Obesity is defined as excess adipose tissue measured by body mass index (BMI) which is =/>30 (CDC, 2016). It can lead to cardiovascular, respiratory, musculoskeletal, gastrointestinal, psychosocial and problems. At a current weight of 134.5 kg and Ht of 68 inches, Mr.C’s BMI is 46.4, which put him in the category III: “severe” or morbid obesity (CDC, 2016). Having elevated blood sugar, cholesterol and Triglycerides in addition to low HDL predisposes him to cardiovascular disease including Diabetes Type 2, Hypertension, and Coronary Heart Disease. Bariatric surgery is currently the only treatment that has been found to have a successful and lasting impact for sustained weight loss for severely obese individual. I believe that bariatric surgery is an appropriate intervention. Mr. C meets the criteria for surgery which include BMI ≥40, Type 2 Diabetes, heart disease and sleep apnea. There is no evidence/s of untreated depression, psychosis, binge eating disorders, bulimia, drug and alcohol abuse, severe cardiac disease with anesthetic risk, coagulation problem, or inability to comply with nutritional requirements
on Mr. C’s history that will disqualify him for the surgery (NIDDK, 2016).
Medication Administration
Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL PO 1 hour before bedtime and 3 hours after mealtime and at bedtime. ----- Take at 10am, 3pm and 9pm
Ranitidine (Zantac) 300 mg PO at bedtime. ----- take at 10 pm
Sucralfate/Carafate 1 g or 10ml suspension (500mg / 5mL) 1 hour before meals and at bedtime. ---- take at 6 am, 11 am, 5 pm, and 10:30 pm.
Sucralfate can make it harder for the body to absorb other medications you take by mouth. If your doctor does recommend using an antacid, avoid taking it within 30 minutes before or after taking sucralfate. Therefore, Sucralfate should be taken 30 mins after Zantac (Healthwise, 2013).
Functional Health Assessment
Pattern of health perception and health management
Seeks solution for his current medical problem especially being morbidly obese.
Follows low salt diet
Nutritional Metabolic Pattern
Eats 4X /day including late night snacking before bedtime
Follows low salt diet
High cholesterol, triglyceride levels
High Fasting blood sugar
Pattern of Elimination
Taking Mylanta and antacids can cause, diarrhea, constipation or bloating
Pattern of Activity and Exercise
Works at catalog telephone center
Most probably sitting at work all day
Cognitive Perceptual Pattern
A/O X 4
Works at catalog telephone center
Pattern of Sleep and Rest
Patient with history of sleep apnea
Pattern of self-perception and self-concept
Morbid obesity
Looking for solution to lower body weight
Role relationship pattern
32 year-old, single
Sexuality-reproductive pattern
32 year-old, single
Pattern of coping and stress tolerance
Presently diagnosed of peptic ulcer disease which can be a sign of stress
Pattern of value and belief
Overweight since childhood
What actual or potential problems can you identify? Describe at least five problems and provide the rationale for each.
Mr.C’s fasting plasma glucose (FPG) is elevated at 146. A FPG of ≥126 is one criteria of being diagnose of diabetes mellitus (DM) type II. In addition, obesity is the most powerful risk factor of developing DM type II.
Cardiovascular problems- Mr.C’s blood pressure and cholesterol levels are high which predisposes him to cardiovascular problems such as coronary vascular disease (CVD) that may lead to myocardial infarction.
Respiratory problems such as obesity hypoventilation syndrome due to increased work of breathing. In addition, Mr.C is already suffering from sleep apnea.
Potential musculoskeletal problems such as osteoarthritis due to the stress on the weight-bearing joints such as hips and knees.
Obesity causes 100,000 cases of cancer in the US each year. It is the most important known preventable cause of cancer. The types of cancer most strongly linked to excess body far are cancer of the breast, endometrium, kidney, colon/rectum, pancreas, esophagus, and gallbladder (Lewis et al., 2011).
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