Potential Diagnosis and Intervention Comprehensive Nursing Essay Example

Potential Diagnosis and Intervention Comprehensive Nursing Essay Example

Mr. C.’s potential diagnosis and intervention(s)

Clinical Manifestations

Mr. C. requests bariatric surgery for his obesity. According to Mr. C., he has always been heavy, even as a child. He has gained around 100 pounds in the last 2-3 years. Mr. C. also says he has sleep apnea, has high blood pressure, experiences shortness of breath during activity, his ankles swell, and his skin is itchy. Objective data indicates, a BMI of 45.1, hypertension stage 2, a high heart rate, and respiratory rate. The patient has grade three edema, a high fasting blood sugar of 146, indicating pre-diabetes, a high cholesterol level, and a high triglycerides level. The HDL of 30mg/dL is below average. The creatinine level is high, indicating the possibility of impaired kidney function or kidney disease. A high BUL value also indicates the kidney not functioning at full length or kidney disease.(Potential Diagnosis and Intervention Comprehensive Nursing Essay Example)

Potential health risks for obesity

Health consequences for obesity include high blood pressure, low HDL cholesterol, high levels of triglycerides, stroke, coronary heart disease, type 2 diabetes, kidney malfunctioning, gallbladder disease, sleep apnea, breathing problems, osteoarthritis, clinical depression, anxiety, body pain, difficulty with activity, and low quality of life (Centers for Disease Control and Prevention, 2020). The objective data indicates high BP, HR, and RR, which are signs of hypertension. A high level of fasting blood sugar shows the risk for type 2 diabetes. High creatinine level and BUL level show the risk of potential kidney disease or malfunctioning. Mr. C. also has high cholesterol levels and high fat in blood level. Third-grade edema indicates heart disease or blood vessel blockage.(Potential Diagnosis and Intervention Comprehensive Nursing Essay Example)

I would recommend bariatric surgery since Mr. C. has serious health issues related to his obesity. He needs help with weight loss, and bariatric surgery would be necessary since he has serious health problems (Arterburn, Telem, Kushner, & Courcoulas, 2020). Bariatric surgery alongside exercises and healthy dieting would help Mr. C. recover and live a high-quality life. Exercises and dieting are long-term weight loss interventions, and I would recommend them any day. However, Mr. C. is at risk of heart disease, stroke, hypertension, type 2 diabetes, and kidney disease. He already suffers from sleep apnea. Therefore, bariatric surgery is highly recommended.(Potential Diagnosis and Intervention Comprehensive Nursing Essay Example)

Mr. C.’s functional health patterns

Based on health-perception and health management pattern, Mr. C. generally considers himself unhealthy and needs help with weight loss. Mr. C. is controlling hypertension by restricting dietary sodium. He says he has always been heavy, even as a child. In the last 2-3 years, he has gained around 100 pounds. Mr. C. now requests bariatric surgery. Mr. C.’s nutritional-metabolic pattern reveals high levels of fats and cholesterol in the blood, which indicates a high-fat diet. He has also gained weight over the years and suffers from pruritus, a skin problem. Eliminating dietary sodium is the only diet restriction. The examination provides Mr. C.’s elimination pattern that indicates high creatinine and BUL levels that show potential kidney malfunctioning or kidney disease. Mr. C.’s activity-exercise pattern reveals no form of exercise patterns and leisure activities. He experiences shortness of breath with activity. Based on the sleep-rest pattern, Mr. C. already suffers from sleep apnea. He does not perceive himself as healthy, he has experienced weight gain over the years, and he needs help. Mr. C.’s functional patterns indicate risk of hypertension, heart disease, kidney problems, sleeping problems, skin problems, and cognitive problems. The risk factors include unhealthy dieting, lack of activity and exercise, self-care, and other disease management initiatives. (Potential Diagnosis and Intervention Comprehensive Nursing Essay Example)

Staging of end-stage renal disease

The stages to end-stage renal disease, according to the National Kidney Foundation, include stage 1 with a glomerular filtration rate (GFR) of 90 mL/min and above. Stage 1 means the kidney working is normal or near-normal. At stage 2, there is mild loss of kidney functioning, and the GFR is 60 to 89 mL/min. Kidney function loss in stage 3a is mild to moderate, and the GFR is 45 to 59 mL/min. At stage 3b, the kidney function loss is moderate to severe, with a GFR of 30 to 44 mL/min. There is a severe loss of kidney function at stage 4, and the GFR is 15 to 29 mL/min. Stage 5 is kidney failure, and the GFR is below 15 mL/min. End-stage renal disease occurs when the kidney function is less than ten percent the normal one (Benjamin & Lappin, 2020). Contributing factors include hypertension, prolonged obstruction of the urinary tract, diabetes mellitus, glomerulonephritis, polycystic kidney disease, obesity, family history, male sex, and tobacco use. (Potential Diagnosis and Intervention Comprehensive Nursing Essay Example)

ESRD prevention and health promotion opportunities

Contributing factors originate primarily from lifestyle choices. To prevent ESRD and promote health, individuals should lose weight if necessary, be active and engage in vigorous activities most of the days, and eat balance-nutritious diets, low in salts, especially sodium. Individuals should also control their blood pressure and strictly take the prescribed medications as required. It is also vital to have a cholesterol and triglycerides checkup at least once every year and control blood sugar levels. Patients should also quit smoking and use of tobacco products and go for regular checkups (Mayo Clinic Staff, 2019).(Potential Diagnosis and Intervention Comprehensive Nursing Essay Example) Patient education is also mandatory to help patients prevent ESRD and manage contributing factors such as obesity and hypertension. Nurses need to help the patient cope with lifestyle changes and emphasize the need for commitment and adherence to guidelines. Patients need information about how to live a quality life to prevent future events and restore their health. They should be informed about which foods to avoid, the quantity of salt and sugar to consume, and what exercises to do. A nurse-patient therapeutic relationship is vital to help patients overcome the psychological and emotional distress their health problems cause.(Potential Diagnosis and Intervention Comprehensive Nursing Essay Example)

Type of resources available for ESRD patients for nonacute care

Some of the resources ESRD patients need to restore their health include rehabilitation centers to help them quit smoking. These patients also need supervised gyms where they can exercise under supervision. Life option rehabilitation programs are also vital to guide patients to cope with lifestyle changes. Portable hemodialysis devices and dialysis machines are also critical treatment and disease management resources. Videos and other educational resources help patients and families cope with and manage their conditions. Multidisciplinary teams include different professions to help patients achieve their goals. They entail nurses that provide patients with clinical guidelines, therapists, and counselors to help patients change their lifestyle and adopt healthier ones. Nutritionists help patients with dieting (Johns, Yee, Smith-Jules, Campbell & Bauer, 2015). Social workers are also vital in promoting healthy lifestyle changes. Gym supervisors and instructors would also be core in helping patients exercise routinely. Patients need to be more active during the day. The practitioners need to encourage them to avoid lifts in apartments and buildings and instead take the stairs. They should also avoid cars and taxis for transportation over short distances and walk instead. Resources like community programs to help patients engage in fun activities like swimming, hill climbing, boxing, and yoga should be developed.(Potential Diagnosis and Intervention Comprehensive Nursing Essay Example)

References

Arterburn, D. E., Telem, D. A., Kushner, R. F., & Courcoulas, A. P. (2020). Benefits and risks of bariatric surgery in adults: a review. Jama, 324(9), 879-887.(Potential Diagnosis and Intervention Comprehensive Nursing Essay Example)

Benjamin, O., & Lappin, S. L. (2020). End-stage renal disease. StatPearls [Internet]. (Potential Diagnosis and Intervention Comprehensive Nursing Essay Example)

Centers for Disease Control and Prevention. (2020, September 17). Adult Obesity Causes & Consequences. Retrieved from https://www.cdc.gov/obesity/adult/causes.html(Potential Diagnosis and Intervention Comprehensive Nursing Essay Example)

Johns, T. S., Yee, J., Smith-Jules, T., Campbell, R. C., & Bauer, C. (2015). Interdisciplinary care clinics in chronic kidney disease. BMC nephrology, 16(1), 1-10.(Potential Diagnosis and Intervention Comprehensive Nursing Essay Example)

Mayo Clinic Staff. (2019). End-stage renal disease. Retrieved from https://www.mayoclinic.org/diseases-conditions/end-stage-renal-disease/symptoms-causes/syc-20354532(Potential Diagnosis and Intervention Comprehensive Nursing Essay Example)

https://www.ncbi.nlm.nih.gov/