weight gain of about 100 pounds in the previous years. Second, the assessment of the sleep, rest and relaxation patterns shows that the patient has impairments due to a history of sleep apnea. Silva & Jones (2021) state that this pattern involves disruptions in sleep quality due to frequent cessation of breathing and snoring, making the client feel tired when waking up. Third, an assessment of the health perception indicates that Mr. C has a good perception of his health. He is aware that he has hypertension, obesity, and sleep apnea.
Fourth, an analysis of the activity-rest pattern shows that he has poor exercising habits. Judging from his work as a telephone operator, Mr. C spends much of his day sitting down and minimally exercising, contributing to the weight gain. Finally, an examination of the health management pattern indicates that Mr. C has good health management practices, which is seen through his going to the hospital to qualify for bariatric surgery.
Staging of the End-Stage Renal Disease
The basis for staging end-stage renal disease (ESRD) is the impairment in glomerular filtration rate (GFR). Stage 1 involves kidney damage with normal or near-normal kidney function with GFR of over 90mL/min/1.73M2. stage 2 is GFR of 60-89 mL/min/1.73M2. stage 3 is GFR of 30-59 mL/min/1.73M2. stage 4 is GFR of 15-29 mL/min/1.73M2. Stage 5 is GFR of less than 15 mL/min/1.73M2 (Nazzal et al., 2020). The contributing factors to ESRD include poorly controlled type 2 diabetes mellitus and high blood pressure.
Health Promotion in ESRD
Mr. C requires health education and health promotion services to prevent future events, health restoration, and avoidance of deterioration of renal status. First, Mr. C should adopt an appropriate diet, engage in physical activities, and evade stress to reduce weight gain and avoid an increase in blood pressure. Furthermore, he needs to seek high fasting blood sugars, elevated cholesterol and triglycerides, and increased blood pressure, indicating type 2 diabetes mellitus to reduce further disruptions in kidney function. Moreover, undergoing bariatric surgery is necessary to reduce the weight to the desired range according to age and sex.
Resources for ESRD
Patients with ESRD require specialized resources and care from a multidisciplinary team. First, they need to be put on a dialysis machine to excrete excess fluids and electrolytes effectively. Second, the input of nurses, nutritionists, and physicians is beneficial for managing this condition. Nurses are useful in helping client meet their activities of daily living, including eating, ambulation, toileting, and clotting. Nutritionists are integral in instituting a proper dietary plan for patients with ESRD (Nazzal et al., 2020). Furthermore, physicians are required to treat the condition and other complications. Good multidisciplinary collaboration is critical in managing clients with ESRD.
References
Ansari, S., Haboubi, H., & Haboubi, N. (2020). Adult obesity complications: Challenges and clinical impact. Therapeutic Advances in Endocrinology and Metabolism, 11, 2042018820934955. Web.
Nazzal, Z., Hamdan, Z., Masri, D., Abu-Kaf, O., & Hamad, M. (2020). Prevalence and risk factors of chronic kidney disease among Palestinian type 2 diabetic patients: A cross-sectional study. BMC Nephrology, 21(1), 1-8. Web.
Silva, R. & Jones, D. A. (2021). An integrative review of comprehensive nursing assessment tools developed based on Gordon’s Eleven Functional Health Patterns. International Journal of Nursing Knowledge. Web.