DQ week 5
What health risks associated with obesity does Mr. C. have?
Is bariatric surgery an appropriate intervention? Why or why not?
Considering that the patient has a BMI of BMI = 29.55 kg/m2, bariatric surgery is a good option for him. Bariatric surgery is recommended for patients with a BMI of beyond 25 and who have been ascertained to indicate any other signs of extreme obesity. Bariatric surgery is a life-altering process but it has been noted to have positive impact on the life of the patient especially those with chronic severe obesity issues and this helps them reduce weight and subsequently maintain weight at a level that is manageable. It is also a solution to a majority of other weight related conditions such as type 2 diabetes, heart disease and high blood pressure (Jarvis, 2015).
Mylanta: The administration schedule will be as follows: 10 a.m, 4 p.m., and 9 p.m.
Ranitinidine (Zantac): The medication will be taken each day at bedtime, scheduled at 10 p.m.
Sucralfate / Carafate: The medication schedule is as follows and will be taken approximately one or two hours prior to any meal. 6. Am, 11 am, 5 pm and 9 pm
1. Health perception-Health management: His apparent weight gain of up to 100lbs in 2-3 years is a concern but Mr. C recognizes the need for help. He has however failed to manage his health as indicated by the obese and overweight as well as other developing illnesses such as peptic ulcers.
2. Nutritional-Metabolic pattern: Presence of high cholesterol, peptic ulcers and overweight due to excessive intake of some content. Imbalanced nutrition is a major problem and there is need for an objective dietary plan and exercise plan.
3. Elimination pattern: The patient does not have any serious issues with his elimination but there is monitor blood spots in stool.
4. Activity-exercise pattern: This is one of Mr. C weakest areas and he prefers or adopts a sedentary lifestyle. This could be attributed to lacking health education on the importance of exercise and physical activity especially considering his nature of work which restricts him to any movement.
5. Sexuality-reproductive pattern: Mr. C is not married and has no children and he lives alone. He does not mention of his sexual life and esteem issues owing to the obese state could have influence. Further assessment is necessary.
6. Sleep-rest pattern: Mr. C has sleep apnea which is significantly attributed to the obesity but he does not indicate any cases of sleep disturbance.
7. Sensory-perceptual pattern: The peptic ulcers are causing pain and discomfort to the patient. There is need for further diagnosis to determine the levels and impact of pain.
8. Cognitive pattern: The patient is actively positive on his cognitive capabilities. He is still working professionally. However, he needs to be educated on a more proactive approach to his life particularly to manage his health.
9. Role-relationship pattern: Mr. C is single and it is visibly clear that he lives a lonely life. It is important to help him develop a social network which may have been hindered by low self-esteem related to his obese state.
10. Self-perception-self-concept pattern: Mr. C is well aware of the need to undergo bariatric surgery which is a positive aspect of his perception of the self. There could however be some apparent anxiety and there is need to assess this prior to the surgery.
11. Coping-stress tolerance pattern: While the patient does not indicate any aspects of his coping mechanisms, his obesity issue could be having an impact on his livelihood and the need to integrate social network that enables him to work through his health issues would be a critical addition to his life.
12. Value-belief pattern: Over the course of the visit, the patient does not mention any aspect of their religious or spiritual belief
Obesity: With a BMI of 44.42, MR. C is obese since any BMI value beyond 30 is regarded as an indication of obesity which then places the patient at risk of other related illnesses such as hypertension, coronary heart disease and liver disorders. The bariatric surgery could help resolve the problem as the patient’s health perception is positive to this treatment option (Jayasekara, 2010).
Peptic ulcers: The patient has been diagnosed with peptic ulcers and even though on medication, the illness has significant impact on comfort and rest especially at night. The range of medication should be maintained as it is but aligned with his dietary schedule so that he takes his medication after or prior to the meals.
Type-2 diabetes: A high level of fasting blood glucose is an indication of the presence and risk of development of type 2 diabetes to severity. The patient has to take a new approach towards exercise and physical activity considering that he lives a significantly sedentary lifestyle (Haines, Nelson, Gonzalez, Torrella, Martin, Kandil & Murr, 2007).
Sleep apnea: The patient has been noted to have a collection of at around the neck which is an indication of overweight and obesity and which significantly affects the sleeping habits. The patient may not be getting enough sleep and this could influence high consumption of calories. Sleeping apnea is a chronic breathing problem that significantly interrupts the sleeping patterns of an individual. Once the patient undergoes the bariatric surgery, his self-esteem could be aroused and help him develop and nurture roles and relationships and these relationships could be crucial in managing his anxiety levels (Jayasekara, 2010).
Dumping syndrome: The patient proposes to have bariatric surgery and this could expose him to the risk of dumping syndrome which is usually a side effect associated with the process. It is characterized by a sudden emptying of the bowels leading to symptoms such as dizziness, flushing, nausea, palpitation and general body weakness. The patient has to be assisted to develop a reasonable dietary plan that could as well as have a caregiver who will monitor them over the post-surgery period (Haines, Nelson, Gonzalez, Torrella, Martin, Kandil & Murr, 2007).
References
Haines, K. L., Nelson, L. G., Gonzalez, R., Torrella, T., Martin, T., Kandil, A., & Murr, M. M. (2007). Objective evidence that bariatric surgery improves obesity-related obstructive sleep apnea. Surgery, 141(3), 354-358.
Jarvis, C. (2015). Physical Examination and Health Assessment–. Elsevier Health Sciences.
Jayasekara, R. (2010). Weight loss surgery for obesity. AJN The American Journal of Nursing, 110(12), 61.
