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The clinical manifestations present in Mr. C. should be described before the general assessment is done. As such, Mr. C. has sleep apnea, which means the patient experiences excessive daytime tiredness, loud snoring, and bouts of halted breathing during sleep (Mayo Clinic, 2021a). Moreover, his awakenings are sudden and followed by panting or choking, as well as dry throat and headache in the morning (Mayo Clinic, 2021a). Sudden reductions in blood oxygen levels caused by sleep apnea raise blood pressure, which is confirmed by Mr. C. These symptoms alone imply that Mr. C. might have cardiovascular problems. These issues are worsened by the fact that the patient has edema, the signs of which are swelling under the skin in the legs and arms produced by a buildup of fluid in one body’s tissues (Mayo Clinic, 2020). Furthermore, Mr. C. experiences shortness of breath and itching (pruritus), which signifies pulmonary edema. The sum of these clinical manifestations might lead to congestive heart failure if not prevented.
The potential health risks of obesity and the appropriateness of bariatric surgery in these conditions should be considered. Namely, rapid weight increase due to fluid retention is a sign of a high probability of heart failure (Mayo Clinic, 2021b). Moreover, other factors, such as high levels of blood lipids (triglycerides, LDL cholesterol, and total cholesterol), as well as low levels of HDL cholesterol, increase the risks. Hence, obesity directly adds to the occurrence of cardiovascular risk factors, which, in turn, are linked with mortality. It might seem that any operations on the patient in this condition are harmful and dangerous. However, research suggests that bariatric surgery may enhance heart function and serve as a stopgap measure if transplantation is planned (Yang et al., 2020). In addition, in obese individuals with severe heart failure, bariatric surgery is both safe and successful, resulting in significant improvements in cardiovascular output and symptoms (Yang et al., 2020). Thus, the requested operation is the most beneficial option for Mr. C.
Mr. C.’s functional health patterns could be assessed via the provided information. Health perception and health management of the patient seem to be adequate: Mr. C. visits health check-ups and is concerned about his condition, as well as takes measures to prevent health issues. The nutritional-metabolic pattern is disrupted since Mr. C.’s skin is itching and swelling; moreover, the patient is obese. Hence, edema and the risk of heart failure due to obesity are the problems associated with this area of health. The elimination pattern does not seem upsetting since the patient has not raised any concerns about it. The activity-exercise abilities are restricted because of breathing shortage and fatigue, which indicates another problem in the health patterns of the patient. His sleep-rest pattern is complicated by apnea, which is also a health issue. The self-perception of Mr. C. might also be damaged due to his problems with skin and obesity. Finally, the cognitive-perceptual, role-relationship, sexuality-reproductive, stress tolerance, and value-belief functions of Mr. C. are intact.
The staging of end-stage renal disease is also an essential consideration in the case of the patient. End-stage renal disease is the last, irreversible stage of chronic kidney disease in which kidney function has diminished to the extent that the kidneys cannot operate on their own (American Kidney Fund, 2022). Diabetes, high blood pressure, heart illness, drug addiction, urinary tract obstructions, family background, inflammation, and some genetic diseases are all significantly more likely to develop chronic kidney disease (American Kidney Fund, 2022). These factors can eventually lead to end-stage renal failure, which is mortality-related. The most relevant factors for Mr. C. are high blood pressure and heart disease, as well as obesity.
Some prevention and health promotion opportunities could be proposed to remove the risks of end-stage renal disease for Mr. C. As such, the patient might be able to delay its progression by adopting a healthy lifestyle. First, he needs to obtain and keep a healthy weight, the first step toward which could be bariatric surgery. After that, Mr. C. should be active daily and limit his protein intake in favor of consuming a well-balanced diet of healthful, low-sodium meals. Next, it is important to maintain healthy blood pressure and a healthy blood sugar level; for this, one should take medications that are prescribed for this condition. Furthermore, the patient should have his cholesterol levels examined at least once a year. Moreover, it is vital to stop smoking or using tobacco products. Finally, Mr. C. should schedule frequent checks of his general health status.
Patients who are at risk of having end-stage renal disease might use several resources for non-acute care. As such, these people could be provided with education concerning their conditions and the existing apps that help to maintain a healthy diet. The multidisciplinary care approach also could be afforded for better care for chronic kidney disease. Other clinicians, advanced practice doctors, pharmacists, nutritionists, nurses, and social workers may be part of the team, all working together to offer optimal treatment to individuals with the issue.
References
American Kidney Fund. (2022). Kidney failure, end-stage kidney disease (ESKD) or end-stage renal disease (ESRD). Web.
Mayo Clinic. (2020). Edema – symptoms and causes. Web.
Mayo Clinic. (2021a). Obstructive sleep apnea – symptoms and causes. Web.
Mayo Clinic. (2021b). Heart failure – symptoms and causes. Web.
Yang, T. W. W., Johari, Y., Burton, P. R., Earnest, A., Shaw, K., Hare, J. L., & Brown, W. A. (2020). Bariatric surgery in patients with severe heart failure. Obesity Surgery, 30(8), 2863–2869. Web.
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