course material

1. Surgery Risk Factors Discussion
Surgery Risk Factors DiscussionSurgery Risk Factors DiscussionMr. C is a young gentleman
that has various medical problems. He is wishing to have bariatric surgery. At this time he
does not qualify for bariatric surgery. He has uncontrolled hypertension, which makes him a
risk for stroke, heart attack or death. He also has peptic ulcer disease, which makes him a
risk for bleeding and infection. He also has high cholesterol which increases his risk for
stroke and heart attack. Diet changes and possibly medication are needed to decrease his
cholesterol. He needs to become more stable prior to his surgery. He needs to start an
exercise routine, and change his diet to prepare his body for the drastic food intake changes.
He needs blood pressure medication started. He also has sleep apnea, and prior to bariatric
surgeries MD’s have you do a sleep study test to address and treat any sleep apnea (Pories,
2008).The above are his risk factors that need to be addressed prior to surgery.Functional
Health PatternsHis functional health patterns are not able to be holistically addressed
relating a lack of information in the patient history profile.Health-perception including
health management: health perception is that the patient is wanting to make life style
changes by seeking bariatric surgeryNutritional-metabolic: the patient has excess calories
per energy expenditure as noted by obesity. He also has high cholesterol levels. He has
peptic ulcer disease which would affect his nutritional status.Elimination: not addressed
Surgery Risk Factors DiscussionActivity-exercise: sedentary lifestyle with sit down
jobSleep-rest: sleep is disturbed, unrestful and his body is not getting oxygenated
appropriately relating sleep apneaCognitive-Perception: cognitive and perception is not
addressed. He is employable.Self-perception-self -concept and role relationship: this area is
not addressed in the profile other than being a single male.Sexuality-reproduction: his
sexuality was not addressedCoping-stress intolerance: his coping and stress tolerance has
not been addressed.Actual Problems and Rationale1- Disturbed sleep pattern as
evidenced by sleep apnea2- Knowledge deficit relating healthy lifestyle3- Alteration in
comfort relating peptic ulcer disease4- Alteration in cardiac output relating uncontrolled
hypertension5- Alteration in nutrition relating hypercholesterolemia and elevated blood
sugars(Ackley & Ladwig, 2011)Rationale: Patient has sleep apnea, which means he stops
breathing many times during the night. Sleep apnea increases your risk for stroke and heart
attack and causes weight gain. Sleep apnea causes decreased energy during the
day.Rationale: Patient is controlling his hypertension with a low sodium diet, and his blood
pressure is uncontrolled and is elevated. He is not caring for his high blood pressure in a
safe way. He has a sedentary lifestyle, which increases his chance for medical problems

2. including cancer and heart problems. It increases obesity.Rationale: He has been diagnosed
with peptic ulcer disease which is uncomfortable relating pain, nausea food intolerance
etc.Rationale: He has uncontrolled hypertension which effects his cardiac output.
Hypertension increases his risk for stroke and heart attackRationale: His good cholesterol
HDL is low at 30. His triglycerides are high at 312. His total cholesterol is 250 which is
elevated. This puts him at risk for strokes and heart attacks. He should be on a low
cholesterol diet. He also has elevated blood sugars. His fasting blood sugar is 146. It should
be between 70-100.Potential ProblemsPotential for heart attack and stroke relating
hypercholesterolemia, sleep apnea and uncontrolled blood pressurePotential for bleeding
relating peptic ulcer disease and uncontrolled blood pressure Surgery Risk Factors
DiscussionPotential for malabsorption symptoms relating peptic ulcer diseaseMedication
ScheduleCarafate 1gm 6amMylanta 15cc 10amCarafate 1gm 11amMylanta 15cc
3pmMylanta 15cc 9pmCarafate 1gm 9pmCarafate 1gm 10pmZantac 300mg 10pmMylanta
15cc 10pmReferencesAckley, B. & Ladwig, G. (2011). Nursing diagnosis handbook: An
evidence based guide to planning care (9th edition). St. Louis: Mosby, ElsevierPories, W. J.
(2008). Bariatric Surgery: Risks and Rewards. The Journal of Clinical Endocrinology and
Metabolism, 93(11 Suppl 1), S89–S96. http://doi.org/10.1210/jc.2008-1641ORDER NOW
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