Edwardo is a 22-year-old Mexican American male who is about to embark on a rigorous exercise program to lose weight. He works as IT support for an organization, a position that requires most of his shift to be seated in his chair with a headset, responding to IT requests online for the duration of his shift. He is a full-time graduate student in an IT program at the local university. He goes out with friends once weekly “for some fun and relief”, he drinks socially, 0ne to two beers with his friends, does not smoke or use recreational drugs. He takes no medications, has not had a physical since he enrolled in his first college program and that consisted of completing a form. He played football in high school but has had no time for sports since enrolling in his first college program. He considers his studies the most essential aspect for his focus. His parents are healthy and invite him over once weekly for “one good meal” and he takes groceries offered by his mother home so that he has food in his apartment. He sleeps well, feels “sluggish” sometimes, especially during his bus ride to and from work. This concerned him and so he has managed to find time to go to a gym for exercise. He hopes to feel better and lose at least 30 pounds by working out at the gym. He goes to visit his personal trainer for the first session and is surprised to hear his trainer suggest that he go to his primary healthcare provider for a checkup first. He began thinking about his parents and their health habits. Both are working full-time and active and healthy, eat nutritious meals, which he enjoys when he has the time to visit, and they take no meds. He has no brothers or sisters. You learn this during your introductory conversation with him and now you must determine where to begin with this “healthy” young man and apparently, his trainer. You applaud his new plan and begin to discuss with him some health goals and objectives.
B/P 124/70 H/R 70 R 18 WT 200 pounds HT 70 inches
Based on the provided patient information, think about the health history you would need to collect from the patient.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.
Identify three to five possible conditions that may be considered in a differential diagnosis or at risk for the patient or that you share with him he is at risk for having.
Consider clinical guidelines that might support each diagnosis.
Develop a realistic preventive health treatment plan for the patient that includes health promotion and patient education strategies for special populations. How would you categorize him as “special population”? Use social determinants of health, information that you gather during your assessment, to guide your realistic preventive health plan.
Determine if you will refer Edwardo back to his trainer for full approval of an exercise program or will you follow up with him first, or concurrently, or tell him that he should not enter an exercise program now (share your reasoning for your decision). This is primarily a PREVENTIVE health assessment. No pathology must be found. Preventive health is a must. Enjoy!
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