Reference no: EM133749515

Problem

My name is Thomas....Thomas Sykes...and I'm 17. I live in an apartment with my sister, Keisha, and her 3-year-old son Torrey. I've lived with my sister since I was 10 and my mom died from her diabetes. She was big and never ate what she was supposed to. My dad hasn't been in my life since I was born. I've been big for most of my life, but have gained a lot of weight since we moved. I don't know how much, but I know my clothes don't fit anymore. Keisha does what she can to get clothes for me, but I don't have much to wear. The worst part is that I know I'm going to get diabetes, like my mom did. I'm not going to live a long time either. We moved last year for Keisha's job. She works rotating shifts at the battery packaging plant not too far from here, so I watch Torrey when she works late. Since we moved, I had to start in a new school and haven't made any friends. I spend most of my time playing video games or watching television with Torrey. He's my only friend. Keisha just found out that I've been skipping school and said she was worried about me and I need to see a doctor. Says she thinks I'm depressed. Maybe so. I didn't tell her the reason I'm skipping school. It's because of the kids in my class. They've been teasing me since right after I started there and now they say mean things on social media. They call me "fat" and "a dumb-a"...well, you know what I mean. I even found out that three months ago somebody took a picture of me in the locker room when all I had on was my underwear. They posted it on social media and now every time I go to school, people laugh at me. I hate it and I'm not going to keep going there. I don't need a diploma. I don't need anything or anybody. I hate my life. I'll just disappear and Keisha won't have to worry about me anymore. Everyone would be better off without me. I said I'd go to the doctor to make Keisha happy. She always says how nice you are to Torrey. I haven't seen a doctor in three years, which was fine with me. My doctor from the last place was mean and I could tell he didn't like me. So here I am. Thomas is assessed in the primary care setting. Discuss the clinical manifestations evidenced during your assessment. How would you explain these manifestations? Explain the nursing management considerations for this patient. Discuss the knowledge guiding your thinking. What specific issues would you want to take into consideration to provide for this patient's unique care needs?