Nursing Case Study: 55 Year Old Male

This nursing case study discusses a 55 year old male who is overweight and needs to reduce pressure to avoid cardiovascular diseases. It also covers topics such as cellular respiration, oxygenation, electrolytes, venous return, and risks for coronary artery disease. The study provides recommendations on how to reduce body weight, increase physical activity, and reduce stress. It also explains how oxygen moves through the respiratory system and how common cold affects the respiratory system and the whole body. The study concludes with the significance of oxygen in myocardial metabolism and how high blood pressure and cholesterol build up can lead to coronary artery disease.

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NURSING CASE STUDY: 55 YEAR OLD MALE
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This a nursing case studies on a 55 year old male, with a height of 185 cm, weight of 95 kg
and waist circumference of 100 cm.
1. The body size interpretation depends on two major factors: weight and height. The
standard metric used to interpret the body size is the BMI that recommends 18.5 to 25 for both
male and females and higher than that increase the probability of health problems such as obesity
and heart attack (Lin 2018, p.2). Using the BMI calculator of height against weight, Bodie BMI
is 27.8, which is above the recommended. This is proves that Bodie is overweight and needs to
reduce the pressure to avoid cardiovascular diseases such as heart attack through the following
recommendations:
a) Eat wisely
Food provides both the energy and the production of the lean mass in the body. Most of the
meals are rich in calories, especially fatty and sugary foods. The body tends to use a specific
amount of food, and the excess is deposited in the body in the form of fats, that increase the body
size. Therefore, Bodie should check on the types of the foods consumed by avoiding food such
as whole grains, nuts, and red meats among many others and increase the consumption of fibers
and water (Young et al., 2018, p.6). Bodie should also reduce the portion of food consumed to
reduce the deposition of excessive fat in the body. The eating speed should also be reduced to
allow the body to detect when it is full: through this Bodie will avoid taking excess food.
Additionally fasting intermittently helps also in reducing the body weight. Fasting intermittently
refers to an eating pattern those cycles between periods of fasting and eating such as 5:2 diet,

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16:8 and eat-stop-eat method. The models aim at making a person to eat fewer calories without
consciously restricting the intake during the eating periods that eventually leads to weight loss.
b) Physical activity
The daily live-action dictates the body size. Bodie should engage in a more physical activity such
as running, going into the gym and many others. Physical activity tends to burn out the excessive
calories in the body hence reducing the body mass (Gaddad et al., 2018, p.776). Consequently,
the exercise increased the blood flow in the body, opening the blood vessels thus avoiding the
blockage of the blood arteries.
c) Reduce stress
Stress tends to affect the hormonal balance of the body since, under stress; the body produces
glucocorticoids that are a determinant of appetite. The increase of appetite ignites an individual
to eat a large amount of food that is not fully utilized in the body; hence the excess gets
deposited in the body increasing the lean body mass. Therefore, Bodie should avoid all issues
that might ignite stress in his life.
2. Cellular respiration is the breakdown of organic compounds from foods to make ATP.
The production of adenosine triphosphate (ATP) by muscle in the presence of oxygen is aerobic
while in the absence of oxygen is anaerobic (Sanchez, 2013, p.1625).
Aerobic
During the exercise, the muscles are always at work, through expansion and contraction;
therefore the mitochondria of the muscles fibers produce ATP from the food energy (glucose and

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fat) in the presence of oxygen (Jang et al., 2016, p.308). During the process, the carbohydrate in
the presence of oxygen is broken down into acetyl coenzyme, carbon dioxide and hydrogen ions
that undergo the electron transport chain and other series of reaction t produce ATP and water.
Anaerobic
Anaerobic happens mostly during the vigorous exercise, where the muscles contract very quickly
(Jang et al., 2016, p.310). In such situations, oxygen are incapable of traveling to the muscles
cells fast to keep up with the muscles’ ATP requirement, therefore, switching to break down the
organic compounds in the absence of oxygen (Larsen et al., 2013, p.471). The process is capable
of producing a large amount of energy within a short period of 30-60 seconds, beyond which the
accumulation of lactic acid leads to muscle fatigue.
The anaerobic process only produces two molecules of ATP for every molecule of glucose while
producing about 38ATP molecules from every molecule of glucose hence becoming the most
preferred method by cells (Sanchez, 2013, p.1627). The aerobic process tends to prefer fatty
acids to glucose(glucose sparing) as the fuel hence reduces the level of fatty acid in the body that
might cause other diseases additionally, the excess energy produced during the aerobic
respiration tends to keep the body temperature.
3. Oxygen moves from the atmosphere into the body cells through a respiratory system that
happens when we breathe. During the breathing, the diaphragm contracts increasing the chest
space and the lungs expand hence air is sacked in from the atmosphere, and when the diaphragm
expands, lungs contracts and the air is expunged out of the body (Nessel, 2014, p.6). The
changes in the pleural cause the alveolar pressure to change forcing air to move in and out of the

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lungs. The sacked air through the mouth/nostril follows Nasopharynx Oral Pharynx
Glottis Tracheas Lungs Bronchi Bronchioles Alveoli (Cleg & Delfour
2018, p.183). The gas exchange takes place between the alveoli sacs and the small capillaries of
the system into the bloodstream through the diffusion process, whereby the oxygen attaches to
the hemoglobin (oxygen-binding molecule) of the red blood cells then transported into other
cells in the body with low content of oxygen.
4. Electrolytes are body minerals and have electric charges such as sodium, potassium,
and calcium (McLafferty et al., 2014, p.45). These electrolytes are essential to the body in
numerous ways such as balancing the body water, acid, nutrient, and waste movement and
maintain the action of nerves and muscles. These electrolytes have a significant effect on the
neuron system of the body. The nerve cells require electrical currents to function correctly. The
brain cells contain ion pumps that allow sodium to flow in and out of the cells balancing the
electrical charge that is responsible for setting off the electrochemical nerve impulse in the brain
causing functions such as information interaction and communication (Kear, 2017, p.492).
Potassium is significant in the second part of the action. After sodium gets into the nerve cells,
potassium electrolytes get in to neutralize the charged cells to allow the re-establishment of the
cells to the resting state (Sharma, 2018, p.68). Inadequate amount of potassium the nerve is
incapable of sending more than one electrochemical impulse that confuses. Calcium, on the other
hand, tends to the electrical activity of potassium and sodium by modifying the opening and
closing of the nerve channels. Calcium tends to trigger the synaptic process.
The imbalance of sodium, for example, a large amount in the bloodstream (hypernatremia)
causes brain problems as the natural electrical current of the nerves are disrupted leading to

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seizures, restlessness, and twitching. On the other side, a low level of sodium (Hyponatremia)
may lead to a constant headache, confusion, and unconsciousness.
5. Venous returns refer to the flow of the blood from the periphery back to the right
atrium, also referred to as the cardiac output. The blood flow I the body are always determined
by pressure gradient and resistance: systematic pressure minus the right arterial pressure, while
resistance is the total peripheral vascular resistance (Alzghoul,et al., 2017,p.61). The mean
systematic pressure is affected by the vascular tone and the blood pressure; for example, in an
average blood volume, the mean systemic pressure is 7mmHg.
Therefore, whenever an exercise happens such as the respiratory activity, the venous return to the
heart by altering the atrial pressure that forces the blood the blood through one way into the heart
(Ooue et al., 2013, p.943). The increased lung activity creates changes in the thoracic pressure
that draws blood into the heart hence regular exercise improves the venous return by increasing
the total blood volume, reducing peripheral resistance increasing the size and contractile strength
of the heart muscle and end diastolic volume.
Brodie’s venous return cannot be reduced by 150/95mmHg systematic arterial blood pressure
since above 70mmHg is enough to sustain organs of an average person. Given the age of 55 and
a body weight of 95 kg, 150/95mmHg is so high that might result in cardiac arrest and
hypertension (Hayashi, Abe and Matsuoka 2018, p.1). The blood pressure of 150/95mmHg will
activate the veins in a higher rate to increase the venous pressure, however with the body size,
the venous return will fail since the blood volume, and the peripheral resistance is high for the
blood arteries resulting into over cardiac output. If in any case, the blood pressure is increased to

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150/95mmHg, then Bodie is likely to die as a result of breakage of the blood arteries since the
pressure will be too much for the arteries to sustain.
6. The oxygenation is influenced and affected by the respiratory muscles. The infraction
of the upper respiratory system tends to reduce the muscle function, and the physical
performance hence affects the oxygenation process (Lee and August 2014, p.349). The mild cold
affects the sinuses, nasal passages, pharynx and larynx. The common cold is characterized by
nasal congestion and runny nose resulting into the nasal inflammation since the excess fluid
causes the blood vessels and the mucous membrane to swell. The continuous accumulation of the
fluid results into a thicker and yellow/ green discharge that fully or partially blocks the nasal
passage. Once the nasal is blocked, the normal breathing process is affected as no or less amount
of oxygen is allowed to pass into the lungs resulting into oxygen-carbon dioxide imbalance
(Gupta, 2012, p.2). The cold virus may extend to bronchitis and the lungs affecting the walls
hence resulting into difficulty in berating process.
Common cold always affects the respiratory system and eventually affects the whole body. After
the infection, the muscles and the head tend to ache and alert the immune system of the body
such as neutrophils and macrophages cells of the infection (Channappanavar and Perlman, 2017,
p.530). The cells then initiate the production of small hormone-like molecules called cytokines
and chemokine. Cytokines and chemokine are a small secreted protein that is pro and anti-
inflammatory that helps in regulating inflammatory pains. As the cytokines initiate another
component of the immune system such as T lymphocytes among many others, to fight against
the common cold virus, chemokine direct these components to the sites of infections. When the

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T lymphocytes identify the cold virus, they proliferates the lymph nodes around the throat
causing the swelling and pain. In the lungs, the T lymphocytes kill the infected cells.
During the production of both cytokines and chemokine, the innate immune cells in the lungs
become systemic as they enter into the bloodstream (Sheshadri et al., 2018, p.15). These triggers
biological events in the body such as interleukin: activation of cytokines inflammatory type.
Interleukin is significant in creating the T-Cell killer response against the cold virus, a process
that affects the hypothalamus of the brain resulting into rising of body temperatures hence fever.
Consequently, during the fight against the flu, the immune system tends to pull proteins from the
muscles leading to the muscles aches since the white blood cells are sent by the immune system
to fight the infection, a process that leaves the muscles feeling achy and stiff.
7. Brodie's blood pressure and cholesterol are both significant risks for the development
of coronary artery disease, in which a blockage in a coronary blood vessel leads to insufficient
blood flow reaching heart muscle cells. High blood pressure and cholesterol build up tend to
harden the arteries which decrease the blood flow (Ljones et al., 2017, p.13). High blood
pressure tends to have extra force that damages the arterial cells making the lining to be rough.
The rough parts act as the collection of the fatty bits as they get caught and build up with time,
eventually closing the arterial gap. The closed gap reduces the blood flow, and since oxygen is
diffused in the blood, that make the distribution, thus some body parts such as heart and brain get
the inadequate amount. Hypercholesterolemia results in cholesterol accumulation in
macrophages facilitating the inflammatory of the blood vessel cells reducing the blood flow, and
the breakage of the vessels.

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Oxygen is a significant fuel in myocardial metabolism. Therefore, in the aerobic situation, the
heart muscles tend to receive enough oxygen reducing the contracting and expansion of the
arteries. Just like other muscles, the heart muscles contain numerous mitochondria that facilitate
the aerobic respiration and the production of ATP that aid the heart muscle contraction (Garipi,
2017, p.446). During the muscle contraction, the cellular respiration majorly depends on the
availability of energy from the metabolism process.
An adequate supply of oxygen in the heart muscle cells, aerobic respiration occurs as the organic
food compounds are broken down to provide the required energy for the cell muscles. However,
in the anaerobic respiration: When the heart muscle cells receive inadequate oxygen other parts
of the heart gets damaged as the heart’s muscles functionality are affected. During the anaerobic
period, lactate from the lactic acid fermentation is created. At standard metabolic rates,
approximately 1% of energy is received from lactate while about 10% is derived from
hypoxia/low oxygen supply condition. Therefore, in a hypoxic condition, less energy is liberated
which is incapable of sustaining the ventricular contraction, eventually leading to heart failure.

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