Potential Health Risks and Appropriateness of Bariatric Surgery

Clinical Manifestations

The 32-year male is 68 inches tall and weighs 134.5 kg. According to Apovian (2016), Mr. C.’s body mass index (BMI) is 45.4 kg/m squared, which falls under the category of obese patients. Mr. C. has elevated blood pressure of 172/98, and a relatively increased hear rate of 88. Also, the patient’s fasting blood glucose 146 mg/dL is above normal and reaches the level of prediabetes. The total cholesterol of 250 mg/dL is considered higher than normal. The patient’s complaints about his obesity, sleep apnea, swollen ankles, and shortness of breath he has experienced recently, combined with the objectively identified clinical manifestations, allow for determining potential health risks.

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The patient with obesity, given his vital signs and clinical symptoms, is exposed to multiple health threats. Firstly, the development of cardiovascular conditions is of high probability due to the observed elevated heart rate, blood pressure, and cholesterol level. A high level of glucose in Mr. C.’s blood indicates the risk for the development of diabetes. Also, according to Apovian (2016), obese patients are likely to have hypothyroidism and cancer. Thus, the patient needs to lose weight to eliminate the risk of developing the listed diseases. Ultimately, bariatric surgery is appropriate for Mr. C. given his current condition, failed attempts to lose weight in the past, and his willingness to eliminate the threats of chronic diseases. As research demonstrates, bariatric surgery “results in dramatic weight loss, improvements in peripheral tissue insulin sensitivity, and diabetes remission in a large percentage of patients” (Coen et al., 2018, p. 262). Therefore, the patient’s administration to the surgery will allow for obtaining significant benefits for his health in the long-term perspective.

Functional Health Patterns Assessment

The patient’s functional health patterns include the evaluation of the decisive areas of life associated with his health status. From the perspective of health perception, Mr. C. perceives himself as an unhealthy individual, whose obesity causes discomfort, becomes a physical and psychological burden, and leads to comorbidities. The patient’s health management is manifested through his desire to obtain information on his current state, willingness to keep to a diet, and be operated to lose weight. However, the patient does not report any efforts in attempting to combat his sleeping disorder, which might result in severe mental health complications in the future (Apovian, 2016). The nutritional, functional patterns are manifested through the patient’s dieting and concern with sodium that is addressed as a threat to his health. The indicators and vital signs demonstrate Mr. C.’s metabolic issues that might lead to more severe digestive conditions in the future. The lack of information on elimination does not allow for making a conclusion.

Activity patterns are assumed as insufficient since the patient reports swollen ankles and shortness of breath that might be obstructing when exercising. A well-structured schedule of exercising appropriate for the patient’s condition might improve his weight loss journey and eliminate the risks for comorbidities. Sleep apnea is a significant issue that might result in depressive disorder and other mental health problems and should be timely addressed. Cognitive-perceptual and self-perceptual domains are manifested through the discomfort and dissatisfaction of Mr. C. with his current body image, as well as his health status. His desire to obtain professional assistance indicates his awareness of the potential risks he is at. The patient’s marital status is unknown; however, it is necessary to ensure support provided to him during and after the surgery that will improve the chances of overcoming post-surgical pain, psychological burden, and increase stress tolerance.

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

End-Stage Renal Disease (ESRD) is one of the conditions that impact multiple populations and is characterized by several contributing factors. While diabetes is one of the leading causes of ESRD, other conditions play the roles of contributors (Lee et al., 2018). They include “hypertension, glomerulonephritis, polycystic kidney disease, prolonged obstruction of the urinary tract, vesicoureteral reflux, recurrent pyelonephritis” (Benjamin & Lappin, 2020, para. 2). Since Mr. C. is at risk of developing diabetes, ESRD is a threat to his future health. The staging of the disease is manifested in five stages differing in the level of GFR. The first stage is kidney damage with normal GFR, the second is a mild reduction in GFR, the third is characterized by a moderate reduction in GFR, the fourth stage is a severe reduction in GFR, and stage five is a renal failure (Benjamin & Lappin, 2020). Thus, ESRD prevention is relevant to Mr. C.’s treatment plan.

ESRD Prevention and Health Promotion Opportunities

The most common ESRD prevention opportunities are associated with leading a healthy lifestyle aimed at reducing body fat and adhering to nutritious dieting. To avoid deterioration of renal status, Mr. C. must control his blood pressure, cholesterol level, and diet. Regular exercising and cessation of harmful habits are of great importance. The most important issue at this stage is losing weight, which will ensure the achievement of positive results in other preventative areas.

Resources Available for ESRD Patients

Competent multidisciplinary care is necessary for patients at risk of ESRD to manage their conditions and eliminate the threat of the disease. The multifaceted nature of the factors contributing to the development of the disease necessitates the work of professionals in the fields of metabolic, cardiovascular, mental health, and other areas to ensure a complex approach. Among the resources available to ESRD patients, there are multiple informative domains and such organizations as the National Kidney Foundation, the American Kidney Fund, and others.

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References

Apovian, C. M. (2016). Obesity: Definition, comorbidities, causes, and burden. American Journal of Managed Care, 22(7), 176-185.

Benjamin, O., & Lappin, S. L. (2020). End-stage renal disease [Data set]. Web.

Coen, P. M., Carnero, E. A., and Goodpaster, B. H. (2018). Exercise and bariatric surgery: An effective therapeutic strategy. Exercise and Sport Sciences Reviews, 46(4), 262-270.

Lee, E. J., Jang, H. N., Cho, H. S., Bae, E., Lee, T. W., Chang, S. H., & Park, D. J. (2018). The incidence, risk factors, and clinical outcomes of acute kidney injury (staged using the RIFLE classification) associated with intravenous acyclovir administration. Renal Failure, 40(1), 687-692.

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