Pathophysiology and Management in Nursing Care: Mr. C Case Study

This case study analyzes the health history and medical information of Mr. C, a 32-year-old male seeking bariatric surgery. The analysis focuses on his clinical manifestations, including high blood pressure, elevated blood glucose and cholesterol levels, and pitting edema, which indicate potential health risks like diabetes, hypercholesterolemia, and kidney dysfunction. The study explores the staging of end-stage renal disease (ESRD), considering Mr. C's contributing factors and the suitability of bariatric surgery. It also discusses functional health patterns, health promotion strategies, and the resources needed to manage his condition, including nutritional education, low protein diets, and multidisciplinary approaches involving nutritionists, exercise trainers, nurses, and social workers. The conclusion emphasizes the importance of education, resources, and interventions to improve patient outcomes and quality of life.

Running head: PATHOPHYSIOLOGY AND MANAGEMENT IN NURSING CARE
PATHOPHYSIOLOGY AND MANAGEMENT IN NURSING CARE
Name of the student:
Name of the university:
Author note:

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PATHOPHYSIOLOGY AND MANAGEMENT IN NURSING CARE
Introduction:
Obesity is the most common and preventable disease in the united states that negatively
impacted thousands of lives every year. Approximately 39.6% of individuals aged 20 years or
more than 20 years are obese and experiences at least one chronic disease such as diabetes, end
of life renal disease or any cardiac disease. Obesity is considered as the most common risk factor
for the development of the end-stage renal disease. The case study involves a 32-year-old single
male, Mr. C presented at the outpatient center for seeking information regarding bariatric
surgery. The paper aims to provide a critical discussion of clinical manifestations, functional
health patterns, staging of end-stage renal disease (ESRD) and health promotion along with
resources required for the patient in the following paragraphs.
Discussion:
Clinical manifestation:
In this context, the clinical manifestations in terms of vital signs are high blood pressure
( BP 172/98 whereas normal blood pressure is 120/80), moderate heart rate (HR 88 whereas
normal heart rate is 60-100 bpm) and increased respiratory rate (RR 26 whereas the normal
respiratory rate is 12-24 bpm) (Cardona-Morrell et al., 2016). He exhibited elevated blood
glucose level since his Fasting blood glucose is 146 mg/dL whereas normal blood glucose level
is 100 to 125 mg/dL. He exhibited a high cholesterol level of 250 mg/dL whereas an optimized
cholesterol level must be less than 170mg/dL. He exhibited elevated Triglycerides of 312 mg/dL
whereas the optimized triglyceride range is less than 150mg/dL (Bowyer et al., 2017). He also
exhibited a high serum creatinine level of 1.8 mg/dL whereas the normal range is 0.6 to 1.2
milligrams. The patient had exhibited 3+ pitting edema bilateral feet and ankles which is

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common amongst patients with heart, kidney or liver dysfunction. Furthermore, the patient
suggested that he experienced shortness of breath and sleep apnea.
The potential health risks for obesity and suitability of bariatric surgery:
Considering the obesity data, the potential health risk for obesity is the development of
diabetes as the patient had high fasting glucose since in obese individuals, patients are required
to process more nutrition which resulted in diabetes (Ulla et al., 2017). The second health risk
is Hypercholesterolemia, as he had a high cholesterol level (Ulla et al., 2017). The third health
risk is kidney dysfunction as the patient had high serum creatinine and 3+ pitting edema bilateral
feet and ankles. In this context, bariatric surgery is a suitable intervention since bariatric surgery
improves the symptoms of diabetes by decreasing blood glucose and improves symptoms of
kidney dysfunction by positively impacting glomerular filtration (Batterham & Cummings,
2016). However, side effects can be oxalate lithiasis.
Potential health risk:
Considering Mr. C.'s functional health patterns, the first issue is a metabolic issue as he
had Fasting blood glucose is 146 mg/dL, indicating he might have a metabolic disorder )
(Cardona-Morrell et al., 2016). The second issue is the nutritional issues as he had elevated
cholesterol of level of 250 mg/dL, indicating he might consume fat-containing food (Cardona-
Morrell et al., 2016). The third issue is sleep rest as he had sleep apnea which impacted sleep and
rest. The fourth issue is activity and exercise as he experienced breathing difficulties while doing
physical activities which impacted his activity. The fifth issues are health management as he was
obese, lives alone and experience difficulties while doing exercise. Therefore, he had poor health
management.

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Staging of end-stage renal disease (ESRD) and contributing factors:
End-stage renal disease is the fifth stage of kidney disease where kidney function is 10 to
15% compared to normal function. During this period, the kidney failed to remove excess fluid
from the body (Kerr et al., 2017). The most common contributing factors for ESRD are high
blood pressure and obesity as observed in this case study. On the other hand, the patient had high
blood glucose and serum creatinine level which might be the contributing factors behind ESRD.
Health promotion and prevention:
In this context, for improving health conditions and prevention of future events, he must
be provided with education regarding adequate nutrition such as elimination of sodium and fat-
containing food and incorporation of vegetables and fruits (Botchlett et al., 2017). It will reduce
obesity and improve the symptoms of kidney disease. Considering the health restoration, he can
be provided with a low protein diet, vitamin, and diuretics so that his kidney function can be
restored and edema can be reduced (Wong et al., 2018). He can be suggested dialysis or kidney
translation for improving kidney function and reducing creatinine function. For reducing obesity
and high blood pressure, Jung and Chung (2016), suggested that low sodium diet, low
carbohydrate diet would be suitable intervention. For improving sleep apnea, his sleeping
position can be optimized and his healthy weight can be maintained through nutritional alteration
and deep breathing exercises (Canales et al., 2020). Considering avoidance of deterioration, he
can involve in deep breathing and low to moderate physical activity so that he does not
experience dyspnea and exhibit reduced weight, blood pressure, heart rate, and improved kidney
function. Nursing professionals are required to assess vital signs after interventions.

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PATHOPHYSIOLOGY AND MANAGEMENT IN NURSING CARE
Resources and multidisciplinary approach:
In this context, the multidisciplinary approach can be taken where he can be supported
with a nutritionist for diet, physical activity trainer for exercise, a nurse for monitoring health
condition and social work who will ensure that he can join the telephone center and he can live in
appropriate housing condition (Cochrane et al., 2017). For improving sleep apnea, the patient can
be provided with a continuous positive airway pressure device (CPAP) as a device (Canales et
al., 2020). Since he had swollen ankle and enema, he can be provided with transportation for
seeking clinical assistance and going to the telephone center (Cochrane et al., 2017). He can be
provided with proper housing such as a non-skidded floor and lighting so that he can have proper
living conditions. Additionally, the social worker required to ensure that the company has
returned to work policies and facilities for sick workers. If no return to work policy present, he
can be referred to the company where return to work policy and facilities are present for him.
Conclusion:
On a concluding note, it can be said that Obesity is the most common and preventable
disease in the United States that contributed to the development of end of life kidney disease.
Other contributing factors include diabetes, high blood pressure, and high creatinine. In this
context, appropriate education, resources, and interventions can empower patients and enable
them to live a life.

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