Mr. C is 32 years old, he is 68 in and 299 lbs.

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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