NRS-410V Module 5 - Disease Management Case scenario

Disease Management Case scenario

Mr. C., a 32-year-old single man, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He reports that he has always been heavy, even as a small child, but he has gained about 100 pounds in the last 2-3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has high blood pressure, which he tries to control with sodium restriction and sleep apnea. He current works at a catalog telephone center.

Objective Data

• Height: 68 inches; Weight 134.5 kg
• BP: 172/96, HR 88, RR 26
• Fasting Blood Glucose: 146/mg/dL
• Total Cholesterol: 250mg/dL
• Triglycerides: 312 mg/dL
• HDL: 30 mg/dL

Critical Thinking Questions

1) What health risks associated with obesity does Mr. C. have? Is bariatric surgery an appropriate intervention? Why or why not?

2) Mr. C. has been diagnosed with peptic ulcer disease and the following medications have been ordered:

a) Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL PO 1 hour before bedtime and 3 hours after mealtime and at bedtime

b) Ranitidine (Zantac) 300 mg PO at bedtime

c) Sucralfate / Carafate 1 g or 10ml suspension (500mg / 5mL) 1 hour before meals and at bedtime.

The patient reports eating meals at 7 a.m., noon, and 6 p.m., and a bedtime snack at 10 p.m. Plan an administration schedule that will be most therapeutic and acceptable to the patient.

3) Assess each of Mr. C.'s functional health patterns using the information given (Hint: Functional health patterns include health-perception - health management, nutritional - metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception - self-concept, role-relationship, sexuality - reproductive, coping - stress tolerance).

What actual or potential problems can you identify? Describe at least five problems and provide the rationale for each.