Critical Analysis of Ted's Case Study: Health and Treatment

This case study presents a detailed analysis of Ted's health challenges, including colon cancer, diabetes, hypertension, heart failure, and gout. The analysis explores the biopsychosocial, spiritual, and cultural factors influencing Ted's health, including genetic predispositions, psychological attitudes, s...Read More

Running Head: CASE STUDY 1
Critical Analysis of Case Study
Name of Student
Name of Professor
Institution Affiliation
Date

CASE STUDY 2
Biopsychosocial, cultural and spiritual factors
Biological
Some of the conditions that Ted is suffering from are genetically connected. Research
indicates that diabetes is a condition that is inherited in a family due to similar genes. There is
also significant evidence indicating that gout can run in the family. However, the frequency of
this is not exactly known but can range from 11-80% (Hirai & Matsui, 2018, p. 201-208).
However, in all cases involving gout, some genes cause excess levels of uric acid in the blood,
and hence inheritance of gout is variable.
Ted's obesity is also a major biological factor resulting in the various health problems he
is currently facing. Obesity significantly increases the risk of suffering from hypertension.
Obesity also significantly contributes to heart complications and hence resulting in heart failure
and high blood pressure (Okumura et al., 2017, p. 37-49).
Psychological
The psychological factors that could impact Ted's health and family include negative
attitudes towards exercise. Ted could have a negative perception or behavior, which makes it
difficult for him to carry out physical exercises and hence making it difficult to lose weight and
minimize the risk of adverse effects from the conditions that are affecting him. Ted needs high
self-esteem to cope with the new condition where he is using temporary colostomy since it can
result from declining in self-esteem.
Social

CASE STUDY 3
Ted does not live with any of his family members since his wife passed away, and his
children live far away. This, therefore, might make it difficult for him to cope since he doesn’t
have family support at the time when he is sick. However, he has a partner and lives in a
retirement village and hence has a good social life.
Spiritual
There is no indication of Ted being spiritual, and hence this factor is not expected to
impact his health after the surgery.
Question 2
From the information provided in the case study, it is clear that colon cancer is a health
priority. Bowel resection is a surgery that is aimed at removing parts of the bowel, which may
include the large intestines and the rectum (Race, 2017, p. 59-64). The most likely cause of this
kind of operation is cancer. In this kind of surgery, the size of the bowel removed depends on the
size and location of cancer. The number one priority problem for Ted currently is overcoming
cancer and recovering from the surgery so that the temporary colostomy can be returned as usual.
Hypertension and heart failure is the second priority problem for Ted. High blood
pressure plays a key role in the evolution of the syndrome to heart failure. Therefore,
hypertension contributes greatly to the left ventricular hypertrophy, which leads to ventricular
diastolic dysfunction. High blood pressure adds to the workload of the heart and significantly
increasing the risk of a heart attack. Hypertension occurs as a result of the narrowing of arteries,
which are less elastic and hence making it difficult for smooth flow of blood throughout the body
(Mottalib et al., 2018, p.42-51). This, therefore, means that the heart works harder and struggles
more as a result of the narrow arteries. The high workload leads to enlarged heart over time and

CASE STUDY 4
hence making it less efficient and hence resulting in heart failure. This condition is very
dangerous for Ted, given the other medical complications that he is experiencing. His age also
increases the risk of him suffering from heart failure or stroke. Since he is obese, it means there
is excess fat in the bloodstream and hence making him susceptible to various heart
complications.
Diabetes is the third priority health problem for Ted. Diabetes type two is a life-
threatening health condition that develops when the body becomes resistant to insulin or when
the pancreas is unable to produce enough insulin (Pillai et al., 2017). This, therefore, results in
poor uptake of glucose by the cells from the blood. Diabetes type two occurs as a result of
genetic and environmental factors. Research has shown that a person born of parents who had
diabetes is likely to suffer from diabetes type two as compared to one whose parents never had
the condition. The environmental factors that cause the condition include lack of physical
exercises, lifestyles of smoking and drinking alcohol as well as an unhealthy diet. Obesity is
closely related to diabetes and heart diseases. Having excess body weight brings about various
complications in the body that may cause adverse effects to a patient. It comes about as a result
of genetic factors as well as environmental factors. Poor diet and lack of physical exercise are a
major contributing factor to obesity.
Gout is the other priority health problem for Ted. Gout occurs when crystals of urate
accumulate in the body, and it is characterized by sudden and severe attacks of pain, which cause
redness and swelling of the joints, especially the big toe (Asaad et al., 2016). The problem is
associated with high levels of uric acid in the blood. The body might produce too much uric acid,
or the kidney could be excreting very little uric acid and hence contributing to a build in the
blood. The risk factors include a diet rich in meat and seafood, obesity, and family history.

CASE STUDY 5
Question 3
 Healthy Diet-Poor diet has been identified as one of the major contributing factors to the
health problems that Ted is undergoing (Altomare & Finaldi, 2019, p. 65-76). Therefore,
one of the methods that should be used to intervene and treat Ted is ensuring that he
adheres to a strict healthy diet. He should avoid food risk in fat and carbohydrates
because it contributes to the accumulation of fat in the body and hence resulting in poor
health. Ted should mostly eat small quantities each time and focus more on vegetables
and fruits to achieve 7% weight loss, which will keep him within the range of healthy
weight (van den Buijs et al., 2018). This will play a major role in overcoming diabetes,
and hence Ted will not suffer from related health consequences of diabetes. A healthy
diet is an intervention for diabetes because it helps in ensuring a stable blood glucose
level and hence ensuring that Ted remains healthy. Diet is also critical in treating heart
failure. This is because the thickening of the arteries occurs as a result of excess fat in the
arteries. Eating less fatty foods, therefore, will contribute to the widening of the arteries
because the excess fat will be used up in the body, and hence Ted will regain normal
health status.
 Health education-Studies carried out by various researchers have established the
importance of health education as an intervention for improving health outcomes. When a
patient understands their health condition, they can care for themselves better and hence
avoid frequent hospitalization or suffering from complications resulting from the disease
(Sobrado Junior et al., 2020) Ted will be offered education on how to treat and care for
his surgical wound once he is discharged. This will assist him in avoiding infection on the
wound and in recovering from the operation quickly. Furthermore, he will be taught how

CASE STUDY 6
to monitor his blood pressure and blood glucose level. According to (American Diabetes
Association (2017, p. 57-67), monitoring of blood glucose level and BP has been
established to improve patient outcomes. This is because it helps the patient to pay
attention to the factors which could contribute to the worsening of their condition and
ensure that they are in check.
 Physical Exercises-Regular physical exercise contributes greatly to the improvement of
health for patients with diabetes, obesity, and heart failure (Machado et al., 2020, p. 153-
159). However, the exercise plan should be developed in collaboration with the physician
because so much exercise can result in undesirable consequences. Physical exercise
contributes to weight loss by up to 60%. Furthermore, exercise helps in improving the
flow of blood in the body and hence enabling the heart to remain healthy and to pump
blood accordingly (Cummings et al., 2016, p.945-953). Exercising also helps in the
control of BGL since it helps in the use of excess glucose in the blood and hence ensuring
that the patient is not affected by high blood sugar.
 Behavioral therapy and Psychotherapy-Cognitive behavioral therapy has been
established by researchers to be very effective in overcoming obesity as well as diabetes.
This intervention involves the application of strategies aimed towards changing the
behavior of a person to become positive to overcome a healthy condition (Aran et al.,
2016, p.195-203). This is very critical in, for example, helping people to stop smoking
habits or adopt healthy eating habits. Research indicates that psychotherapy contributes to
12% in assisting a patient with obesity change their attitude towards physical exercises
and poor diet and adopt a healthier lifestyle, which helps to avoid illnesses (Pecorelli et
al., 2018, p. 1760-1771).

CASE STUDY 7
 Medication intervention-For Ted to get well and overcome the health problems
highlighted above, he must take medication. According to Conway & Kelechi (2017,
medication combined with non-pharmacological interventions is critical in treating
diabetes type two, heart failure, and obesity. Ted should continue taking Metformin to
ensure that his blood pressure is good. The hypertension medication is also managing the
condition because they help to relieve the symptoms of the disease and prevents it from
advancing further. Some of the common medications for cardiovascular diseases include
angiotensin two receptor blockers, Diuretics, Beta-blockers, and Alpha-blockers. There
are also medications for reducing uric acid in the blood so that to manage gout. Some of
these medications include Allopurinol, Colchicine, Febuxostat, and Indomethacin.
Question 4
Pain medication
Post-surgical pain is managed using multiple pain-reducing medications, also known as
analgesics (Connelly et al., 2018, p. 22). The type of medication depends on the type of surgery
and the degree of pain the patient is experiencing. One of the powerful pain-relieving
medications used after surgery is opioids. It is a powerful medication that diminishes the
perception of pain, and it may be administered intravenously. Some examples of opioids include
OxyContin and ROxicet. Non-steroid anti-inflammatory drugs (NSAIDs) such as ibuprofen and
ketorolac are also commonly used in relieving pain for patients just after surgery. Some of these
medications, such as opioids, have side effects on the patient. Some of its side effects include
nausea, vomiting, constipation, urinary retention, and poor respiratory functions. There is also a
high risk of misuse of these drugs, and hence they must be managed keenly.

CASE STUDY 8
Anticoagulants
Anticoagulants are types of medication used after surgery to prevent excess loss of blood.
This is very critical because surgeries like the one Ted has undergone lead to open wounds,
which can bleed a lot if the right medication is not administered to the patient. This type of
medication also protects the wound from being infected and hence ensuring that the patient
recovers quickly. This medication can be given either orally or can be injected. It can also be
administered through IV. Some examples of the drugs include Coumadin and Heparin.

CASE STUDY 9
References
Altomare, D. F., & Finaldi, A. (2019). Nutritional Support in Patients with Intestinal Stoma. In
Nutritional Support after Gastrointestinal Surgery (pp. 65-76). Springer, Cham.
American Diabetes Association. (2017). 7. Obesity management for the treatment of type 2
diabetes. Diabetes Care, 40(Supplement 1), S57-S63.
Aran, V., Victorino, A. P., Thuler, L. C., & Ferreira, C. G. (2016). Colorectal cancer:
epidemiology, disease mechanisms, and interventions to reduce onset and mortality.
Clinical colorectal cancer, 15(3), 195-203.
Asaad, G., Soria-Contreras, D. C., Bell, R. C., & Chan, C. B. (2016, December). Effectiveness of
a lifestyle intervention in patients with type 2 diabetes: The Physical Activity and
Nutrition for Diabetes in Alberta (PANDA) trial. In Healthcare (Vol. 4, No. 4, p. 73).
Multidisciplinary Digital Publishing Institute.
Connelly, T. M., Malik, Z., Sehgal, R., Coffey, J. C., & Peirce, C. (2018). Should surgical
intervention become a primary treatment modality in Crohn’s disease?—A review of the
role of surgery and emerging surgical techniques. Mesentery and Peritoneum, 2, 2-2.
Conway, C. M., & Kelechi, T. J. (2017). Digital health for medication adherence in adult
diabetes or hypertension: an integrative review. JMIR Diabetes, 2(2), e20.
Cummings, D. E., Arterburn, D. E., Westbrook, E. O., Kuzma, J. N., Stewart, S. D., Chan, C.
P., ... & Flum, D. R. (2016). Gastric bypass surgery vs. intensive lifestyle and medical
intervention for type 2 diabetes: the CROSSROADS randomized controlled trial.
Diabetologia, 59(5), 945-953.
Hirai, F., & Matsui, T. (2018). Endoscopic Intervention in Inflammatory Bowel Disease. In
Advances in Endoscopy in Inflammatory Bowel Disease (pp. 201-208). Springer, Tokyo.

CASE STUDY 10
Machado, C. L. F., Botton, C. E., Brusco, C. M., Pfeifer, L. O., Cadore, E. L., & Pinto, R. S.
(2020). Acute and chronic effects of muscle power training on blood pressure in elderly
patients with type 2 diabetes mellitus. Clinical and Experimental Hypertension, 42(2),
153-159.
Mottalib, A., Salsberg, V., Mohd-Yusof, B. N., Mohamed, W., Carolan, P., Pober, D. M., ... &
Hamdy, O. (2018). Effects of nutrition therapy on HbA1c and cardiovascular disease
risk factors in overweight and obese patients with type 2 diabetes. Nutrition journal,
17(1), 42.
Okumura, K., Kubota, T., Nishida, K., Lefor, A. K., & Mizokami, K. (2017). Treatment of
Complete Anal Stricture after Diverting Colostomy for Fournier’s Gangrene. Case
reports in surgery, 2017, 37-49
Pecorelli, N., Hershorn, O., Baldini, G., Fiore, J. F., Stein, B. L., Liberman, A. S., ... & Feldman,
L. S. (2017). Impact of adherence to care pathway interventions on recovery following
bowel resection within an established enhanced recovery program. Surgical endoscopy,
31(4), 1760-1771.
Pillai, N., Dusheiko, M., Burnand, B., & Pittet, V. (2017). A systematic review of cost-
effectiveness studies comparing conventional, biological, and surgical interventions for
inflammatory bowel disease. PloS one, 12(10).
Race, E. (2017). Acute Care Physical Therapy Status Post Colostomy For A Patient With
Colorectal Cancer: A Case Report, 59-64
Sobrado Junior, C. W., Guzela, V. R., Sobrado, L. F., Nahas, S. C., & Cecconello, I. (2020).
Local treatment of colostomy prolapse with the MESH STRIP technique: A novel and
highly efficient day hospital technique. Clinics, 75.

CASE STUDY 11
van den Buijs, B. J., Backx, F. J., Los, M., Erdkamp, F. L., Bloemendal, H. J., Koopman, M., ...
& Peeters, P. H. (2018). Effects of an exercise program in colon cancer patients
undergoing chemotherapy. EFFECTS OF EXERCISE ON CANCER-RELATED
FATIGUE MOVING FORWARD, 48(5), 21.