NRS 410V Case Study Mr. C. Assignment

NRS 410V Case Study Mr. C. Assignment

The case involves Mr. C who is a 32 years old male. The patient reports having always been heavy and gaining about 100 pounds in the last three years. Also, the patient has sleeping apnoea with high blood pressure. The current blood pressure is 172/98mmHg which is significantly high. The clinical manifestation indicates the possible illnesses the patient may be having and are used to develop a diagnosis

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Clinical Manifestation

. In this case, the patient is hypertensive with a blood pressure reading of 172/98. He experiences shortness of breath with activity and has a swollen ankle. The patient has had pruritus for the past 6 months. Similarly, the patient cannot engage in strenuous activities due to the increasing shortness of breath with activity and this shows a reduced cardiorespiratory endurance level. The clinical manifestations are also used to justify the objective data provided. There are no indications of fatigue and pain reported by the patient.

Potential Health Risk

Obesity is linked to a number of health problems, including diabetes and high blood pressure. The patient is already hypertensive and at risk of developing the complications that come with it. Stroke and atrial fibrillation are two of the most common health risks associated with high blood pressure (Giacomo Fassini, 2017). Patients who are hypertensive are at a significantly higher risk of having a heart attack. A heart attack occurs when the arteries that supply the body with blood and oxygen become clogged by fat plaques. The patient has low levels of high-density lipoprotein, which raises the risk of a heart attack. High-density lipoproteins (HDLs) are good cholesterol that aid in fat removal by the liver. Furthermore, the patient’s blood sugar level is elevated, indicating that he is diabetic.

Another risk factor for obesity is diabetes. Patients who are overweight are also more likely to experience emotional and psychological distress. Certain circumstances make depression more likely. Bariatric surgery is a procedure that aids in weight loss and thus lowers the risk of diabetes-related complications such as heart failure and stroke. As a result, the patient received proper care. Obesity-related complications, such as stroke, impose a significant financial and emotional burden on patients and their families.

An RN-BSN-prepared nurse must exhibit a better awareness of disease , clinical symptoms, and treatment regimens, as well as how these influence clients throughout their lives.

Examine Mr. C.’s health history and medical information, which is provided below.

Form a conclusion based on your evaluation based on this information, then complete the Critical Thinking Essay assignment as directed below.

Read Also:

Health History and Medical Information

Health History

, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He currently works at a catalog telephone center. He reports that he has always been heavy, even as a small child, gaining approximately 100 pounds in the last 2-3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control by restricting dietary sodium. Mr. C. reports increasing shortness of breath with activity, swollen ankles, and pruritus over the last 6 months.

Mr. C reports that he has had problems with being overweight since childhood with 100pounds being gained in the previous 2-3years. Currently, he complains of sleep apnea, high blood pressure, easy fatigability, ankle edema, and pruritus. Further, his objective assessment reveals high blood pressure, elevated fasting blood sugar, dyslipidemia, and deranged liver function owing to the elevated BUN and serum creatinine. Most of these patients’ presentations are related to being obese.
Patients who are obese have increased fat storage in the adipose tissues. These fat deposits increase the fatty acid availed to the liver for conversion into triglycerides which contributes to dyslipidemia (Vekic et al., 2019). When the serum cholesterol and lipids are deposited into the vessel walls, they lead to atherosclerosis by stiffening the vessel walls and narrowing the lumen. Given the blood pressure depends on the size of the lumen of the vessel, the narrowed lumen due to dyslipidemia would lead to hypertension (Shariq & McKenzie, 2020). Further, obesity also leads to increased serum levels of glucose due to increased conversion of lipids to glucose. The obese patients are therefore at risk of type 2 diabetes mellitus (DM) (Ortega et al., 2020). Hypertension, diabetes mellitus, and dyslipidemia are risk factors for kidney disease.
Hypertension, diabetes mellitus, and dyslipidemia may lead to atherosclerosis including that of renal arteries. This impairs the blood supply to the kidney parenchyma which can then lead to its necrosis, scarring, and eventual kidney damage (de Leeuw et al., 2018). Kidney damage and kidney failure affect the excretion of water, toxins such as urea, and even creatine thus leading to edema of the legs and uremic pruritus (Vekic et al., 2019). Clinical manifestations of Mr. C, therefore, developed as complications of obesity.

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mr. C.’s potential diagnosis and intervention(s). Include the following:

  1. Describe the clinical manifestations present in Mr. C.

Case Study: Mr. C.

Obesity refers to an imbalance between energy expenditure and energy intake. It mostly occurs secondary to a long-term sedentary lifestyle and excessive calorie intake. It is characterized by an abnormal increase in the proportion of fat cells (Fruh, 2017). It primarily occurs in the visceral and subcutaneous tissues of the body. For the condition to persist, caloric consumption must exceed energy expenditure. Genetic, environmental, and psychosocial factors have been associated with obesity (Fruh, 2017). This essay aims to analyze the case of Mr. C, a 32-year-old male patient with obesity. The essay will also discuss End-stage renal disease, including its staging, prevention, and resources for patients[K1] .

Clinical Manifestations Present In Mr. C

Mr. C has a history of obesity since childhood and has gained approximately 100 pounds over the last 2-3 years. He reports experiencing sleep apnea and high blood pressure. He also reports increasing exertional dyspnea, swollen ankles, and pruritus over the last six months. Objective findings include a height of 68 inches and a weight of 134.5 kg, a BMI of 46.4 classified under morbid obesity. Vital signs indicate an elevated blood pressure of 172/98 and tachypnea of 26b/min. Positive physical findings include 3+ pitting edema on bilateral feet and ankles. Lab results reveal an elevated levels of fasting blood glucose- 146 mg/dL, Total cholesterol-250 mg/dL Triglycerides-312 mg/dL and low HDL of 30 mg/dL. In addition, his comprehensive metabolic panel reveals elevated levels of serum creatinine at 1.8 mg/dL and BUN at 32 mg/dl, which suggests impaired kidney function[K2] .

[K1]Well done intro!
[K2]Good discussion of clinical manifestations

  1. Describe the potential health risks for obesity that are of concern for Mr. C. Discuss whether bariatric surgery is an appropriate intervention.
  2. Assess each of Mr. C.’s functional health patterns using the information given. Discuss at least five actual or potential problems can you identify from the functional health patterns and provide the rationale for each. (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.)
  3. Explain the staging of end-stage renal disease (ESRD) and contributing factors to consider.
  4. Consider ESRD prevention and health promotion opportunities. Describe what type of patient education should be provided to Mr. C. for prevention of future events, health restoration, and avoidance of deterioration of renal status.
  5. Explain the type of resources available for ESRD patients for nonacute care and the type of multidisciplinary approach that would be beneficial for these patients. Consider aspects such as devices, transportation, living conditions, return-to-employment issues.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice. NRS 410V Case Study Mr. C. Assignment

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the for assistance. 

Topic 1 DQ 1

Identify a cardiac or respiratory issue and outline the key steps necessary to include for prevention and health promotion,

Asthma is defined as a chronic inflammatory illness of the airways that affects people of all ages. According to McCracken et al. (2017) chronic inflammation is linked to airway hyper responsiveness; an exaggerated airway-narrowing response to particular triggers such as allergens, viruses, and exercise. This disease process results in recurrent episodes of wheezing, breathlessness, chest tightness, and/or coughing that vary in frequency and intensity over time. Symptom bouts are frequently accompanied by variable airflow blockages in the lungs, which is usually reversible either naturally or with proper asthma medication, such as a fast-acting bronchodilator (McCracken et al., 2017).

There is evidence that asthma development may be linked to a genetic predisposition. Several chromosomal areas connected to the generation of IgE antibodies, expression of airway hyper responsiveness, and the creation of inflammatory mediators has been linked to asthma susceptibility (Davis & Smallwood, 2020). However, further research is needed to identify particular genes involved in asthma, as well as gene-environment interactions that could lead to disease manifestation.

In regards to management of this illness, allergen-specific immunotherapy has the potential to change the course of disease, but it should only be prescribed by allergy specialists according to (Davis & Smallwood, 2020). All asthma patients should have regular follow-up visits during which their asthma control, adherence to therapy, and inhaler technique are evaluated.

Limiting the amount of time spent outside during peak pollen seasons, as well as avoiding exposure to tobacco smoke and other relevant allergens/irritants, is an important part of asthma management.  I chose this respiratory issues because I have been dealing with asthma most of life and I am seemingly developing more triggers as I age. I think it is important for a person dealing with this disease to learn their personal triggers if possible to help with management and prevent predictable occurrences. Currently in Central Florida we are having a streak of rainy days, accompanied by the wonderful pollen and fluctuating temperatures, I woke up wheezing with chest pressure and audible wheezing. I can often tell when the weather will change all because of my breathing. Thus far, my asthma has not inhibited how I live my day to day life and prayerfully it never will.

Patient compliance is usually suboptimal because these avoidance strategies can be difficult. According to Trevor & Chipps (2018) only 22% of asthma patients were treated by a specialist on a regular basis in a 2012 survey, and 48% of patients had never seen a specialist. Adherence to these strategies often requires frequent reassessments, encouragement, and empowerment. Patients should also be encouraged to use a combination of avoidance measures for best results, as single-strategy interventions have shown no measurable benefits in asthma control (Davis & Smallwood, 2020).

References

Davis, M. D., & Smallwood, C. D. (2020). 2019 Year in Review: Asthma. Respiratory Care65(7), 1024–1029. https://doi.org/10.4187/respcare.07809

McCracken, J. L., Veeranki, S. P., Ameredes, B. T., & Calhoun, W. J. (2017). Diagnosis and Management of Asthma in Adults. JAMA318(3), 279. https://doi.org/10.1001/jama.2017.8372

Trevor, J. L., & Chipps, B. E. (2018). Severe Asthma in Primary Care: Identification and Management. The American Journal of Medicine131(5), 484–491. https://doi.org/10.1016/j.amjmed.2017.12.034

NRS 410V Case Study Mr. C. Assignment

Course Code Class Code Assignment Title Total Points
NRS-410V NRS-410V-O500 Case Study: Mr. C. 120.0

Criteria Percentage Unsatisfactory (0.00%) Less Than Satisfactory (75.00%) Satisfactory (79.00%) Good (89.00%) Excellent (100.00%)
Content 80.0%
Clinical Manifestations of Mr. C. 10.0% Clinical manifestations are omitted. Clinical manifestations are partially presented. There are major omissions and inaccuracies. Clinical manifestations are summarized. An overview of the general symptoms is presented. Some findings are incomplete. Subjective and objective clinical manifestations are described. Overall, the clinical manifestations are accurate and reflect observed and perceived signs and symptoms. Subjective and objective clinical manifestations are detailed. The clinical manifestations are accurate and clearly report the observed and perceived signs and symptoms.

Potential Health Risks for Obesity and Bariatric Surgery 10.0% Potential health risks for obesity and whether bariatric surgery is an appropriate intervention are not discussed. A partial summary on the potential health risks for obesity and whether bariatric surgery is an appropriate intervention is presented. There are major inaccuracies. More information is needed. No evidence or rationale is provided to support discussion. A summary on the potential health risks for obesity and whether bariatric surgery is an appropriate intervention is presented. There are some inaccuracies. More evidence or rationale is needed to support discussion. A discussion on the potential health risks for obesity is presented. A discussion on whether bariatric surgery is an appropriate intervention is presented but needs some evidence or rationale for support. A detailed discussion of the potential health risks for obesity is presented. A through and compelling discussion on whether bariatric surgery is an appropriate intervention is presented. The discussion is well-developed and supported by evidence and additional rationale.

Functional Health Patterns 15.0% Actual or potential problems based on the assessment of functional health patterns of the patient are omitted or are irrelevant for the patient and his condition. The overall criteria for this assignment are not met. At least four actual or potential problems identified from the functional health patterns are presented. The identified problems are not entirely relevant for the patient and his condition. Rationale or evidence is required for support. At least five actual or potential problems identified from the functional health patterns are summarized. The identified problems are generally relevant for the patient and his condition. Some rationale and evidence is required for support. Five or more actual or potential problems identified from the functional health patterns are discussed. The identified problems are relevant for the patient and his condition. Overall, the discussion is supported by rationale and evidence. Some detail is needed for clarity or accuracy. Five or more actual or potential problems identified from the functional health patterns are discussed. The discussion is insightful, and the identified problems are highly relevant for the patient and his condition. The discussion is well-supported by rationale and evidence.

Staging and Contributing Factors of End-Stage Renal Disease (ESRD) 10.0% Staging and contributing factors for ESRD are omitted or inaccurate. Staging of ESRD is partially summarized. The contributing factors for ESRD are vague. There are inaccuracies. The staging of ESRD and the contributing factors for ESRD are generally explained. Some information is required; there are minor inaccuracies. The staging of ESRD and the contributing factors for ESRD are explained. Some information or detail is needed for clarity or detail. The staging of ESRD and the contributing factors for ESRD are explained. The information is accurate and reflects contemporary practice and research.

Health Promotion and Prevention for ESRD 20.0% Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is omitted. Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is partially summarized. There are inaccuracies. Some aspects are not relevant for the patient and his health status. Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is generally described. There are minor inaccuracies. Overall, the proposed items are relevant for the patient and his health status. Some evidence and rationale are needed to support the discussion. Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is described. The proposed items are relevant and appropriate for the patient and his health status. Evidence and rationale generally support the discussion. Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is thoroughly described. The proposed items are clearly presented and highly relevant and supportive of patient and his health status. Strong evidence and rationale generally support the discussion. NRS 410V Case Study Mr. C. Assignment

Resources for ESRD Patients for Nonacute Care and Multidisciplinary Approach 15.0% Types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, are not discussed. An incomplete explanation on the types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, is presented. There are major inaccuracies. A general explanation on the types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, is presented. There are minor inaccuracies. Some additional information is required. An explanation on the types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, is presented. Some detail is required for clarity. A clear and detailed explanation on the types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, is presented. The explanation demonstrates insight into both resources and multidisciplinary approaches for nonacute care for ESRD patients.

Organization, Effectiveness, and Format 20.0%
Thesis Development and Purpose 5.0% Paper lacks any discernible overall purpose or organizing claim. Thesis is insufficiently developed or vague. Purpose is not clear. Thesis is apparent and appropriate to purpose. Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

Argument Logic and Construction 5.0% Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

Mechanics of Writing (includes spelling, punctuation, grammar, language use) 5.0% Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech. Writer is clearly in command of standard, written, academic English.

Paper Format (use of appropriate style for the major and assignment) 2.0% Template is not used appropriately, or documentation format is rarely followed correctly. Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent. Appropriate template is used. Formatting is correct, although some minor errors may be present. Appropriate template is fully used. There are virtually no errors in formatting style. All format elements are correct.

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 3.0% Sources are not documented. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

NRS 410V Case Study Mr. C. Assignment

NRS 410V Case Study Mr. C. Assignment

NRS 410V Case Study Mr. C. Assignment

NRS 410V Case Study Mr. C. Assignment

Clinical Manifestations

One of the clinical manifestations that Mr. C presented to the outpatient center is being always heavy. He reports that he gained approximately 100 pounds in the last 2-3 years. The other clinical manifestation is sleep apnea and high blood pressure. He also reports increasing shortness of breath in engaging in activity, pruritus over the last six months, and swollen ankles.

Potential Health Risks for Obesity

One of the potential health risks for obesity in the patient is type 2 diabetes. Obesity increases the risk of type 2 diabetes due to high insulin resistance. As a result, there is an increased risk of developing the disease due to obesity. The other health risk is elevated blood pressure. The patient is at a risk of hypertension due to the thickening of the blood vessels and increased cardiac workload for the heart. This is likely to increase the patient’s risk for cerebrovascular accidents and heart disease. These complications arise from the worsening situation of the cardiac muscles. There is also the increased risk for coronary artery disease. This is likely to result from the deposition of fatty streaks on the blood vessels. The consequences including the thickening of the vessels, increased resistance in the blood vessels, and occlusion of blood supply to tissues. The other potential health risk for the patient is cancer. The patient is also at a risk of developing kidney disease. This is likely to arise from the complications of diabetes type 2 and heart disease. The patient is also at a risk of bone problems such as fractures and osteoarthritis (Shekar & Popkin, 2020). Bone fractures are likely to occur due to large body weight that the bones cannot bear.

Bariatric surgery is appropriate for the patient. He meets all the indications that should be considered for this management approach. Firstly, the patient weighs more than 100 pounds. Besides the BMI, he also has other co-morbidities such as sleep apnea and hypertension. The patient reports that he has tried weight management approach that has been unsuccessful. These conditions are the indications for bariatric surgery, hence, its appropriateness for the patient (Gordeladze, 2017).

Functional Health Patterns

Functional health patterns allows for the accurate assessment of the patient’s problems in nursing. The patient’s health perception pattern is unaltered since he understands his problems and ways of managing it. His nutrition metabolic health pattern is unaltered since food and fluid intake is normal. However, there is an increased risk for metabolic disorders such as diabetes type 2. The patient’s elimination pattern is unaltered. The patient’s activity exercise pattern is altered as evidenced by his difficulty in breathing while engaging in activity. The sleep-rest pattern is altered as evidenced by sleep apnea. The self-perception pattern is also altered since being obese has affected patient’s perception of self. The coping-stress pattern has also been altered as evidenced by patient’s need for additional care due to failure of his adopted weight management interventions.

Actual or Potential Health Problems from the Functional Health Patterns

One of the actual problems facing the patient is negative perception of self. The obesity has significantly altered patient’s perception of self. He is at a risk of developing low self-esteem due to his physical appearance. The other actual health problem is altered sleep-rest pattern as evidenced by sleep apnea. The patient’s ability to get adequate sleep is likely to be altered if the current health problem is not addressed. The third actual health problem that the patient faces is activity intolerance. The patient reports that he experiences shortness of breath in engaging in activity. This is likely to limit his ability to live a healthy lifestyle. The fourth potential health problem he faces is the increased risk for metabolic disorders such as type 2 diabetes. This is likely to occur due to high insulin resistance. The last health problem that the patient is at a risk of developing is poor coping with the stressful health needs due to his condition. The patient has tried sodium diet restriction as part of managing his weight gain but unsuccessful (Gordeladze, 2017). He is therefore at a risk of developing poor coping skills with his stress should the adopted interventions prove ineffective.

Staging of End Stage Renal Failure and Factors to Consider

End stage renal disease is classified into five stages. The staging takes into consideration the glomerular filtration rate, which reflects the level of kidney function. Stage 1 end stage kidney disease is characterized by glomerular filtration rate (GFR) of 90 and above with normal or almost normal kidney function. Stage 2 is characterized by GFR of 60-89 with mild loss of the desired kidney function. Stage 3 is characterized by GFR of 30 to 59 with mild to moderate loss of the kidney function. Stage 4 is GRL of 15-29 with severe loss of the kidney function. Stage 5 is GFR less than 15 with kidney failure.

Patient Education

The patient should be educated on the causes and risk factors for end stage renal failure. This will help him come up with ways of minimizing them in his life. He should also be educated on the signs and symptoms of end stage renal disease and the need for reporting them to the physician. He should also be educated on lifestyle and behavioral changes that he needs to adopt. This includes dietary modifications and engaging in physical activity to reduce the risk of obesity and its associated complications. He should also be educated on the importance of medication adherence to prevent deterioration of the kidney function (Stanhope et al., 2019).

Resources

Non-acute patients suffering from end stage renal disease require a number of resources for their health and wellbeing. One of them is the social support from the family and the community. The family and community should provide the patient with the physical, social, and emotional support he needs. The community should support his needs by incorporating him into the existing social support systems for patients with chronic illnesses. The community should also be supportive by discouraging discrimination of patients with chronic illnesses. The patient also requires multidisciplinary interventions. They include active collaboration between physicians, nutritionist, physiotherapist, counselors, and nephrologist. Active collaboration is needed to optimize the health outcomes of care for the patient (Stanhope et al., 2019). The patient should be educated on delayed return to his normal activities such as resumption of job and normal activities of the daily living.

References

Gordeladze, J. (Ed.). (2017). Adiposity: Epidemiology and Treatment Modalities. BoD–Books on Demand.

Shekar, M., & Popkin, B. (Eds.). (2020). Obesity: Health and Economic Consequences of an Impending Global Challenge.

Stanhope, M., Faan, R. D., Lancaster, J., & Faan, R. P. (2019). Public Health Nursing E-Book: Population-Centered Health Care in the Community. Elsevier Health Sciences.

Rubric Criteria

Total 120 points

Criterion

1. Unsatisfactory

2. Less Than Satisfactory

3. Satisfactory

4. Good

5. Excellent

Functional Health Patterns

Functional Health Patterns

0 points

Actual or potential problems based on the assessment of functional health patterns of the patient are omitted or are irrelevant for the patient and his condition. The overall criteria for this assignment are not met.

13.5 points

At least four actual or potential problems identified from the functional health patterns are presented. The identified problems are not entirely relevant for the patient and his condition. Rationale or evidence is required for support.

14.22 points

At least five actual or potential problems identified from the functional health patterns are summarized. The identified problems are generally relevant for the patient and his condition. Some rationale and evidence is required for support.

16.02 points

Five or more actual or potential problems identified from the functional health patterns are discussed. The identified problems are relevant for the patient and his condition. Overall, the discussion is supported by rationale and evidence. Some detail is needed for clarity or accuracy.

18 points

Five or more actual or potential problems identified from the functional health patterns are discussed. The discussion is insightful, and the identified problems are highly relevant for the patient and his condition. The discussion is well-supported by rationale and evidence.

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

0 points

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

4.5 points

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.

4.74 points

Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.

5.34 points

Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.

6 points

Writer is clearly in command of standard, written, academic English.

Paper Format (use of appropriate style for the major and assignment)

Paper Format (use of appropriate style for the major and assignment)

0 points

Template is not used appropriately, or documentation format is rarely followed correctly.

1.8 points

Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent.

1.9 points

Appropriate template is used. Formatting is correct, although some minor errors may be present.

2.14 points

Appropriate template is fully used. There are virtually no errors in formatting style.

2.4 points

All format elements are correct.

Resources for ESRD Patients for Nonacute Care and Multidisciplinary Approach

Resources for ESRD Patients for Nonacute Care and Multidisciplinary Approach

0 points

Types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, are not discussed.

13.5 points

An incomplete explanation on the types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, is presented. There are major inaccuracies.

14.22 points

A general explanation on the types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, is presented. There are minor inaccuracies. Some additional information is required.

16.02 points

An explanation on the types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, is presented. Some detail is required for clarity.

18 points

A clear and detailed explanation on the types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, is presented. The explanation demonstrates insight into both resources and multidisciplinary approaches for nonacute care for ESRD patients.

Argument Logic and Construction

Argument Logic and Construction

0 points

Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

4.5 points

Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

4.74 points

Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

5.34 points

Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

6 points

Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

Thesis Development and Purpose

Thesis Development and Purpose

0 points

Paper lacks any discernible overall purpose or organizing claim.

4.5 points

Thesis is insufficiently developed or vague. Purpose is not clear.

4.74 points

Thesis is apparent and appropriate to purpose.

5.34 points

Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

6 points

Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

Staging and Contributing Factors of End-Stage Renal Disease (ESRD)

Staging and Contributing Factors of End-Stage Renal Disease (ESRD)

0 points

Staging and contributing factors for ESRD are omitted or inaccurate.

9 points

Staging of ESRD is partially summarized. The contributing factors for ESRD are vague. There are inaccuracies.

9.48 points

The staging of ESRD and the contributing factors for ESRD are generally explained. Some information is required; there are minor inaccuracies.

10.68 points

The staging of ESRD and the contributing factors for ESRD are explained. Some information or detail is needed for clarity or detail.

12 points

The staging of ESRD and the contributing factors for ESRD are explained. The information is accurate and reflects contemporary practice and research.

Potential Health Risks for Obesity and Bariatric Surgery

Potential Health Risks for Obesity and Bariatric Surgery

0 points

Potential health risks for obesity and whether bariatric surgery is an appropriate intervention are not discussed.

9 points

A partial summary on the potential health risks for obesity and whether bariatric surgery is an appropriate intervention is presented. There are major inaccuracies. More information is needed. No evidence or rationale is provided to support discussion.

9.48 points

A summary on the potential health risks for obesity and whether bariatric surgery is an appropriate intervention is presented. There are some inaccuracies. More evidence or rationale is needed to support discussion.

10.68 points

A discussion on the potential health risks for obesity is presented. A discussion on whether bariatric surgery is an appropriate intervention is presented but needs some evidence or rationale for support.

12 points

A detailed discussion of the potential health risks for obesity is presented. A through and compelling discussion on whether bariatric surgery is an appropriate intervention is presented. The discussion is well-developed and supported by evidence and additional rationale.

Health Promotion and Prevention for ESRD

Health Promotion and Prevention for ESRD

0 points

Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is omitted.

18 points

Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is partially summarized. There are inaccuracies. Some aspects are not relevant for the patient and his health status.

18.96 points

Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is generally described. There are minor inaccuracies. Overall, the proposed items are relevant for the patient and his health status. Some evidence and rationale are needed to support the discussion.

21.36 points

Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is described. The proposed items are relevant and appropriate for the patient and his health status. Evidence and rationale generally support the discussion.

24 points

Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is thoroughly described. The proposed items are clearly presented and highly relevant and supportive of patient and his health status. Strong evidence and rationale generally support the discussion.

Clinical Manifestations of Mr. C.

Clinical Manifestations of Mr. C.

0 points

Clinical manifestations are omitted.

9 points

Clinical manifestations are partially presented. There are major omissions and inaccuracies.

9.48 points

Clinical manifestations are summarized. An overview of the general symptoms is presented. Some findings are incomplete.

10.68 points

Subjective and objective clinical manifestations are described. Overall, the clinical manifestations are accurate and reflect observed and perceived signs and symptoms.

12 points

Subjective and objective clinical manifestations are detailed. The clinical manifestations are accurate and clearly report the observed and perceived signs and symptoms.

Documentation of Sources

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

0 points

Sources are not documented.

2.7 points

Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

2.84 points

Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

3.2 points

Sources are documented, as appropriate to assignment and style, and format is mostly correct.

3.6 points

Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

Case Study MR C

The assigned case study demonstrates a male patient, Mr. C, who is 32 years old, seeking information regarding bariatric surgery as the best medical intervention for his obesity. The patient’s overweight puts him at high risk of cardiac arrest, hypertension, and diabetes. However, with bariatric surgery, the amount of food that the patient’s stomach will be able to comfortably accommodate will be reduced hence helping with weight reduction (Jakobsen et al., 2018). The purpose of this paper is to evaluate the provided health history and medical information of Mr. C and suggest the most appropriate cause of action.

Clinical Manifestations

From the provided information, the patient mainly presents with symptoms caused by his overweight nature. Even though the patient has not been diagnosed with metabolic disorders, he stands a great chance of developing this condition, if timely intervention is not taken. The collected objective data indicate that the patient’s blood pressure is elevated and heart rate and respiratory rate increased (Ryan & Kahan, 2018). He also reports suffering from sleep apnea which might be attributed to the accumulation of fats on the neck. His idyllic HDL levels are very low, while his cholesterol levels and triglycerides are surprisingly high.

Potential Health Risks

            Mr. C is at great risk of developing several obesity-related health complications like kidney disease, sleep apnea, diabetes mellitus, hypertension, hyperlipidemia, and stroke among others. The patient has however made the right choice to consider bariatric surgery as the most effective intervention to avoid these complications. Evidence-based practice has proven great effectiveness in reducing the risks of obesity-related complications among patients who have undergone bariatric surgery (Jakobsen et al., 2018). Studies also report that the effectiveness of bariatric surgery in helping patients manage their obesity can best be realized with patients who integrate physical activity and dietary interventions as part of their care plan.

Functional Health Patterns

From the provided information, the patient’s functional health patterns that need to be accessed include his metabolic function, self-perception, stress coping and tolerance, sleep rest cycle, and health management. From the assessment, it is clear that the patient perceives himself as unhealthy due to his obesity, and even considers bariatric surgery to promote his health (Veroux et al., 2021). He also seems to adopt a sedentary lifestyle, with limited activity/exercise and a poor diet, with high calories since he gained about 100 pounds over the past 2 to 3 years, and his objective data reveal high cholesterol levels. The patient also reports sleep apnea, which affects his sleep-wake cycle. His shortness of breath also affects his respiratory function finally. As such, the patient needs to adopt life modification strategies such as engaging in physical activity and consuming a healthy diet to promote appropriate functional health patterns

Staging and Contributing Factors of ESRD

            Renal disease is usually classified into 5 main categories, based on kidney function. Clinical guidelines recommend the use of the glomerular filtration rate (GFR) of the patient to determine the kidney functioning for diagnosing and staging the renal disease. End-stage renal disease is normally diagnosed when the kidney function of the patient drops to less than 10% of its normal functioning, with a GFR of less than 15 mL/min (Lin et al., 2018). Some of the contributing factors to ESRD include low hemoglobin levels, hypertension, alcoholism, smoking, high cholesterol level, advanced age, and low education among others.

 

 

Health Promotion and Prevention Measures for ESRD

To date, no cure has been discovered for ESRD. However, through evidence-based practice, several interventions like kidney transplants and dialysis have proven to be effective in promoting the health of the patient, hence prolonging their life (Veroux et al., 2021). Consequently, patients are educated on appropriate health promotion and prevention measures such as engaging in physical activity and a healthy diet to prevent complications associated with the disease. Patients are also advised to attend to their comorbid conditions to promote their health once diagnosed with ESRD.

Resources for ESRD Patient for Nonacute Care and Multidisciplinary Approach

Many resources have been provided for patients diagnosed with ESRD, to help them understand the condition better and the available course of action needed to help manage the condition. Such resources include support groups for ESRD survivors, and multidisciplinary approaches with procedures helping in tracking down the patient’s diet and exercise plans (Lin et al., 2018). Dialysis centers have also been established in most clinics to promote care for patients with CKD. Additional sources include internet sources like USDA Nutrient Database, The DASH Diet Eating Plan,  American Dietetic Association, Renal Support Network (RSN), and FitDay among others.

Conclusion

Mr. C presents with obesity which predisposes him to several health complications such as hypertension, diabetes, sleep apnea, and kidney disease among others. However, he considers bariatric surgery as the most appropriate intervention to prevent these comorbidities and promote his health. Studies have displayed great effectiveness with the use of bariatric surgery in addition to physical exercise and dietary intervention in the management of obesity and associated comorbidities.

 

 

References

Jakobsen, G. S., Småstuen, M. C., Sandbu, R., Nordstrand, N., Hofsø, D., Lindberg, M., … & Hjelmesæth, J. (2018). Association of bariatric surgery vs medical obesity treatment with long-term medical complications and obesity-related comorbidities. Jama319(3), 291-301. doi:10.1001/jama.2017.21055

Lin, T. Y., Liu, J. S., & Hung, S. C. (2018). Obesity and risk of end-stage renal disease in patients with chronic kidney disease: a cohort study. The American Journal of Clinical Nutrition108(5), 1145-1153. DOI: 

Ryan, D. H., & Kahan, S. (2018). Guideline recommendations for obesity management. Medical Clinics102(1), 49-63.

Veroux, M., Mattone, E., Cavallo, M., Gioco, R., Corona, D., Volpicelli, A., & Veroux, P. (2021). Obesity and bariatric surgery in kidney transplantation: A clinical review. World Journal of Diabetes12(9), 1563. DOI: 

 

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