Mr. C is 32 years old, he is 68 in and 299 lbs. and his BMI is 44.44. He is obese, has a sedentary job, and has high blood, high blood pressure, hyperlipidemia, diabetes, peptic ulcer disease, and sleep apnea. He is at risk for poor wound healing, DVT, stroke, and heart attack. He may be a candidate for bariatric surgery because of BMI greater than 35, and he has comorbidities, but he is not necessarily appropriate for surgery. He needs to be motivated to make lifestyle changes, eat smaller portions, eat a heart healthy diet,use a CPAP machine for sleep apnea. Sleep apnea can cause hypertension, and lead to stroke. Mr. C started gaining weight back a couple of years ago. There is an extensive screening process to qualify for bariatric surgery. We need to get a history from the patient about underlying reasons for weight gain, diet history, eating habits, activity, exercise habits, medical history such as diabetes, heart disease, peptic ulcer disease and sleep apnea. Psychological status is important such as anxiety, binge eating, Patients motivation must be assessed such as ability and willingness to follow through recommendations in diet and exercise. Compliance with medications for blood pressure and diabetes, and use of c-pap machine. Age is also a factor in getting to be a candidate. Risks increase of surgery increases with age (The Big Gastric Bypass Diet Guide, 2016). Mr. C needs to take medication to heal his stomach ulcer. Mylanta should be given at 10 am, again at 3 pm, and 9pm. Zantac should be taken at 9 pm, and Carafate should be given at 6 am, 11 am, 5pm and 9pm. The five problems I have identified is health maintenance and management as he mentions he has gained 100 lbs. in 2-3 years, may not be seeing physician regularly, and feels that he should look at surgery first and mentions he has tried a low sodium diet. Nutritional because he has a high cholesterol, triglycerides, and diabetes. Activity and exercise, judging by his occupation of catalog telephone center, his job is sedentary. Sleep apnea interrupts sleep and rest. Coping and Stress tolerance, Mr. C has a peptic ulcer that may be indicative of stress. Bariatric surgery is not a quick fix and will require an even more compliance than what most people think.
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