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 sleep apnea and
high blood pressure, which he tries to control with sodium restriction. He current works at
a catalog telephone center.
Objective Data
1. Height: 68 inches; Weight 134.5 kg
2. BP: 172/96, HR 88, RR 26
3. Fasting Blood Glucose: 146/mg/dL
4. Total Cholesterol: 250mg/dL
5. Triglycerides: 312 mg/dL
6. HDL: 30 mg/dL
Critical Thinking Questions
What health risks associated with obesity does Mr. C. have? Is bariatric surgery an
appropriate intervention? Why or why not?
Mr. C. has been diagnosed with peptic ulcer disease and the following medications have
been ordered:
1. Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL PO 1 hour before
bedtime and 3 hours after mealtime and at bedtime.
2. Ranitidine (Zantac) 300 mg PO at bedtime.
3. 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.
1. 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.)
This study source was downloaded by 100000847426977 from CourseHero.com on 06-03-2022 07:53:08 GMT -05:00
https://www.coursehero.com/file/17842242/DB-week-5-patho/
, 2. What actual or potential problems can you identify? Describe at least five problems
and provide the rationale for each.
Some health risks associated with Mr. C’s obesity are increased BP (hypertension), sleep apnea,
elevated cholesterol, elevated triglycerides and possible start of diabetes (due to increase glucose
levels) (Lewis, 2011). Mr. C needs to lose weight or he will be a diabetic and have
cardiovascular disease. It is clear that with the glucose levels being what they are, he is already
pre-diabetic already. Mr. C needs to lose weight to prevent himself from becoming diabetic and
to decrease his hypertension. Mr. C would benefit from have bariatric surgery, since his is
already morbidly obese. If he were to lose weight, he could decrease his chance from becoming a
diabetic and or having possible heart attack. There is a high reduction in mortality rates with
bariatric surgery. There is a significant improvement in those diseases that are caused or
worsened by obesity, including: blood pressure, diabetes, and heart disease, and stroke (ASMBS,
2016). There is still a need for Mr. C to undergo some counseling to help change his lifestyle.
Mr. C has gained 100 pounds within 2-3 years; there is clearly a need to educate Mr. C on good
eating habits and better lifestyle choices.
Mr. C’s medication schedule should be as follows:
6:00am – Sucralfate/Carafate
7:00am – Breakfast
10:30am – Mylanta and Suralfate/Carafate
12:00pm – Lunck
3:00pm – Mylanta
5:00pm – Sucralfate/Carafate
6:00pm – Dinner
9:00pm – Mylanta and Sucralfate/Carafate
10:00pm – Snack
11:30pm – Bedtime – Zantac, Mylanta, and Sucralfate/Carafate
When assessing Mr. C’s functional health patterns, it is important to look at the following:
Health – Pereption – Health – Management: It is very clear that Mr. C is at risk for serious
diseases. Mr. C needs to be educated on a good/healthy diet. I believe that Mr. C would benefit
from counseling to help him with better lifestyle choices.
This study source was downloaded by 100000847426977 from CourseHero.com on 06-03-2022 07:53:08 GMT -05:00
https://www.coursehero.com/file/17842242/DB-week-5-patho/
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 sleep apnea and
high blood pressure, which he tries to control with sodium restriction. He current works at
a catalog telephone center.
Objective Data
1. Height: 68 inches; Weight 134.5 kg
2. BP: 172/96, HR 88, RR 26
3. Fasting Blood Glucose: 146/mg/dL
4. Total Cholesterol: 250mg/dL
5. Triglycerides: 312 mg/dL
6. HDL: 30 mg/dL
Critical Thinking Questions
What health risks associated with obesity does Mr. C. have? Is bariatric surgery an
appropriate intervention? Why or why not?
Mr. C. has been diagnosed with peptic ulcer disease and the following medications have
been ordered:
1. Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL PO 1 hour before
bedtime and 3 hours after mealtime and at bedtime.
2. Ranitidine (Zantac) 300 mg PO at bedtime.
3. 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.
1. 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.)
This study source was downloaded by 100000847426977 from CourseHero.com on 06-03-2022 07:53:08 GMT -05:00
https://www.coursehero.com/file/17842242/DB-week-5-patho/
, 2. What actual or potential problems can you identify? Describe at least five problems
and provide the rationale for each.
Some health risks associated with Mr. C’s obesity are increased BP (hypertension), sleep apnea,
elevated cholesterol, elevated triglycerides and possible start of diabetes (due to increase glucose
levels) (Lewis, 2011). Mr. C needs to lose weight or he will be a diabetic and have
cardiovascular disease. It is clear that with the glucose levels being what they are, he is already
pre-diabetic already. Mr. C needs to lose weight to prevent himself from becoming diabetic and
to decrease his hypertension. Mr. C would benefit from have bariatric surgery, since his is
already morbidly obese. If he were to lose weight, he could decrease his chance from becoming a
diabetic and or having possible heart attack. There is a high reduction in mortality rates with
bariatric surgery. There is a significant improvement in those diseases that are caused or
worsened by obesity, including: blood pressure, diabetes, and heart disease, and stroke (ASMBS,
2016). There is still a need for Mr. C to undergo some counseling to help change his lifestyle.
Mr. C has gained 100 pounds within 2-3 years; there is clearly a need to educate Mr. C on good
eating habits and better lifestyle choices.
Mr. C’s medication schedule should be as follows:
6:00am – Sucralfate/Carafate
7:00am – Breakfast
10:30am – Mylanta and Suralfate/Carafate
12:00pm – Lunck
3:00pm – Mylanta
5:00pm – Sucralfate/Carafate
6:00pm – Dinner
9:00pm – Mylanta and Sucralfate/Carafate
10:00pm – Snack
11:30pm – Bedtime – Zantac, Mylanta, and Sucralfate/Carafate
When assessing Mr. C’s functional health patterns, it is important to look at the following:
Health – Pereption – Health – Management: It is very clear that Mr. C is at risk for serious
diseases. Mr. C needs to be educated on a good/healthy diet. I believe that Mr. C would benefit
from counseling to help him with better lifestyle choices.
This study source was downloaded by 100000847426977 from CourseHero.com on 06-03-2022 07:53:08 GMT -05:00
https://www.coursehero.com/file/17842242/DB-week-5-patho/
