NURS FPX 6011 Assessment 1 Diabetes Patient Concept Map

You are currently viewing NURS FPX 6011 Assessment 1 Diabetes Patient Concept Map

Analysis

NURS FPX 6011 Assessment 1 Diabetes Patient Concept Map

Carole Lunde is a 44–year–older woman of mixed Native American and European descent and a new mother. She has recently been diagnosed with diabetes, which she was first diagnosed with at 30 weeks of pregnancy. After being told by her OB/GYN that gestational diabetes should clear up after childbirth, She is concerned that she has not recovered due to continued elevated blood glucose (BG). Carole’s BG has been over 200 postprandial and 150-200 fasting. 

After Carole was diagnosed with gestational diabetes, her doctor suggested she begin Insulin to reduce her BG. After consulting with tribal leaders that Insulin was not a good thing due to being created with animal hormones, she declined treatment. Carole refused therapy after it was revealed to her Insulin was a synthetic hormone because she did not want to become dependent on it. Carole reports that her daughter Kassandra was born big but healthy despite elevated blood glucose during pregnancy.

Currently, Carole lives off of the reservation with her ten-week-old daughter post-c-section. She independently cares for her daughter, does freelance work, and has no other financial assistance or support. During the initial postpartum period, Carole’s mother helped her care for her illness and newborn. Her mother has since returned to the reservation. Between caring for her daughter and working, her health is the least important in her life; however, she worries about her daughter developing Diabetes II. Even though Carole has not cared for herself, she is open and receptive to learning more about diabetes to lower Kassandra’s risk of contracting it.

Value and relevance of the evidence

Carole’s cultural beliefs, diabetes knowledge limitations, and psychosocial variables are roadblocks to effective health outcomes, which is why the data offered in the concept map is significant and relevant. It is said by (Teixeira et al., 2017) that lack of information becomes an obstacle to user empowerment and treatment adherence. Her outcomes would vastly improve if she had the correct information and assistance from her surroundings. (Teixeira et al., 2017), also stated in the article that “Impaired sleep increases blood pressure, increases appetite and may compromise insulin sensitivity, and being associated with the incidence of diabetes.” Carole’s high blood sugar levels and the likelihood of future problems could be due to a lack of sleep, her age, and additional life stress.

NURS FPX 6011 Assessment 1 Diabetes Patient Concept Map

Carole is alone and lacks a solid support structure necessary for self-care. Self-care is an acquired skill that is influenced by one’s surroundings. Nonetheless, family-centered care is founded on the belief that professionals cannot and do not know what is best for their clients, such as a family. The importance of a client’s role in their family significantly impacts their ability to self-care, which can have a long-term effect on a client’s commitment to behavioral changes and treatment regimens, and overall outcomes (Kumar, 2007).

Carole’s future success in caring for herself and her kid depends on addressing the risk of dangerous blood glucose levels, a lack of knowledge of diabetes II, and treating her high blood sugars. Due to cultural barriers and her family being isolated from the Native American community, inefficient family therapeutic regimen management is a nursing diagnosis I would use. Native Americans may not follow recommended treatment plans due to mistrust and misunderstanding of Western medicine. Therefore, gaining the trust of Carole and her family is essential in facilitating a better health outcome for her. Carole’s Native American background will be utilized when creating her care plan. In her care plan, I will ensure anyone she authorizes is involved in her care. Family members, tribal leaders, extended family, or other members of the community are part of the decision-making process for Indian patients (Patient and Family Educational Services, n.d.). Asking patients who’d like to be involved in their care can build trust between the family and the patient (Patient and Family Educational Services, n.d.). During my visit with Carole, I will avoid making direct eye contact, refrain from touching her hair, and thoroughly explain any treatments I may perform. By understanding that she may communicate discomfort through storytelling or express silence, I am aware that listening closely without interruption and utilizing humor is another step in achieving trust to encourage positive outcomes. During Carole’s visit, I will also remember that American Indians view illness from a holistic perspective. Individuals, communities, nature, and spirituality are considered interwoven, affecting a person’s physical, spiritual, mental, and emotional health. Discord between these sources may be interpreted as the cause of illness (Patient and Family Educational Services, n.d.). During my visit with Carole’s group, I will explain the benefits of referring her to different specialists, such as an Endocrinologist and Dietitian. I’d clarify that an endocrinologist and dieticians can provide her with additional diabetes education, support, and close monitoring of her blood sugar levels and possibly treat her diabetes with an oral medicine like metformin. Endocrinologists frequently have dieticians on staff who can better assist her in following a diabetic diet. It would also be helpful to engage with tribal leaders to teach them about diabetes so that diabetes awareness can become ingrained in their culture and care. Encouraging Carole to communicate with her family and join support groups can help her avoid despair and gain control over her health. Family and community support can assist her with caring for Kassandra so she may obtain adequate sleep and work as needed to be able yy. 

NURS FPX 6011 Assessment 1 Diabetes Patient Concept Map

Carole could be referred to financial resource organizations like Women, Infants, and Children (WIC) to help her with some financial concerns. WIC helps moms and children under five with nutritional education, health referrals, and breastfeeding support and provides extra nourishment.

Type 2 diabetes is a severe global public health issue that disproportionately affects the poor, especially Native Americans and Alaskans. In 2009, people eligible for the Indian Health Service (IHS) had a 16.1% age-adjusted diabetes prevalence, more than double that of non-Hispanic white individuals (Jiang et al., 2013). Large-scale public health interventions in Native American communities, such as the Diabetes Prevention Program (DPP), have proven that lifestyle modifications can prevent or delay the onset of diabetes for people at risk (Jiang et al., 2013). Healthy lifestyle change in the Native American community highly relies on trust and community collaboration. This will ultimately promote a positive outcome.

Patient Info

44-year-old Native American and European female ten weeks post-partum diagnosed with gestational diabetes at 30 weeks pregnant with persistent hyperglycemia.

References

Alfadhli, E. M., MD, FRCP. (2015). Gestational diabetes mellitus36(4), 399–406. https://doi.org/10.15537/smj.2015.4.10307

Doenges, M. E. (2019). Nursing care plans guidelines for individualizing client care across the life span (10th ed.). F. A. Davis Company.

Jiang, L., Manson, S. M., Beals, J., Henderson, W. G., Huang, H., Acton, K. J., & Roubideaux, Y. (2013). Translating the diabetes prevention program into American Indian and Alaska Native communities. Diabetes Care36(7), 2027–2034. https://doi.org/10.2337/dc12-1250

Kalbfleisch, P. J. (2009). Effective Health Communication in Native Populations in North America. Journal of Language and Social Psychology, 28(2), 158–173. https://doi.org/10.1177/0261927X08330607

Kumar, C. P. (2007). Application of Orem’s self-care deficit theory and standardized nursing languages in a case study of a woman with diabetes. International Journal of Nursing Terminologies and Classifications18(3), 103–110. https://doi.org/10.1111/j.1744-618x.2007.00058.x

Mayo Clinic. (n.d.). Patient care & health information-Diabetes. Retrieved June 4, 2022, from https://www.mayoclinic.org/diseases-conditions/diabetes/diagnosis-treatment

Mendes, L. C., Carvalho de Sousa, V. E., & s de Oliveira Lopes, M. V. (2011). Accuracy of diagnosis of the defining characteristics of ineffective family therapeutic regimen management. Acta Paul Enferm24(2), 219–224.

NURS FPX 6011 Assessment 1 Diabetes Patient Concept Map

Patient and Family Educational Services. (n.d.). Communicating with your American Indian/Alaska native patient [pdf]. Culture Cues. https://www.lacrosseconsortium.org/uploads/content_files/files/American%20Indian.pdf

Stotz, S. A., Charron-Prochownik, D., Terry, M. A., Marshall, G., Fischl, A. R., & Moore, K. R. (2020). Stopping gestational diabetes in American Indian and Alaska native girls: Nutrition as a critical component to gestational diabetes risk reduction. Current Developments in Nutritionhttps://doi.org/10.1093/cdn/nzaa081

Teixeira, A., Tsukamoto, R., Lopes, C., & Silva, R. E. (2017). Risk factors for unstable blood glucose level: Integrative review of the risk factors related to the nursing diagnosis. Revista Latino-Americana de Enfermagem25(0). https://doi.org/10.1590/1518-8345.1688.2893