The case scenario provided will be used to answer the discussion questions that follow.

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.)
2. What actual or potential problems can you identify? Describe at least five problems and provide the rationale for each.

 

Collaborative Learning Community assignment.  Explore Spirituality according to the faith belief assigned.  Prepare in slide presentation 5 – 7 slides.  Presentations are to be posted under the main forum entitled CLC – Exploring Spirituality.

Group 1- Baha’i

Group 2 – Jehovah Witness

Group 3 – Sikhism

Group 4- Agnosticism

Group 5 – Islam

Group 6 – Mormonism

Create a 5-7 slide presentation with speaker notes that focuses on views of evil and suffering from the assigned religions per your group.

After researching information on your assigned religion, address the following:

1. Describe the view of suffering (source and cause of suffering and solution).
2. Explain grieving process.
3. Identify approaches to dealing with grief (solution to deal with suffering).

Include a comparison of assigned religion to Christianity. How does your assigned religion differ from Christianity?

Support your position by referencing at least three to five academic resources (preferably from the GCU Library) in addition to the Bible and the textbook. Incorporate the research into your writing in an appropriate, scholarly manner.

Select one team member to post the presentation to the “Exploring Spirituality” thread in the Main Forum. Respond to at least one other presentation.

While APA format is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

 

You are admitting a 19-year old female college student to the hospital for fevers.  Using the patient information provided, choose a culture unfamiliar to you and describe what would be important to remember while you interview this patient. Discuss the health care support systems available in your community(maryland) for someone of this culture. If no support systems are available in your community, identify a national resource.

Abdominal bloating can be the result of many different ailments. Several questions can help the provider find the cause of the symptoms. The first question you can ask is when did she notice the bloating? This will help give some direction of how long the complaint has been going on and what may have caused it. If there is any associated pain and if so when was the onset, duration, frequency and relationship can help eliminate causes and questions such as: Does it get better or worse when you eat certain foods? Does movement or rest alleviate symptoms? Where is the bloating feeling exactly? Location can provide clue regarding the mechanism of the bloating. Has she has had any nausea or vomiting? Although the patient has passed gas, this writer would ask when was the last bowel movement because the patient could also be constipated. 

The physical examinations should include vitals and assessment of the abdomen (inspection, auscultation, percussion, and palpation). Included in the physical exam of this visit will be an oral exam making sure to thoroughly exam the teeth and the mucosa for sores, noting the teeth and mucosal colors. A musculoskeletal exam would also be performed noting any muscle weakness, fatigue, joint pain, numbness or tingling. Generalized skin exam noting skin color, lesions, or rashes. Neurological examination for headaches, migraines, or confusion. Psychosocial for any anxiety or depression. Social habits for any drug or alcohol abuse. There are tons of differential diagnoses that comes along with abdominal pain since this area can reciprocate pain from other areas in the body. Differential diagnosis can include constipation, bowel obstruction, Chrons, food allergies, enteritis, irritable bowel syndrome or celiac disease.

Test should be ordered and performed along the history and physical to help assist diagnosing. A complete blood count, serum chemistries, liver function tests, urinalysis, pregnancy test, and abdominal films will help determine the acuity of the problem (Dunphy, Winland-Brown, Porter, & Thomas, 2015). Antibody levels that are elevated indicate an immune reaction to gluten. Genetic testing could also be an option, and might include antigens that are used to rule out celiac (Bascunan, Vespa & Araya, 2017). A kidney, utter, and bladder (KUB) x-ray may also be ordered to asses organs, structures, causes of the bloating. Further testing may include endoscopes and possible biopsy to rule out other gastrointestinal (GI) conditions. 

The main thing about managing any disease is diet, education, and pharmacological and nonpharmacological interventions. This is most true for IBS. If gluten is the issue, the patient must have a strict diet that includes avoiding wheat, barley, rye, malt, and more. Education is key. In doing so, this promotes decreased inflammation and intestinal healing (Mayo Clinic, 2018). Crohn’s disease can also be treated with latter. It is mostly treated with immunosuppressant drugs. Medical follow-up is also necessary to ensure a healthy body response to the new changes. If unresponsive to this surgical interventions are required. 

References

Bascuñán, K., Vespa, M. & Araya, M. (2017). Celiac disease: Understanding the gluten-free diet. European 

Journal of Nutrition, 56(2), 449–459. doi: https://doi-org.wgu.idm.oclc.org/10.1007/s00394-016-1238-5.

Dunphy, L., Brown, J., Porter, B., Thomas, D. (2015). Primary Care: The Art and Science of Advanced 

Practice Nursing. Philadelphia: F.A. Davis Company.

Mayo Clinic (2018). Celiac Disease. Retrieved from https://www.mayoclinic.org/diseases-conditions/celiac- (Links to an external site.)Links to an external site.

disease/diagnosis-treatment/drc-20352225 (Links to an external site.)Links to an external site..

     

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Some believe that MCOs are best at managing a patient’s wellness and supporting preventive and early detection services.

Explain the benefit to a third-party payer of this approach over a program such as major medical that only gets involved when the patient has a major illness (hospitalization).

Be specific. 

Discussion board 

250 word count minimum, 

please use APA format, in text citations, include references

Please include two additional post 50 words minimum.