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Case Study: Mr. C.

Case Study: Mr. C.

Sample Answer 

Case Study: Mr. C.

Bariatric Surgery

According to the guidelines provided by the Centers for Disease Control (CDC), a Body Mass Index (BMI) of 30 or higher classifies a patient as obese (2016). According to the vital signs taken from Mr. C, his weight is 134.5 kg, and his height is 68 inches, which implies that his BMI is 45.1, thereby qualifying him as severely obese. Obesity might come with complications such as type 2 diabetes, high blood pressure, coronary heart disease, stroke, metabolic syndrome, high cholesterol, sleep apnea, gallstones, cancer, reproductive problems, and osteoarthritis, among other complications (NHI, 2012). According to the signs reported from Mr. C, he is suffering from high blood pressure, as presented by his BP of 172/98, sleep apnea, and possible type 2 diabetes, as indicated by a Fasting Blood Glucose of 146 mg/dL. To be considered healthy, his total cholesterol should be below 200mg/dL. However, his total cholesterol is at a high of 250 mg/dL. Finally, his HDL of 30mg/dL should be more than 60mg/dL.

During his assessment with the nurse, Mr. C reports that he has always been heavy, even as a small child, but recently gained about 100 pounds in the recent few years. According to Skinner (2014), about a third of children in the United States are overweight or otherwise obese, which exposes them to the risk of many chronic diseases, including cardiovascular diseases, type 2 diabetes, and depression. If Mr. C tests negative for peptic ulcers and other related conditions upon diagnosis, I recommend that he be appropriate for bariatric surgery since the symptoms are overwhelming. Controlling these issues should include the following:

  1. Give Mylanta at 9 am, 2 pm, and 8 pm,
  2. Zantac at 9 pm, and
  3. Sucralfate at 6 am, 10 am, 4 pm, and 10 pm

Functional Health Patterns

The functional health patterns can undergo substantial changes when a person shifts on the illness/health spectrum. According to the case study, Mr. C’s health perception is that he has always been overweight since childhood. However, with the increase in weight, he might be experiencing more complications by the day, thereby instigating him to seek medical attention. Nevertheless, the case study does not provide much information about his health management other than his possible low-sodium diet. It could be possible that the patient is unaware of the amount of salt in pre-packaged food and is also not adding additional salt to his food. We only know that he works in an office but are unaware of the patient taking part in any other physical exercises, which predisposes him to type 2 diabetes.

However, setting times for meals for the patient would work to the advantage of his treatment. Obesity also predisposes a patient to metabolic syndrome. His elimination patterns are unknown to us, but his high FBS could prompt a check on his kidney functions. Working at a sedentary office without physical exercise puts the patient at a high risk of heart problems and obesity. Sleep apnea also alters his sleep-rest patterns. Therefore, the patient should be using a bi-pap or c-pap at night.

The best thing is that the patient has come to a self-realization that he needs to watch his weight and approach the medical facility of free will. Mr. C needs support to separate his past from the present since he reports that he has been overweight since he was a child. If not handled properly at the health facility, this could lead to poor self-concept and serious self-esteem issues. A positive role model should be introduced to help the patient to interact properly in his relationships, sexuality, and positive coping mechanisms.

The following problems should be considered when evaluating the patient:

  1. The surgery should not be performed before addressing issues of peptic ulcers to be sure that the area is not compromised
  2. The patient should be tested for A1c to address his blood sugar and confirm his diabetes status. High blood sugar after the surgery would expose the patient to a high risk of infections. Therefore, prescribe a strict diet for the patient before and after the surgery to keep the blood sugar level as low as possible
  3. Address the high blood pressure as presented by the vital signs. Identify the medications the patient is currently taking and see if adjustments are needed. Checking blood pressure is important in managing any bleeding after the surgery
  4. Address nutritional needs. The patient needs a strict diet to control his BP. Since the diet for bariatric surgery is so strict, it is very significant to evaluate compliance with the diet, including the use of alcohol and drugs.
  5. Finally, conduct interviews and counseling sessions with the patient. A good surgeon would turn away a patient if he assesses that the patient has poor intentions. It is important to ascertain why our patient has opted to undergo surgery and the reason he has significantly added weight over the previous 2-3 years. Additionally, it is important to get the patient’s history relating to previous attempts to lose weight and his ability to understand and follow the extent and the rules of the surgery.


Skinner, J.A. Skelton. (2014). Prevalence and trends in obesity and severe obesity among children in the United States, 1999–2012. JAMA Pediatr, pp. 561–566.

NIH. (2012, July 13). What Are the Health Risks of Overweight and Obesity? – NHLBI, NIH. Retrieved October 7, 2019, from

Defining Adult Overweight and Obesity. (2016, June 16). Retrieved October 7, 2019, from


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Case Study: Mr. C.

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mr. C., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mr. C., a 32-year-old single male, 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.

Case Study - Mr. C.

Case Study – Mr. C.

Objective Data:

Height: 68 inches; weight 134.5 kg
BP: 172/98, HR 88, RR 26
3+ pitting edema bilateral feet and ankles
Fasting blood glucose: 146 mg/dL
Total cholesterol: 250 mg/dL
Triglycerides: 312 mg/dL
HDL: 30 mg/dL
Serum creatinine 1.8 mg/dL
BUN 32 mg/dl

Critical Thinking Essay

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

Describe the clinical manifestations present in Mr. C.
Describe the potential health risks for obesity that are of concern for Mr. C. Discuss whether bariatric surgery is an appropriate intervention.
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.)
Explain the staging of end-stage renal disease (ESRD) and contributing factors to consider.
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.
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.

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.

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