Functional Health Patterns Assessment Guide
Case Study: Mr. D.
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. D., presented below.
Health History and Medical Information
Mr. D. is a 65-year-old male nonadherence 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:
1. Height: 68 inches; weight 134.5 kg
2. BP: 140/94, HR 84, RR 22
3. 2+ 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
10. GRF (glomerular filtration rate)-13mL/min
2
Clinical Manifestations
Describe the clinical manifestations present in Mr. D., focusing on the normal and abnormal
findings and how this relates to his current condition.
Subjective
Objective
Potential Health Risks for Diabetes With End-Stage Renal Disease
Identify the potential health risks for a diabetic with ESRD and the impacts of nonadherence.
Identify the potential health
risks for a diabetic with end-
stage renal disease (ESRD) that
are of concern for Mr. D.
How does Mr. D.’s
nonadherence to his diabetes
self-management plan for DM
Type II contribute to ESRD?
Describe the common
considerations with insulin use
for practicing Muslims.
Pathophysiology of Renal Dialysis
Explain the pathophysiology of renal dialysis.
Explain the pathophysiology of
renal dialysis. Compare
peritoneal dialysis and
hemodialysis.
Describe in detail the
pathophysiological explanation
and stages of renal disease that
leads to ESRD.
Explain the potential factors
that contributed to Mr. D.’s
ESRD.
3
Functional Health Problems
Evaluate of Mr. D.’s functional health patterns.
Evaluate each of Mr. D.’s
functional health patterns using
the information given.
Discuss at least five actual or
potential problems you can
identify from the “Functional
Health Patterns Assessment
Guide,” located in the Topic 3
Resources. Provide a rationale
for each.
Nursing Health Management and Health Promotion
Provide ESRD nursing management and health promotion opportunities.
Provide ESRD nursing
management and health
promotion opportunities.
Develop a patient education
plan for ESRD that could be
offered to Mr. D. for prevention
of future events, health
restoration, and maintaining
renal status.
Assume Mr. D. lives in your
community. Include community
resources and supportive care
available for Mr. D. for ESRD
care and management at home.
Discuss the nurse’s role in
using the holistic
multidisciplinary care approach
that would be safe and effective
for patients like Mr. D.,
including aspects such as
devices, transportation,
eligibility for transplant, living
conditions, promotion of
resiliency, and independence.
