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.

This week we will explore current events related to epidemiology. You will present a scientific article to the class. Please focus on interpreting the research question, methodology, results, and conclusions from a sample of peer-reviewed scientific literature. Please be sure the article is related to epidemiology, summarizing its contents for the class, and providing a succinct written summary. Current events must have been published within the last six months. Written summaries should include:

• State the objectives of the study
• Summarize the study design and findings
• Provide a reference of the article
• Provide your opinion on how the “average” reader will respond to the article. Will the article influence decision making or thinking? Does the article leave out any important information?

Sample;

The New England Journal of Medicine published a large study showing that there is a small but significant risk of breast cancer associated with regular use of hormonal birth control pills. The study involved 1.8 million women in Denmark between the ages of 15 and 49 who were followed for about 11 years. Results showed that 11,517 cases of breast cancer occurred (Morch, Skovlund, Hannaford, Iversen, Fielding, & Lidegaard, 2017). “For every 10,000 women, 13 cases of breast cancers were reported with the use of birth control pills. For every 100,000 women using birth control pills, there were 68 new cases of diagnosed breast cancer each year compared to 55 new cases of breast cancer among women who were not using birth control pills” (Mandel, 2017). Current users of hormonal contraceptives were associated with a 20% increased risk of breast cancer. Women who used contraceptives less than a year showed a 9% increased risk, and women who used contraceptives greater than 10 years showed a 38% increased risk (Mandel, 2017). There was noted a rapid disappearance of breast cancer risks after the discontinuation of hormonal contraceptives short-term use (Morch, Skovlund, Hannaford, Iversen, Fielding, & Lidegaard, 2017).

After reading this article, I believe it is a significant public health concern. About 140 million women used hormonal contraception worldwide (Do hormonal contraceptives increase breast cancer risk?, 2017). Like other contraceptives, birth control releases hormones. I think it is important to weigh out the risks and benefits. Oral contraceptives may benefit women with dysmenorrhea, menorrhagia, and has shown to reduce the risks of ovarian, endometrial, and colorectal cancers (Hunter, 2017). I think women should explore the risks and benefits to help decide which treatment is best for them because no type of hormone contraceptive is risk free.

Reference

Do hormonal contraceptives increase breast cancer risk? (2017). Retrieved from http://www.breastcancer.org/research-news/do-hormonal-contraceptives-increase-risk

Hunter, J. D. (2017). Oral contraceptives and the small increased risk of breast cancer. The New England Journal of Medicine.

Mandal, A. (2017). Cancer risk with birth control pills emerges again in latest study. Retrieved from https://www.news-medical.net/news/20171210/Cancer-risk-with-birth-control-pills-emerges-again-in-latest-study.aspx (Links to an external site.)Links to an external site.

Morch, L. S., Skovlund, C. W., Hannaford, P. C., Iversen, L., Fielding, S., & Lidegaard, O. (2017). Contemporary hormonal contraception and the risk of breast cancer. The New England Journal of Medicine. doi: 10.1056/NEJMoa1700732