It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.
Evaluate the Health History and Medical Information for Mr. C., presented below.
Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.
Health History and Medical Information
Health History
Mr. C., a 32-year-old single male, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He currently works at a catalog telephone center. He reports that he has always been heavy, even as a small child, gaining approximately 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 by restricting dietary sodium. Mr. C. reports increasing shortness of breath with activity, swollen ankles, and pruritus over the last 6 months.
Objective Data:

1. Height: 68 inches; weight 134.5 kg
2. BP: 172/98, HR 88, RR 26
3. 3+ pitting edema bilateral feet and ankles
4. Fasting blood glucose: 146 mg/dL
5. Total cholesterol: 250 mg/dL
6. Triglycerides: 312 mg/dL
7. HDL: 30 mg/dL
8. Serum creatinine 1.8 mg/dL
9. BUN 32 mg/dl

Critical Thinking Essay
In 750-1,000 words, critically evaluate Mr. C.’s potential diagnosis and intervention(s). Include the following:

1. Describe the clinical manifestations present in Mr. C.
2. Describe the potential health risks for obesity that are of concern for Mr. C. Discuss whether bariatric surgery is an appropriate intervention.
3. Assess each of Mr. C.’s functional health patterns using the information given. Discuss at least five actual or potential problems can you identify from the functional health patterns and provide the rationale for each. (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.)
4. Explain the staging of end-stage renal disease (ESRD) and contributing factors to consider.
5. Consider ESRD prevention and health promotion opportunities. Describe what type of patient education should be provided to Mr. C. for prevention of future events, health restoration, and avoidance of deterioration of renal status.
6. Explain the type of resources available for ESRD patients for nonacute care and the type of multidisciplinary approach that would be beneficial for these patients. Consider aspects such as devices, transportation, living conditions, return-to-employment issues.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Surveillance vs. Public Health Surveillance 

What distinguishes public health surveillance from other types of surveillance, such as criminal surveillance, military surveillance, and so forth? Provide a specific example and discuss its implementation and record of effectiveness.

Submission Details:

• Submit your response in a 1- to 2-page Microsoft Word document. Be sure to add introduction, APA format headings-bold face, conclusion, and references

Instructions

Step One: The Office of the National Coordinator for Health Information Technology (ONC) Health IT Certification Program helps to ensure that health IT conforms to the standards and certification criteria adopted by the Secretary of Health and Human Services. The Office of Health IT Certification was established to develop and oversee national programs for the certification of health information technology by the Health Information Technology for Economic and Clinical Health (HITECH) Act. Health IT certification provides assurance to purchasers and other users that a system meets the technological capability, functionality, and security requirements. Review the ONC Health IT Certification program – http://www.healthit.gov/policy-researchers-implementers/about-onc-health-it-certification-program (Links to an external site.).
Step Two:  To ensure the requirements are met, ONC Health IT developed a set of functional and conformance testing criteria for certification.  Review the ONC Health IT Testing Requirements page – https://www.healthit.gov/policy-researchers-implementers/2015-edition-test-method. (Links to an external site.)
Step Three:  Go to 170.315(b)(3): Electronic Prescribing and read the companion guide
https://www.healthit.gov/test-method/electronic-prescribing (Links to an external site.)
Step Four:  Also for 170.315(b)(3): Electronic Prescribing, read the test procedure
https://www.healthit.gov/test-method/electronic-prescribing (Links to an external site.) (see second tab)
Step Five:  Also for 170.315(b)(3): Electronic Prescribing, go to the test tool and then to the Electronic Prescribing (eRx) link
https://www.healthit.gov/test-method/electronic-prescribing (Links to an external site.) (see third tab)
Step Six:  Once in the eRx tool, click on the green “Structured SIG Testing: Start Testing” button to use the tool. You will need to register which is free and instantaneous.
Step Seven:  After registering, login using your new credentials. Go into a Test Case and a Test Step by clicking on “test selection” in the top menu bar. Use the left menu to select test cases/scenarios – be sure to expand the case fully to reveal the “test story” page. Take a screen shot of the example message that you see.
Step Eight:  Submit your screen shot, along with a 2-3 page summary detailing what you learned as you reviewed the ONC criteria for grading. Ensure that you include a discussion of the importance of the concepts of vocabulary, language, terminology, and nomenclature. Your summary with screen shot should be in Microsoft Word format.  Cite all sources in APA format.

Case: 
 
Mr. J, age 42, is a construction worker in Las Vegas. He recently noticed that a mole on his face seemed to be getting larger and darker. At first he did not worry because he was in the sun a lot and assumed the change may have been caused by sunburn. After a month, not only was the mole larger and darker, but it appeared to be “bumpy.” His doctor diagnosed a malignant melanoma skin cancer following biopsy of the nevus. Mr. J reports pain in his right shin that does not go away when he puts his feet up or sleeps.
Discussion Questions

• 1) Relate Mr. J’s skin changes to the warning signs for malignant melanoma.
• 2) Discuss the normal progression of this malignancy.
• 3) What is the significance of the bone pain that Mr. J is experiencing?
• 4)Discuss the treatment available for this patient and the prognosis for recovery.