Concept Map for Acute Care
NURS FPX 6021 Assessment 1 Concept Map
Concept Map for Community Care
NURS FPX 6021 Assessment 1 Concept Map
Justification of the Value of Evidence Used for the Concept Maps
NURS FPX 6021 Assessment 1 Concept Map
The first concept map is designed for acute care at the St. Anthony Medical Center, where Mrs. S was admitted with high blood glucose levels and acute kidney failure. According to NANDA, the most urgent diagnosis in acute care is unstable blood glucose levels in a patient with type 2 diabetes mellitus. Individuals with type 2 diabetes have impaired glucose metabolism leading to a rise in their blood glucose levels. Sustained high blood glucose negatively affects these individuals’ health resulting in complications such as retinopathy and diabetic nephropathy. According to Advani (2020), acute kidney failure is a complication of acute hyperglycemic crises among individuals with type 2 diabetes mellitus. Effective management of the high blood glucose levels is therefore critical to minimize the effects of hyperglycemia on the kidney. Individuals with type 2 diabetes are recommended to maintain HbA1c below 7% to prevent complications and minimize disease progression (Davies et al., 2018). Mrs. S has an HbA1c of 8.5%, which reflects poor glycemic control resulting in symptoms such as weakness and blurred vision. Patient education is critical to achieving good blood glucose control and the promotion of early health-seeking behaviors. According to Garg et al. (2019), health education is vital in improving patient knowledge and attainment of blood glucose control which slows down the progression of the disease. The second and third diagnoses of excess fluid volume and fatigue are related to acute kidney failure. Medications such as potassium-sparing diuretics and loop diuretics help increase urine output and minimize fluid overload in patients with acute kidney failure (Patschan et al., 2019). Therefore, referring Mrs. S to a nephrologist for medication prescription is critical to her treatment.
NURS FPX 6021 Assessment 1 Concept Map
The meeting at home with Mrs. S shows that her health status has improved significantly. Though she has not achieved normal fasting blood glucose levels, her current readings signify improvement. The reading of 140mg/dl after meals and 125 in the morning is above the recommended levels, which is a risk for her health. Individuals with type 2 diabetes should aim for fasting blood glucose levels below 100mg/dl, which is the normal value (Davidson et al., 2021). Encouraging the patient to monitor her blood glucose levels every day is critical to achieving self-care behavior and attaining blood sugar control. Educating the patient empowers her to interpret the blood glucose readings prompting her to seek care when necessary. According to (Tefera et al., 2020), health literacy among individuals with type 2 diabetes is vital for executing self-management protocols like blood glucose monitoring, diet control, and physical exercise engagement. Mrs. S voices hope by saying she is ready to learn how to regulate her diet to achieve blood sugar control. Family support is key to helping individuals with type 2 diabetes achieve glycemic control and improved health outcomes. Pamungkas et al. (2017) posit that family support is vital for individuals with type 2 diabetes to attain better glycemic control, self-efficacy, and psychological well-being. Therefore, providing family education for Mrs. S and her daughter is essential to improve her support system and attain improved health outcomes.
Inter professional Strategies Applied to the Concept Maps
NURS FPX 6021 Assessment 1 Concept Map
An inter professional collaborative approach is critical in the management of individuals diagnosed with type 2 diabetes. Several healthcare providers are involved in the diagnosis and treatment process, and they include nurses, physicians, pharmacists, dieticians, and social workers. The inter professional approach is effective in the institution of the chronic care model for Mrs. S and other individuals with chronic illnesses such as type 2 diabetes (Nunchis et al., 2022). Holistic care can be achieved through inter professional collaboration as all patient’s needs are addressed. Referral to a nephrologist is essential for Mrs. S in the acute care setting because of her diagnosis of acute kidney failure. A nephrologist will assess her kidney functions and prescribe diuretics critical in managing her fluid overload status (Patschan et al., 2019). She reported having blurred vision which could be due to hyperglycemia or a complication of uncontrolled blood glucose levels, as her HBA1C was 8.5. Referral to an ophthalmologist is critical to have her vision assessed. Engaging in physical activity is vital for Mrs. S in her long-term goal of achieving blood sugar control, and therefore referral to a physiotherapist is recommended (Harris-Hayes et al., 2020). Physical therapists provide activity tolerance assessments and provide patient education on optimal physical activities according to the patient’s status. Through inter professional collaboration, individuals like Mrs. S can be provided with patient-centered care and individualized treatment goals.
Unknowns and Areas of Uncertainty
NURS FPX 6021 Assessment 1 Concept Map
The interprofessional strategies can be effective with patient and family support to actualize the recommendations formulated. Family support is an area of uncertainty in this scenario. This is because Mrs. S’s daughter, who is her only support system, is not readily available due to her commitment to her family and her job. It is uncertain whether she will remain committed to implementing the evidence-based solutions that will be provided by the interprofessional team. There is no information provided regarding the socioeconomic status of Mrs. S. The implementation of some of the recommended interprofessional strategies is financially demanding. Her surrounding environment also plays a major role, such as the availability of physical exercise amenities. However, this information is missing.
Strategies to Ensure Clear Communication
NURS FPX 6021 Assessment 1 Concept Map
Communication is critical in healthcare and a major factor in determining patient health outcomes. Healthcare providers should adopt effective communication approaches to enhance patient care and the attainment of treatment goals. According to Kwame and Petrucka (2021), health communication is essential to achieve improved health outcomes. This is achieved through the passage of information from healthcare providers to patients in a simplified manner, clarification where necessary, listening without interruptions, and allowing patients to express their concerns or ideas. Communication with Mrs. S will be face-to-face when she is physically present and through telehealth for virtual meetings. Telehealth will effectively enable the interprofessional team at St. Anthony Medical Center to communicate with Mrs. S remotely and address her concerns (Wijesooriya et al., 2020). This will reduce healthcare costs while improving her healthcare access to improve health outcomes.
NURS FPX 6021 Assessment 1 Concept Map
References
Advani, A. (2020). Acute kidney injury: A bona fide complication of diabetes. Diabetes, 69(11), 2229–2237.
https://doi.org/10.2337/db20-0604
Davidson, K. W., Barry, M. J., Mangione, C. M., Cabana, M., Caughey, A. B., Davis, E. M., Donahue, K. E., Doubeni, C. A., Krist, A. H., Kubik, M., Li, L., Ogedegbe, G., Owens, D. K., Pbert, L., Silverstein, M., Stevermer, J., Tseng, C.-W., & Wong, J. B. (2021). Screening for prediabetes and type 2 diabetes. JAMA, 326(8), 736–744.
https://doi.org/10.1001/jama.2021.12531
Davies, M. J., D’Alessio, D. A., Fradkin, J., Kernan, W. N., Mathieu, C., Mingrone, G., Rossing, P., Tsapas, A., Wexler, D. J., & Buse, J. B. (2018). Management of hyperglycemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care, 41(12), 2669–2701.
NURS FPX 6021 Assessment 1 Concept Map
https://doi.org/10.2337/dci18-0033
Garg, R., Chawla, S. P. S., Kaur, S., Bharti, A., Kaur, M., Soin, D., Ghosh, A., & Pal, R. (2019). Impact of health education on knowledge, attitude, practices and glycemic control in type 2 diabetes mellitus. Journal of Family Medicine and Primary Care, 8(1), 261–268.
https://doi.org/10.4103/jfmpc.jfmpc_228_18
Harris-Hayes, M., Schootman, M., Schootman, J. C., & Hastings, M. K. (2020). The role of physical therapists in fighting the type 2 diabetes epidemic. Journal of Orthopaedic & Sports Physical Therapy, 50(1), 5–16.
https://doi.org/10.2519/jospt.2020.9154
Kwame, A., & Petrucka, P. M. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: Barriers, facilitators, and the way forward. BMC Nursing, 20(1), 1–10.
https://doi.org/10.1186/s12912-021-00684-2
Nurchis, M. C., Sessa, G., Pascucci, D., Sassano, M., Lombi, L., & Damiani, G. (2022). Interprofessional collaboration and Diabetes Management in Primary Care: A systematic review and meta-analysis of patient-reported outcomes. Journal of Personalized Medicine, 12(4), 643–652.
NURS FPX 6021 Assessment 1 Concept Map
https://doi.org/10.3390/jpm12040643
Pamungkas, R., Chamroonsawasdi, K., & Vatanasomboon, P. (2017). A systematic review: Family Support Integrated with diabetes self-management among uncontrolled type II diabetes mellitus patients. Behavioral Sciences, 7(4), 62–79.
https://doi.org/10.3390/bs7030062
Patschan, D., Patschan, S., Buschmann, I., & Ritter, O. (2019). Loop diuretics in acute kidney injury prevention, therapy, and risk stratification. Kidney and Blood Pressure Research, 44(4), 457–464.
https://doi.org/10.1159/000501315
Tefera, Y. G., Gebresillassie, B. M., Emiru, Y. K., Yilma, R., Hafiz, F., Akalu, H., & Ayele, A. A. (2020). Diabetic health literacy and its association with glycemic control among adult patients with type 2 diabetes mellitus attending the outpatient clinic of a University Hospital in Ethiopia. PLOS ONE, 15(4), 1–15.
https://doi.org/10.1371/journal.pone.0231291
Wijesooriya, N. R., Mishra, V., Brand, P. L. P., & Rubin, B. K. (2020). Covid-19 and telehealth, education, and research adaptations. Paediatric Respiratory Reviews, 35(7), 38–42.
