Directions: Read the case study below. Evaluate the information and formulate a
conclusion based on your evaluation. Complete the critical thinking table and submit this
completed template to the assignment dropbox.
Case Study: Mr. D.
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. D., presented below.
Health History and Medical Information
Mr. D. is a 65-year-old male nonadherence diabetic with end-stage renal disease receiving
dialysis. He is a retired certified public accountant in the last 5 years and practices the Muslim
faith. He reports that he avoids all pork products. His complaints included decreased balance,
loss of sensation, fear of falling, and decreased endurance during activities of daily living due to
the effects of dialysis treatment. Patient’s previous medical evaluation includes end stage renal
disease (ESRD) on dialysis and referral for recommendations for initiating exercise program.
Patient comorbidities include obesity with a body mass index (BMI) of 45, type II diabetes
mellitus with long-term insulin use, hypertension, sleep apnea, depression with lack of family
support and understanding, and diabetic neuropathy. Patient denies suicidal ideation but does
report feelings of loneliness and helplessness. Mr. D. reports increasing shortness of breath with
activity, swollen ankles, and pruritus over the last 6 months.
Objective Data:
1. Height: 68 inches; weight 134.5 kg
2. BP: 140/94, HR 84, RR 22
3. 2+ pitting edema bilateral feet and ankles
4. Fasting blood glucose: 146 mg/dL
5. Total cholesterol: 250 mg/dL
6. Triglycerides: 312 mg/dL
7. HDL: 30 mg/dL
8. Serum creatinine 1.8 mg/dL
9. BUN 32 mg/dl
10. GRF (glomerular filtration rate)-13mL/min