Managing Morbid Obesity And Sleep Apnea In 52-Year-Old Peter Mitchell

The Importance of Clinical Reasoning in Identifying and Prioritizing Health Concerns

Discuss About The Morbid Obesity Rates Continue Rise Rapidly.

The capability to critically think is imperative in the nursing practice. It ensures a patient’s personal and clinical needs are fulfilled hence the provision of medical care is appropriate and efficient. Additionally, clinical reasoning will be paramount in identifying and prioritizing health concerns regarding 52-year-old Peter Mitchell. Two care priorities will be put forth and critically examined to help the patient lead a better life. A primary health care nurse will utilize his medical history to be able to provide the relevant care he requires. Type 2 Diabetes is a chronic disease which manifests itself either when the body fails to make an effective or actual use of the insulin which it produces or when the pancreas fails to produce sufficient insulin. This paper seeks to identify and prioritize complications and medical concerns regarding 52-year-old Peter Mitchell. Two care priorities will be acknowledged and extensively examined by a primary healthcare nurse to help this young patient manage living with this condition.

Clinical reasoning is an important way of making health decisions. It is largely used by healthcare professionals when dealing with patients who have chronic illnesses such as Peter Mitchell. Clinical reasoning, therefore, facilitates systematic problem solving which enables medical practitioners to better assess, create and implement the most relevant care for patients (Kassirer, 2010). In the nursing practice, most medical resolutions are complex and rely on many factors. Consequently, it is necessary for healthcare professionals to depend on a standard decision-making tool (Simmons, 2010).  The utilization of a clinical reasoning cycle enables creative thinking in formulating clinical management plans for patients.

Morbid obesity is a severe health condition which interferes with the basic physical functions of the body, for instance, walking or breathing. People who have morbid obesity like Peter Mitchell have a higher risk of getting other ailments such as sleep apnea, gastroesophageal reflux condition, heart disease, cancer, osteoarthritis, gallstones or diabetes (Sturm and Hattori, 2013). Health conditions related to obesity lower life expectancy. Normally, obese individuals are resistant to insulin that is paramount in regulating blood sugar (D’Hondt, 2011). Consequently, they end up getting more blood sugar hence resulting to the type 2 diabetes which is quite chronic.

Weight loss is one of Peter Mitchell’s care priorities. The primary health-care nurse will aid him loose weight hence controls morbid obesity and subsequently the type 2 diabetes (Chatterjee, Khunti and Davies, 2017). In addition, this is because these adverse medical conditions are greatly interfering with his quality of life. Furthermore, he has developed fatigue hence is unable to work due to his weight. The implementation of this care priority will make Peter stop feeling socially isolated.

Two Care Priorities for Peter Mitchell

The primary health-care nurse ought to provide Peter with patient education on how to handle his weight issue. Peter should be encouraged to continue with the high protein and low energy diet. Additionally, Peter should start eating a low carb diet as it has several advantages. A low carb diet makes people eat less food and they also have fewer calories (Pontiroli and Morabito, 2011). Generally, individuals on this diet burn 300 more calories daily when resting. Another benefit is that it reduces one’s hunger significantly hence makes it easier for a person to consume less food. Peter can also be enlightened to only eat when he is hungry.

Peter is supposed to cut on meals that have a lot of starches and sugars. Additionally, this reduces hunger levels hence the consumption of fewer calories. Another advantage is that reducing starches and sugars also leads to a decline in insulin in the body making the kidneys to shed additional water and sodium. Furthermore, it leads to a reduction in bloat and excessive water weight hence losing weight (Lee, 2012). Peter Mitchell ought to eat vegetables, fat, and protein frequently. Maintaining such a diet automatically controls the intake of carbs. High protein consumption boosts metabolism, lessen cravings and moderate the thoughts about food hence declining the desire for snacks that might cause weight increase.

The primary health-care nurse should help Peter to develop a daily exercise routine to aid in mitigating morbid obesity. This can be implemented through running, jogging, swimming, cycling or walking. Continuous exercise assists in burning calories hence preventing body metabolism from diminishing (Morgan et al, 2010). Most health professionals recommend a minimum of 150 minutes of moderate aerobic exercise in a week or seventy-five minutes of intense aerobic activity. Therefore, Peter Mitchell needs approximately 200 minutes in a week of average physical activity to efficiently lose weight.

Consuming whole unprocessed foods is essential since they are more filling, healthier and cause less overeating. Studies reveal that drinking water thirty minutes before meals is fundamental in managing morbid obesity. Eating food slowly makes a person fuller and stimulates weight-reducing hormones. The consumption of soluble fiber reduces fat precisely in the belly region (Dann and Guterman, 2010). Having adequate sleep is useful in reducing both weight and sleep apnea. Moreover, insufficient sleep results in weight gain.

Physical exercise is necessary for people who have type 2diabetes for a number of reasons.  First, physical exercise makes body cells to be insulin sensitive hence reducing glucose in the blood. Therefore, this lowers sugar levels and significantly provides energy since glucose is transferred to body cells (Blomberg and Källén, 2010). Consequently, daily exercise helps achieve this but additional benefit results when the physical activity aids build muscles. It is imperative to have daily exercise because the advantage of physical exercise on blood sugar last for approximately 48 to 72 hours.

Recommendations for Weight Loss and Management of Morbid Obesity

The primary health-care nurse should utilize clinical reasoning and conduct an evaluation to know if Peter’s health conditions are improving. The nurse ought to assess if Peter’s depression has declined. Typically, obese individuals must deal with frequent depressing emotional issues such as disapproval from friends and family, failed diets and negative remarks from people. Moreover, the nurse should investigate if Peter has overcome the feeling of discrimination by being more comfortable in public places.

Another care priority of Peter care is sleep apnea. Conventionally, the diagnosis of this condition is usually scary, however, it is a manageable and treatable condition. Sleep apnea is a complex health disorder that results when an individual’s breathing is interfered with during sleep. Sometimes the whole body more so the brain is greatly affected as it does not get enough oxygen. In case it is not properly handled it can cause diverse health issues, for example, depression, headaches, blood pressure, diabetes, uneven heartbeats and heart failure.

The primary health-care nurse can advise on various things that can help Peter specifically to moderate the situation. Lifestyle modifications and home remedies will greatly help. Losing weight is one of the key issues that the patient should consider and implement effectively. Traditionally, individuals who are overweight have an extra tissue in the throat that falls frequently over their airway hence blocking air flow into lungs when they are asleep (Gottlieb, 2010) Any significant weight loss by Peter will largely aid in mitigating sleep apnea.

It is the role of the primary health-care nurse to encourage, advice, or counsel Peter to reduce or quit completely smoking. Smoking leads to sleep apnea because it increases fluid retention and inflammation in the upper airway and throat. Another remedy useful is advice on reducing the usage of sedatives, sleeping pills, and alcohol, particularly before bedtime. Likewise, this is because these substances make the throat muscles to relax therefore interfering with breathing (Redline, 2010). Developing a constant routine of physical exercise is essential. Daily exercise is important in influencing the duration of sleep, therefore, improving the quality of sleep. Aerobic training and yoga are effective in strengthening the muscles in Peter’s airways. Consequently, this improves breathing hence reduces the intensity of sleep apnea.

The primary health-care nurse ought to ensure that Peter steers clear taking heavy meals and caffeine two hours prior to bedtime. In the same token, he should maintain a regular sleeping schedule. It is important to note that adapting a steady sleep routine aid in relaxation hence better sleep (Dann & Guterman, 2010). Sleep apneas occurrences will also decline significantly if Peter gets plenty sleep every day.

The Role of Primary Health Nurses in Providing Relevant Care

The primary health-care nurse can edify Peter on some diverse bedtime tips which are vital in evading sleep apnea. The nurse should tell Peter to sleep on his side. Typically, some individuals only have sleep apnea when they sleep on their back (Cushman et al, 2010). In case Peter sleeps on his back, it increases the possibility of soft tissues and tongue obstructing his airway. Furthermore, as Peter sleeps he should prop his head up. Elevating the head of his bed or his body by using a special pillow is quite important in fighting the disease. Moreover, he ought to open up his nasal passages more so at night. He can achieve this by using a saline spray, nasal irrigation, nasal dilator or breathing strips. Alternatively, he can tighten the muscles which make his mouth closed by chewing gum. Subsequently, singing is imperative as it increases muscle control, especially in the soft plate and throat hence decreasing sleep apnea and snoring that is caused by the lax muscles (Tufik et al, 2010). Tongue and throat exercises are also essential in strengthening his throat and soft plate.

Evaluation should be done to determine the appropriateness and implementation of the proposed remedies (Chatterjee, Khunti & Davies, 2017). The nurse should assess if Peter’s health is improving. Daily moderate aerobic activities, for example, swimming or brisk walking ought to be analyzed if they are helpful. Furthermore, Peter’s exercise sessions should be examined if they consume at least ten minutes. This is the easiest way to help Mitchell start slowly and increase gradually the length of his exercise session.

In conclusion, several factors contribute to the care that patients receive from their primary health care nurses more so those with chronic situations. Prioritizing patient necessities is important in improving their health. It is chief to control morbid obesity and sleep apnea because it makes Peter Mitchell be at a higher risk of developing other conditions, for instance, heart conditions and blood pressure.  Clinical reasoning is an important way of making health decisions. It is largely used by healthcare professionals when dealing with patients who have chronic illnesses such as Peter Mitchell. Clinical reasoning, therefore, facilitates systematic problem solving which enables medical practitioners to better assess, create and implement the most relevant care for patients. It is, therefore, important to note that the nurses have to critically think to help patients such as those suffering type 2diabetes to live well with the disease.

Recommendations for Sleep Apnea Management

References

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