Please write a paragraph responding to the discussion bellow. Add citations and references in alphabetical order.

Mr. C. is a young, single man suffering from morbid obesity and its health consequences, including cardiovascular disease, hyperlipidemia, metabolic syndrome, sleep apnea, peptic ulcer disease, and elevated fasting glucose. Mr. C. has struggled with obesity since childhood and his present BMI of 45 ( > 40 BMI = morbid obesity) is indicative of familial predisposition, poor dietary habits, lack of exercise, and a sedentary lifestyle.

Upon physical examination and interpretation of laboratory results, Mr. C. presents with hypertension and tachypnea, and while he states other medical evaluations have not indicated metabolic syndrome, he meets all the criteria. Mr. C.’s fasting glucose is elevated (normal values 100-125), his total cholesterol is 250mg/dl (>240 mg/dl is high), his triglyceride level is elevated (<150mg/dl = normal), his HDL is low (<40 = risk for heart disease), and his blood pressure is elevated according to Copstead and Banasik, (2013).

Findings regarding Mr. C.’s functional health patterns include a poor health perception and ineffective health maintenance as evidenced by his obesity, lab values, and sedentary lifestyle. His nutritional metabolic pattern reveals imbalanced nutrition (more than body requirements) and its consequences with the resulting hyperlipidemia, poor glycemic control, and peptic ulcer disease from a diet high in carbohydrates and saturated fat. Mr. C.’s elimination pattern would indicate constipation due to his sedentary job and general lifestyle. His activity exercise pattern shows activity intolerance and fatigue due to his morbid obesity and sedentary lifestyle. His sleep rest pattern includes insomnia and sleep deprivation from sleep apnea again due to his morbid obesity. His cognitive perceptual pattern shows unilateral neglect of self. His self-perception-self-concept pattern reveals chronic low self-esteem and disturbed body image evidenced by his desire for bariatric surgery. Mr. C. must suffer from impaired social interaction due to his single status and obesity. His sexuality-reproductive pattern is ineffective due again to his morbid obesity. Mr. C.’s coping-stress tolerance pattern reveals defensive coping through habits of over eating. No information is provided regarding his value-belief pattern.

A therapeutic and acceptable medication schedule will help Mr. C. develop healthy health maintenance routines.

6 a.m. Sucralfate suspension

10 a.m. Mylanta 15 ml po

11 a.m. Sucralfate suspension

3 p.m. Mylanta 15 ml po

5 p.m. Sucralfate suspension

9 p.m. Mylanta, Ranitidine, and Sucralfate

Mr. C. should plan to set his cell phone for the above times for success with this schedule.

Mr. C. is interested in bariatric surgery. This surgical procedure will assist him in his long-term weight loss goal and decrease his risks associated with diabetes, hypertension, and sleep apnea. While Mr. C. is at risk for undergoing anesthesia due to his morbid obesity, “subtotal gastrectomy with Billroth II anastomosis (SGBIIA) is still recommended in targeting peptic ulcer disease” (Chen, Hsu, Lin, Chou & Jeng, 2016). Studies showed this procedure lowered patients’ diabetes risk along with the comorbidities of hypertension, hyperlipidemia and coronary artery disease. Mr. C. will need close dietary counseling and evaluation to ensure optimal nutrition and to avoid overeating which could cause surgical complications.

Chen, C.-H., Hsu, C.-M., Lin, C.-L., Chou, A.-K., & Jeng, L.-B. (2016). The Development of Diabetes after Subtotal Gastrectomy with Billroth II Anastomosis for Peptic Ulcer Disease. PLoS ONE, (11). https://doi-org.lopes.idm.oclc.org/10.1371/journal...