(Answered) Mr. C Case Study

(Answered) Mr. C Case Study

(Answered) Mr. C Case Study 150 150 Prisc

Mr. C Case Study

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.
Evaluate the Health History and Medical Information for Mr. C., presented below.
Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mr. C., a 32-year-old single male, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He currently works at a catalog telephone center. He reports that he has always been heavy, even as a small child, gaining approximately 100 pounds in the last 2-3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control by restricting dietary sodium. Mr. C. reports increasing shortness of breath with activity, swollen ankles, and pruritus over the last 6 months.
Objective Data:
Height: 68 inches; weight 134.5 kg
BP: 172/98, HR 88, RR 26
3+ pitting edema bilateral feet and ankles
Fasting blood glucose: 146 mg/dL
Total cholesterol: 250 mg/dL
Triglycerides: 312 mg/dL
HDL: 30 mg/dL
Serum creatinine 1.8 mg/dL
BUN 32 mg/dl

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mr. C.’s potential diagnosis and intervention(s). Include the following:

  • Describe the clinical manifestations present in Mr. C.
  • Describe the potential health risks for obesity that are of concern for Mr. C. Discuss whether bariatric surgery is an appropriate intervention.
  • Assess each of Mr. C.’s functional health patterns using the information given. Discuss at least five actual or potential problems can you identify from the functional health patterns and provide the rationale for each. (Functional health patterns include health-perception, health-management, nutritional, metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception/self-concept, role-relationship, sexuality/reproductive, coping-stress tolerance.)
  • Explain the staging of end-stage renal disease (ESRD) and contributing factors to consider.
  • Consider ESRD prevention and health promotion opportunities. Describe what type of patient education should be provided to Mr. C. for prevention of future events, health restoration, and avoidance of deterioration of renal status.
  • Explain the type of resources available for ESRD patients for nonacute care and the type of multidisciplinary approach that would be beneficial for these patients. Consider aspects such as devices, transportation, living conditions, return-to-employment issues.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.
There is a word limit and points are deducted for going over the word limit.

Sample Answer

Mr. C Case Study

Mr. C is a male patient with obesity and is experiencing numerous diseases and adverse health conditions resulting from the obesity condition. The patient explains that the condition has been there since his childhood and thus needs bariatric surgery to control his excessive weight gain. According to Gadde et al. (2018), an obese person can result in bariatric surgery when the conventional weight loss therapies are generally ineffective. It is important to evaluate the patient’s medical information and find out the clinical manifestations and the potential health concerns of the patient before deciding to use bariatric surgery as an intervention therapy.

Clinical Manifestations

The patient’s subjective data indicates that he is experiencing sleep apnea, shortness of breath, itchy-dry skin, and swollen ankles. Sleep apnea and shortness of breath are associated with an overweight or obese condition, which the patient is complaining about. The swollen ankles are associated with heart, liver, or kidney diseases. The subjective data indicates that the patient is obese with a BMI of 45.5, a severe obese condition. The patient’s blood pressure of 172/98 is higher than the normal blood pressure indicating that the patient is hypertensive. The total cholesterol should be less than 170 mg/dl, but the patient is 250 mg/dl, indicating a high level of fat in the blood, a risk factor for hypertension. The patient also has high levels of creatinine of 1.8 mg/dl, which is higher than the normal of 0.6-1.2 mg/dl, indicating kidney failure associated with fluid retention at the ankles. The patient’s fasting blood sugar is high (146mg/dl) beyond the normal range of 80-100 mg/dl and is an indication that the patient is suffering from diabetes. High levels of triglycerides are also associated with kidney disease, diabetes, and obesity. The patient’s triglycerides (312 mg/dL) are higher than the normal level of 150 mg/dL and below (Truant, 2020). From the subjective and objective data, it is conclusive that the patient has obesity with other interconnected health conditions such as kidney failure, hypertension, and diabetes.

Primary and Secondary Diagnoses

The diagnoses presented by the patient to be considered for treatment are diabetes, hypertension, kidney failure, and obesity. The primary diagnoses are obesity, kidney failure, and diabetes that are highly associated with the patient’s admission. The secondary diagnosis is hypertension which is a condition associated with the three primary health conditions. The four diagnoses should be included in the care plan. The body and blood fat contents are high, which risk factors beyond the normal healthy levels are. The patient is chronically obese with a BMI of 45.5 compared to the normal BMI of 24. According to CDC (2021), obesity causes hypertension, dyslipidemia, apnea, and breathing problems, which are the patient’s chief complaints. By controlling, obesity, the patient will boost control against hypertension, hyperlipidemia, and type 2 diabetes. The patient is diagnosed with kidney disease or failure and should also be controlled to improve the urinary system’s general functionality. Controlling kidney failure diseases will help in alleviating fluid retention at the ankles.

Abnormalities in Nursing Assessment

There are key abnormalities expected during the nursing assessment process on Mr. C. The patient’s respiratory rate is expected to be higher than the normal RR of 12-20 breaths per minute. According to De Jong et al. (2017), higher obesity levels lead to increased respiration levels. The obese condition reduces the volumes of lungs hence respiration difficulties. Abnormalities on heart condition are likely to be found during the nursing assessment. People with obesity are likely to develop atrial fibrillation, irregular and rapid heart rate (Lavie et al., 2017). The patient’s heart rate is thus expected to be higher than the normal rate. For a neurological nursing assessment, the nurse may find abnormalities such as psychological and behavioral apart from the structural reduction of grey matter. According to O’Brien et al. (2017), obesity affects neurological functionality, including cognitive impairment, altered satiety control, and feeding behaviors. The patient is diagnosed with diabetes which is associated with decreased vision (NIDDKD, 2021). The musculoskeletal assessments may find abnormalities in the strengths of the bone structure and inabilities or difficulties in movement and pain.

Effects of the Health Status

The patient’s health status highly affects the patient and the family members both physically, emotionally, and financially. The patient is susceptible to psychological disorders such as anxiety and disorders linked to the dependence nature of the health condition. The patient feels distressed by the condition due to inabilities and other social factors such as body shaming. The patient’s health condition is also depressing since he suffers from numerous chronic diseases, including hypertension, diabetes, and kidney failure, that make him fear death. This also affects the family, with the fear of losing a family member. The patient and the family are also affected emotionally. Having a sick family member is generally depressive, apart from the burden of caregiving. The family is affected financially in catering for the medical bills and other expenditures such as dieting and psychotherapies. The patient requires highly costly medications for diabetes, treatment procedures for kidney failure. The physical and financial burden to the patient and family may highly disturb the peace of the patient and the family.


Various interventions can be put in place to reduce the effects of the health status on the patient and his family. The family and the patient require psychiatric care to lower the depressive condition and fears. According to Fitryasari et al. (2018), psychiatric care for the patients and families reduces the susceptibility of developing adverse mental conditions among the healthy members. Another intervention is education to the family members on better caregiving to the patient. The patient’s condition may be a burden to the family and thus may contribute to abandonment and patient abuse. The nurses should educate the family members on effective caregiving for patients with numerous chronic health issues to ensure adherence to medications and quick recovery. The nurses should also educate the patient and the family members on various insurance plans to help in alleviating most of the financial constraints caused by the disease. Through a study, Gast and Mathes (2019) established that insured patients had higher levels of medication and treatment adherence than the uninsured.