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Please write a paragraph responding to the discussion bellow. Add citations and references in alphabetical order.

Based on the objective data presented, apparently Mr. C. is undergoing various medical health risk condition correlate with his excessive gaining weight (obesity) which warrant him to seek medical intervention for possible bariatric surgery. However, according to National Institute of Health (NIH, n. d), sequel to his elevated body mass index (BMI) of 47.8, with his height of 68inches (5feet 6inhces) and weight 134.5kg (296lbs), basically surgery is an option for his weight loss. However, obesity can constitute a complex progressively or exacerbate a wide spectrum of co-morbidities, including type 2 diabetes mellitus (T2DM), hypertension, dyslipidemia, cardiovascular disease (CVD), liver dysfunction, respiratory and musculoskeletal disorders, sub-fertility, psychosocial problems, and certain types of cancer (American Heart Association, 2017).

Upon careful assessment and evaluation of the below data:

1. High blood pressure elevated: 172/96,(120/80)
2. Diabetes with elevated Fasting blood Glucose: 146mg/dlL (<100mg/dL) 5.6mmol/l
3. High Cholesterol (Fatty Liver): elevated 250mg/dL (<200mg/dL)
4. Hyperlipemia with Triglycerides elevated 312mg/dL (<150mg/dL)
5. sleep apnea. Rapid respiration of 26

Metabolic disorder is not factor for Mr. C to gain weight, maybe he has genetical impact/leptin resistance/certain food habits or sedentary life style caused sudden recent weight gain about 100pounds in last 2-3years as reflected in the data.

Obesity is an abnormal accumulation of fat, it is one of the biggest health problems in the world. It correlates or associated with diverse or various other diseases, which combined kill millions of people per year.In another contemporary, Obesity constitutes a worldwide epidemic with prevalence rates which are increasing in most Western societies and in the developing world. According toWorld Health Organization (WHO) declared obesity a global epidemic,

Bariatric surgery should be a last priority after trying conventional therapies such as consuming fewer calories, increasing exercise, commercial weight-loss programs, etc. His BMI is 47.9 along with other comorbidities he has and may leads to further health impediment or problems so, he has to lose weight by taking aggressive approach (National Institute of Health n. d). Mr. C can undergo gastric bypass surgery if conventional therapies are not helping in losing weight. Gastric bypass is surgery that helps you lose weight by changing how your stomach and small intestine handle the food you eat(American Society for Metabolic and Bariatric Surgery).

For his Peptic ulcer disease Mr. C Should follow the below drug administration chart

Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL	10AM (3hrs after breakfast)	4PM (3hrs after Lunch)	9PM (3hrs after Dinner)	10.30PM (At bed time)
Ranitidine (Zantac) 300 mg PO at bedtime. 10.30				10.30 PM (At bed time)
Sucralfate/Carafate 1 g or 10ml suspension (500mg / 5mL)	6AM (1hr before Breakfast)	12PM (1hr before Lunch)	5pm (1hr before dinner)	10.30 PM (At bed time)

ANS 1:

Assessment of Mr. C. functional health patterns:

• Health perception/ health management-Mr. C. may be depressed because of his weight so he needs medication and diet compliance and also will need regular exercises and regular annual checkups.
• Nutritional metabolic pattern – his pattern of food consumption and fluid intake will have to be moderated so that it can reduce his weight also help in his metabolism
• Sexuality-reproductive activity– may be affected with low libido and dissatisfaction due to his weight and also could also affect his sexual relationships
• Coping/ stress tolerance-Mr. C. may not be able to tolerate lots of stress because of his body image and thoughts of his weight so he may need available support systems to help him to cope
• Value-belief-Mr. C. may have problems with his value beliefs and spiritual goals so he may need guidance and spiritual support as his values or beliefs may conflict with his health issues and special religious practices.
• Elimination-his patterns of excretory patterns may be affected especially bowel movement by the medications he is taking, and there may be frequency or pain in urination and appearance of urine and stool secondary to the disease process and medications.
• Activity/ Exercise-his patterns of activity will be affected by his weight with problems to exercise or have leisure times and also due to respiratory mobility and may affect his activities of daily living
• Cognitive perception-he may have sensory problems following his disease especially if he suffers from diabetes (neuropathy). His vision may be affected, taste sensory, and may have problems to manage his condition and decision making
• Sleep/ Rest pattern-Mr. C., may have problems with sleep and rest as he is already having sleep apnea, his quality of sleep will be affected, and he may need sleeping aids
• Self-perception/self -concept– his self-perception can be affected especially as a father figure or husband and may not provide family satisfaction as the head and bread winner and also with social interactions (Gordon’s 11 functional health patterns).

ANS 2:

The identified Actual or potential health problems:

1. Type2 Diabetes with Rationale : It may be that being overweight causes cells to change, making them resistant to the hormone insulin. Insulin carries sugar from blood to the cells, where it is used for energy. When a person is insulin resistant, blood sugar cannot be taken up by the cells, resulting in high blood sugar.

2. High Blood Pressure with Rationale: Having a large body size may increase blood pressure because your heart needs to pump harder to supply blood to all your cells. Excess fat may also damage your kidneys, which help regulate blood pressure.

3. Heart disease with Rationale: People who are overweight or obese often have health problems that may increase the risk for heart disease. Excess weight may cause changes to your heart that make it work harder to send blood to all the cells in your body.

4. Sleep Apnea with Rationale: A person who is overweight may have more fat stored around his or her neck. This may make the airway smaller. A smaller airway can make breathing difficult or loud (because of snoring), or breathing may stop altogether for short periods of time. In addition, fat stored in the neck and throughout the body may produce substances that cause inflammation. Inflammation in the neck is a risk factor for sleep apnea.

5. Osteoarthritis with Rationale: Extra weight may place extra pressure on joints and cartilage (the hard but slippery tissue that covers the ends of your bones at a joint), causing them to wear away. In addition, people with more body fat may have higher blood levels of substances that cause inflammation. Inflamed joints may raise the risk for osteoarthritis.

Reference:

American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines for the Surgical Weight Loss Patient 2016. Retrieved from: https://asmbs.org/app/uploads/2008/09/ASMBS-Nutritional-Guidelines-2016-Update.pdf

 

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