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Original Question
Read the Health History and Medical Information of Mr. D. and in your own words, Discuss at least five actual or potential problems you can identify from the “Functional Health Patterns Assessment Guide,” listed below. Provide a rationale for each of the 5 potential problems using the information given. Use in-text citation and one reference within the past 5 years (2020-2025). Health History and Medical Information Mr. D. is a 65-year-old male non-adherence diabetic with end-stage renal disease receiving dialysis. He is a retired certified public accountant in the last 5 years and practices the Muslim faith. He reports that he avoids all pork products. His complaints included decreased balance, loss of sensation, fear of falling, and decreased endurance during activities of daily living due to the effects of dialysis treatment. Patient’s previous medical evaluation includes end stage renal disease (ESRD) on dialysis and referral for recommendations for initiating exercise program. Patient comorbidities include obesity with a body mass index (BMI) of 45, type II diabetes mellitus with long-term insulin use, hypertension, sleep apnea, depression with lack of family support and understanding, and diabetic neuropathy. Patient denies suicidal ideation but does report feelings of loneliness and helplessness. Mr. D. reports increasing shortness of breath with activity, swollen ankles, and pruritus over the last 6 months. Objective Data: Height: 68 inches; weight 134.5 kg BP: 140/94, HR 84, RR 22 2+ pitting edema bilateral feet and ankles Fasting blood glucose: 146 mg/dL Total cholesterol: 250 mg/dL Triglycerides: 312 mg/dL HDL: 30 mg/dL Serum creatinine 1.8 mg/dL BUN 32 mg/dl GRF (glomerular filtration rate)-13mL/min Subjective Data: Decreased balance Loss of sensation Fear of falling Decreased endurance Shortness of breath with activity Swollen ankles Pruritus Feelings of loneliness and helplessness Functional Health Patterns Assessment Guide Functional Health Patterns (FHP) Guide Directions: This FHP guide is to be used for organizing patient assessment data in preparation for completion of the topic assignment. The bulleted statements in each section will be used as a guide to conduct the patient assessment using the case study information and to inform any modifications to your plan of care. Value/Belief Pattern •Religious affiliations/spiritual beliefs. •Availability of spiritual resources (i.e., churches/chapels, synagogues, chaplains, Bible studies, sacraments, self-help groups, support groups, etc.). •Does patient value health promotion measures? Health Perception/Management •Predominant health problems/health history.•Immunization history.•General state of health. •Family health history.•History of recent illness(es).•History of present illness. •Patient goals during interaction. Nutrition/Metabolic •Typical daily diet. •Weight and BMI. Increase or decrease in weight over the last several months/1year. •Appetite and dietary restrictions. •Typical daily water intake. •Skin problems. •Dental problems. •Food allergies. Elimination •Urinary elimination patterns. •Bowel elimination patterns. Activity/Exercise •Exercise and activity pattern. •Means of transportation. •Leisurely activities. •Type of activities related to job role. Sleep/Rest •Sleep routines/hours of patient rest: Compare with sleep hour standards (from National Institutes of Health [NIH]). •Sleep patterns. •Indicators of general “restedness” and energy levels. •Factors affecting sleep:•Shift work prevalence of community members •Environment (noise, lights, crowding, etc.)•Consumption of caffeine, nicotine, alcohol, and drugs •Homework/Extracurricular activities •Health issues Cognitive/Perceptual •Primary language: Is this a communication barrier? •Educational level. •Hearing/vision difficulties. •Alterations in sense of taste/smell. •Library or computer/Internet resources and usage. •Memory changes/difficulties. •Understanding of health status. •Health literacy level. Self-Perception/Self-Concept •Pride indicators: Self-esteem or caring behaviors. •Effect of illness on self-perception/self-image. Role/Relationship •Interaction with family/community members.•Living arrangements. •Work/school satisfaction. Sexuality/Reproductive •Relationships/sexually active. •Access to birth control. •Menarche/Menopause as applicable. Coping/Stress •Stressors. •Recent life changes. •Stress management resources (e.g., hotlines, support groups, etc.). •Coping/problem solving strategies. •Recent life changes. •Family/social support. •Prevalent mental health issues/concerns
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