Posted: June 15th, 2022

NURS-FPX6011 Assessment 1 Diabetes Patient Concept Map

Carole Lund Concept Map Example
Concept Map.

Introduction

This case is about Carol Lund, a new mother who is 44 years old. Her child is 10 weeks old. She has gestational diabetes and has a hard time keeping her blood sugar levels normal. The patient says that she is having trouble with her treatment plan and taking care of her health because she is a new mom. She doesn’t sleep enough and says that her health is the last thing on her mind (Capella University, 2022). She doesn’t seem to know how bad diabetes is when it’s not under control.

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The first thing a nurse needs to know about this patient is that their blood sugar levels may be unstable. This is shown by the fact that her glucose levels range from 150 to 200 when she is not eating, and they go above 200 after she eats. A healthy fasting blood glucose level is less than 140 mg/dL, and an after-meal blood glucose level is less than 180 mg/dL. (Kautzky-Willer et al., 2019). Carol’s blood sugar level is not in the range that doctors recommend. She doesn’t know enough about her illness and how it can make her body feel. She also doesn’t follow the plan for taking care of her diabetes. She refuses to take insulin. She also says that she didn’t take the insulin that her OB/GYN told her to take. Insulin is a hormone that controls the amount of sugar in the blood. Blood glucose levels are more likely to be high in people who don’t have enough insulin or who don’t have any insulin at all. Uncontrolled blood sugar in pregnant women can lead to macrosomia, which means having a big baby (Plows et al., 2018 NURS-FPX6011 Assessment 1 Diabetes Patient Concept Map).

The nurse will talk to the patient about the dangers of high blood sugar levels that are not under control. The person should also be told about the signs of hyperglycemia, like increased hunger, thirst, and urination. Signs that aren’t very specific can include blurred vision and tiredness (Plows et al., 2018). Another thing that could be done is to look into what causes blood sugar to get out of control. The third step would be to come up with ways to keep blood glucose levels from going up and down. The patient should also be told to check her blood sugar levels often. The goal would be to control blood sugar as well as possible. This will be shown by how well the blood sugar stays in the normal range. This means that your blood glucose level should be less than 140 when you are fasting and less than 180 after you eat.

The second diagnosis is not knowing enough about the disease, how it works, how it affects the body, and how to care for each person. This is clear from the way Carol thinks about insulin. She doesn’t think that insulin is her only choice. She says she didn’t take the insulin her OB/GYN told her to take. She doesn’t know enough about insulin and what it can do to help people with diabetes mellitus. Insulin is needed to lower blood sugar to a healthy level (Brown et al., 2017).

The nursing care would be to find out how much the patient knows about diabetes and insulin. Then, the patient should be taught. This would involve giving information about how diabetes is caused and how insulin works and is used. Carol will learn how to give herself insulin injections the right way. The expected result is that the patient will say what they know about the disease and how to treat it. The patient will also show that they know how to give themselves insulin properly.

The third problem is that the person has trouble sleeping. The patient’s own report shows this to be true. She says she can’t remember when she last got a good night’s sleep. She is a single mom who just had a baby. Her infant is 10 weeks old. She finds it hard to work, sleep, take care of her health, and care for her baby at the same time.

The right thing for the nurse to do would be to teach the patient about why getting enough sleep is important and what happens when you don’t get enough sleep. She can ask for help to take care of her baby and make better use of her time. This could help her feel less stressed out. The patient can be taught how to take advantage of the way her baby sleeps. Lastly, the nurse can help the person make a plan for going to bed. The goal is for the patient to have a routine before bed. The patient will say that her bedtime routine helps her get good sleep. Also, the person will have less stress and tiredness. The patient will also talk about how they got help with taking care of their children.

How important and useful evidence is

Patients with diabetes who want to take care of themselves must have enough knowledge, motivation, skills, and confidence to do so. The idea of “patient activation” takes these needs into account. There are four levels of patient activation. The first step is for the patient to feel like they need to be involved in their care. In the second stage, the patient is sure of himself or herself and knows enough to be able to take an active role. In the third stage, the patient does something. In the fourth stage, the patient finds reasons to keep doing things (Heitkemper et al., 2021).

It is important to know about diet. To help control blood sugars, you need to eat a low-fat, low-calorie diet. Also, the mother should be encouraged to breastfeed, which has been shown to help her lose weight and keep her baby’s blood sugar levels stable (Killion, 2018). Getting enough exercise is also important for controlling blood sugar. For these changes in activity, diet, and breastfeeding to stick, you may need to be motivated.

Criteria for judging how well a patient did.

Blood glucose measurements can be used to measure the results. Glucose levels should be below 140mg/dL when you’re fasting and below 180mg/dL after you eat (Kautzky-Willer et al., 2019).

The level of HbA1C is another way to measure how well something worked. HbA1C is used to measure long-term control of blood sugar. HbA1C levels of less than 7% are advised (Harreiter & Roden, 2019). The person can also keep track of how much she weighs. Getting rid of stress, staying active, and eating a low-fat, low-calorie diet are all ways to lose weight.

Plan for how the patient and family will talk.

To get the best results for diabetes, the person needs to do what they are told. A nurse should organize a teaching session on diabetes to cover the pathophysiology of diabetes, the presentation, the possible complications, and treatment methods, including the benefits of compliance. Treatment should include the benefits of using insulin for the management of diabetes. The patient should also include the appropriate methods of administering insulin.

Her family should also be involved in the education and creation of treatment goals. The patient says that she talks to older people about her treatment. The elders should be involved in education. This will enable them to help make appropriate decisions that will lead to proper treatment and better treatment outcomes for the patient.

Management of diabetes requires proper tools and resources. The nurse can help the family identify resources within themselves that can be useful in managing this patient. This includes Helping with child care to enable the patient to minimize stress and fatigue.

NURS-FPX6011 Assessment 1 Diabetes Patient Concept Map References
Brown, J., Grzeskowiak, L., Williamson, K., Downie, M. R., & Crowther, C. A. (2017). Insulin for the treatment of women with gestational diabetes. The Cochrane Database Of Systematic Reviews, 11(11), CD012037. https://doi.org/10.1002/14651858.CD012037.pub2

Heitkemper, E., Huang, Y. C., Jang, D. E., García, A. A., & Zuñiga, J. A. (2021). A systematic review and meta-analysis of patient activation in people living with chronic conditions. Patient Education And Counseling, 104(9), 2200–2212. https://doi.org/10.1016/j.pec.2021.02.016

Capella University. (2022). Assessment case study: evidence-based patient-centered concept map. http://media.capella.edu/CourseMedia/msn-fpx6011element16273/wrapper.asp

Harreiter, J., & Roden, M. (2019). Diabetes mellitus – Definition, Klassifikation, Diagnose, Screening und Prävention (Update 2019) [Diabetes mellitus-Definition, classification, diagnosis, screening and prevention (Update 2019)]. Wiener klinische Wochenschrift, 131(Suppl 1), 6–15. https://doi.org/10.1007/s00508-019-1450-4

Kautzky-Willer, A., Harreiter, J., Winhofer-Stöckl, Y., Bancher-Todesca, D., Berger, A., Repa, A., Lechleitner, M., & Weitgasser, R. (2019). Gestationsdiabetes (GDM) (Update 2019) [Gestational diabetes mellitus (Update 2019)]. Wiener klinische Wochenschrift, 131(Suppl 1), 91–102. https://doi.org/10.1007/s00508-018-1419-8

Killion, M. M. (2018). Managing Gestational Diabetes Postpartum. MCN, The American Journal of Maternal/Child Nursing, 43 (4), 231-231. doi:10.1097/NMC.0000000000000444

Plows, J. F., Stanley, J. L., Baker, P. N., Reynolds, C. M., & Vickers, M. H. (2018). The Pathophysiology of Gestational Diabetes Mellitus. International Journal Of Molecular Sciences, 19(11), 3342. https://doi.org/10.3390/ijms19113342

Assessment 1 Instructions: Diabetes Patient Concept Map
Create a concept map graphic and write a 2-4 page narrative on the patient scenario presented in Assessment Case Study: Evidence-Based Patient-Centered Concept Map. Base your report on the information provided in the case study and your own research of 3-5 evidence-based resources.

Evidence-based practice is a key skill in the tool kit of the master’s-prepared nurse. Its goal is to ensure that health care practitioners are using the best available evidence to ensure that patients are receiving the best care possible (Godshall, 2020). In essence, evidence-based practice is all about ensuring quality care.

In this assessment, you will apply evidence-based practice and personalized care concepts to ensure quality care and improve the health of a single patient. The concept map that you will create is an example of a visual tool that you can use for patient and family education.

Reference

Godshall, M. (2020). Fast facts for evidence-based practice in nursing (3rd ed.). Springer Publishing Company.

Scenario
The charge nurse at the wellness center has sent you an email to request that you review a patient file before the patient arrives at the clinic. She has asked you to put together a concept map for your patient’s care plan. The concept map is intended to help you think through the best strategy for your patient’s care and for subsequent use for patient education. In addition, the nurse needs a narrative report that describes your patient with up to five diagnoses, in order of urgency.

Your Role

You are a nurse at a community wellness center who has received a request for patient case review and preparation for an upcoming appointment.

NURS-FPX6011 Assessment 1 Diabetes Patient Concept Map Instructions
Review the Assessment Case Study: Evidence-Based Patient-Centered Concept Map media activity.

Create your concept map and narrative as separate parts of your document. Be sure to note where you must include your evidence-based support and clarify your strategies for communicating information to the patient and the patient’s family.

Integrate relevant evidence from 3–5 current scholarly or professional sources to support your assertions.

Part 1: Concept Map
Develop a graphical concept map for the patient based on the best available evidence for treating your patient’s health, economic, and cultural needs.
Many organizations use the spider style of concept maps (see the Taylor and Littleton-Kearney article for an example).
The Assessment Case Study: Evidence-Based Patient-Centered Concept Map, which includes an example of a concept map, may help you prepare your assessment.
If a particular style of concept map is used in your current care setting, you may use it in this assessment.
Part 2: Narrative Report
Develop a narrative (2–4 pages) for your concept map.
Analyze the needs of a patient and his or her family to ensure that the intervention in the concept map will be relevant and appropriate for their beliefs, values, and lifestyle.
Consider how your patient’s economic situation and relevant environmental factors may have contributed to your patient’s current condition or could affect future health.
Consider how your patient’s culture or family should inform your concept map.
Determine the value and relevance of the evidence you used as the basis of your concept map.
Explain why your evidence is valuable and relevant to your patient’s case.
Explain why each piece of evidence is appropriate for the health issue you are addressing and for the unique situation of your patient and the family.
Propose relevant and measurable criteria for evaluating the outcomes the patient needs to achieve. NURS-FPX6011 Assessment 1 Diabetes Patient Concept Map
Explain why your proposed criteria are appropriate and useful measures of success.
Explain how you will communicate specific aspects of the concept map to your patient and the family in an ethical, culturally sensitive, and inclusive way. Ensure that your strategies:
Promote honest communications.
Facilitate sharing only the information you are required and permitted to share.
Are mindful of your patient’s culture.
Enable you to make complex medical terms and concepts understandable to your patient and his or her family, regardless of language, abilities, or educational level.
Additional Requirements
Organization: Use the following headings for your Diabetes Patient Concept Map assessment:
Concept Map.
Patient Needs Analysis.
Value and Relevance of the Evidence.
Proposed Criteria for Patient Outcome Assessment.
Patient and Family Communication Plan.
Length: Your concept map should fit on one page (possibly a horizontal layout) and your narrative report will be 2–4 double-spaced pages, not including title and reference pages.
Font: Times New Roman, 12 points.
APA Format: Your title and reference pages must follow current APA format and style guidelines. The body of your paper does not need to conform to APA guidelines. Do make sure that it is clear, persuasive, organized, and well written, without grammatical, punctuation, or spelling errors. You also must cite your sources according to APA guidelines.
Scoring Guide: Please review this assessment’s scoring guide. The requirements outlined above correspond to the grading criteria in the scoring guide, so be sure to address each point. In addition, you may want to review the performance-level descriptions for each criterion to see how your work will be assessed.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

Competency 1: Apply evidence-based practice to plan patient-centered care.
Design an individualized, patient-centered concept map, based upon the best available evidence for treating a patient’s specific health, economic, and cultural needs.
Analyze the needs of a patient, and those of their family, to ensure that the intervention in the concept map will be relevant and appropriate for their beliefs, values, and lifestyle.
Competency 3: Evaluate outcomes of evidence-based interventions.
Propose relevant and measurable criteria for evaluating the outcomes the patient needs to achieve.
Competency 4: Evaluate the value and relative weight of available evidence upon which to make a clinical decision.
Determine the value and relevance of evidence used as the basis of a patient-centered concept map.
Competency 5: Synthesize evidence-based practice and academic research to communicate effective solutions.
Develop a strategy for communicating with patients and their families in an ethical, culturally sensitive, and inclusive way.
Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style.

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