NURS-FPX6011 Assessment 1 Diabetes Patient Concept Map Paper

NURS-FPX6011 Assessment 1 Diabetes Patient Concept Map Paper

NURS-FPX6011 Assessment 1 Diabetes Patient Concept Map Paper

Carole Lund Concept Map.

Concept Map. (On Request)                                                                                                                

Introduction

Carol Lund, a 44-year-old woman who just became a mother, is the subject of this case. Her infant is 10 weeks old. She struggles to keep her blood sugar levels within the usual range because she has gestational diabetes. The patient claims that being a new mother presents difficulties, which interferes with her capacity to adhere to her treatment plan and look after her health. She states that she doesn’t get enough sleep and that her health comes last (Capella University, 2022). She doesn’t appear to be aware of how serious uncontrolled diabetes is.

Patient Needs Analysis.

The first nursing diagnosis for this patient is the risk for unstable blood glucose levels. This is supported by her fasting glucose levels which range from 150 to 200 and beyond 200 after meals. Healthy fasting blood glucose is a reading of less than 140 mg/dL and a reading of less than 180 mg/dL after meals (Kautzky-Willer et al., 2019). Carol’s blood glucose does not fall within the recommended therapeutic range. She does not have adequate knowledge about her illness and how it can affect the body.

She also does not adhere to the diabetes management plan. She does not want to use insulin. She also reports failure to take insulin that her OB/GYN prescribed. Insulin is a hormone responsible for the control of blood glucose in the body. A deficiency or absolute lack of insulin in the body predisposes one to have elevated blood glucose levels. One of the complications of uncontrolled blood sugar in pregnant women is macrosomia, i.e., having a big baby (Plows et al., 2018).

The nurse’s intervention is to educate the patient on the dangers of uncontrolled blood sugar levels. The patient should also be educated on the signs of hyperglycemia, such as increased hunger, increased thirst, and increased urination. Nonspecific signs can include blurred vision and fatigue (Plows et al., 2018). Another intervention would be to examine factors contributing to uncontrolled blood glucose.

The third intervention would be to formulate strategies to prevent unstable blood glucose levels. The patient should also be encouraged to monitor her blood glucose regularly. The desired outcome would be optimal blood glucose control. This will be shown by the maintenance of the blood glucose within the acceptable ranges. This includes fasting blood glucose of less than 140 and blood glucose of less than 180 after meals.

The second diagnosis is Deficient knowledge regarding the disease, its pathophysiology, its effects on the body, and individual care needs. This is evidenced by Carol’s misconceptions about insulin. She believes that insulin is not her only option. She reports failure to take insulin prescribed by her OB/GYN. She does not have enough knowledge about insulin and its benefits in the treatment of diabetes mellitus. Insulin is required to reduce blood glucose to therapeutic levels (Brown et al., 2017).

The nursing interventions would be to assess the level of knowledge the patient has on diabetes and insulin. Patient education should then follow. This would entail providing information on the disease process of diabetes and also on the action and use of insulin. Carol will be taught the proper techniques for injecting insulin. The expected outcome is the patient will verbalize an understanding of the disease and the treatment. The patient will also demonstrate the ability to self-administer insulin competently.

The third diagnosis is disturbed sleeping patterns. This is evidenced by the patient’s personal report. She reports that she does not remember the last time she had a good night’s sleep. She is a single parent who recently delivered. Her infant is 10 weeks old. She finds it hard to balance between work, sleep, taking care of her health, and taking care of her baby.

The appropriate nursing intervention would be to educate the patient on the benefits of getting adequate sleep and the adverse effects of sleep deprivation. She can look for assistance to help her take care of her baby and manage her time better. This can help her reduce her stress. The patient can be educated on how she can use her baby’s sleeping patterns to her advantage.

Finally, the nurse can help the patient to create a bedtime routine. The expected outcome is for the patient to have a bedtime routine. The patient will verbalize having quality sleep by following her bedtime routine. The patient will also have less stress and fatigue. The patient will also report the use of support systems to assist with child care. 

Value and relevance of evidence

Diabetic patients must have enough knowledge, motivation, skills, and confidence to engage in self-management. These requirements are captured in the idea of patient activation. Patient activation has four levels. The first stage is whereby the patient feels the urgency to have an active role in their management. In the second stage, the patient has enough confidence and knowledge to participate actively. The patient acts in the third stage. In the fourth stage, the patient motivates herself to continue taking part actively (Heitkemper et al., 2021).

Knowledge of diet is necessary. Following a low fat, a low calorie is essential to help with managing blood sugars. The mother should also be encouraged to breastfeed, which has been shown to reduce maternal weight and helps regulate the baby’s blood sugars (Killion, 2018). An active lifestyle is also necessary for blood sugar control. These changes in activity, diet, and breastfeeding may need the motivation to ensure compliance and adherence.

Criteria for patient outcome evaluation.

Measurement of outcomes can be done using blood glucose measurements. Fasting Glucose should be below 140mg/dL and less than 180mg/dL after meals (Kautzky-Willer et al., 2019).    

Another criterion for measuring outcomes is via the measurement of HbA1C levels. HbA1C is used to measure long-term glycemic control. HbA1C levels below 7% are recommended (Harreiter & Roden, 2019). The patient can also monitor her weight. Weight reduction can be achieved by reducing stress, staying active, and following a low-fat, low-calorie diet.

Patient and family communication plan.

 The patient needs to be compliant to achieve the best outcomes for diabetes. 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 reports that she seeks advice from elders regarding 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 assisting with child care to enable the patient to minimize stress and fatigue.

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.

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.

• • • 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 Evaluation.
    • 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.

NURS-FPX6011 Assessment 1 Diabetes Patient Concept Map Paper Scoring Guide

CRITERIA	NON-PERFORMANCE	BASIC	PROFICIENT	DISTINGUISHED
Design an individualized, patient-centered concept map, based upon the best available evidence for treating a patient’s specific health, economic, and cultural needs.	Does not design an individualized, patient-centered concept map based on the best available evidence for treating a patient’s specific health, economic, and cultural needs.	Designs a patient-centered concept map, but the map is not well individualized to treat a specific patient’s health, economic, or cultural needs.	Designs an individualized, patient-centered concept map based on the best available evidence for treating a patient’s specific health, economic, and cultural needs.	Designs an individualized, patient-centered concept map based on the best available evidence for treating a patient’s specific health, economic, and cultural needs, and identifies. Outcomes for each diagnosis are aligned and complementary.
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.	Does not 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.	Attempts to 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.	Analyzes 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.	Analyzes 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. Identifies unanswered questions or areas of uncertainty where further information could improve the analysis.
Determine the value and relevance of evidence used as the basis of a patient-centered concept map.	Does not determine the value and relevance of evidence used as the basis of a patient-centered concept map.	Partially determines the value and relevance of evidence used as the basis of a patient-centered concept map.	Determines the value and relevance of evidence used as the basis of a patient-centered concept map.	Justifies the value and relevance of evidence used as the basis of a patient-centered concept map, and impartially considers conflicting data and other perspectives.
Propose relevant and measurable criteria for evaluating the outcomes the patient needs to achieve.	Does not propose criteria for evaluating the outcomes the patient needs to achieve.	Proposes insufficient or inappropriate criteria for evaluating the outcomes the patient needs to achieve.	Proposes relevant and measurable criteria for evaluating the outcomes the patient needs to achieve.	Proposes relevant and measurable criteria for evaluating the outcomes the patient needs to achieve and acknowledges challenges specific to such an evaluation process.
Develop a strategy for communicating with patients and their families in an ethical, culturally sensitive, and inclusive way.	Does not develop a strategy for communicating with patients and their families in an ethical, culturally sensitive, and inclusive way.	Develops a strategy for communicating with patients and their families that falls short of being ethical, culturally sensitive, or inclusive.	Develops a strategy for communicating with patients and their families in an ethical, culturally sensitive, and inclusive way.	Develops a strategy for communicating with patients and their families in an ethical, culturally sensitive, and inclusive way, and identifies assumptions on which the strategy is based.
Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style.	Does not integrate relevant and credible sources of evidence to support assertions; does not correctly format citations and references using APA style.	Sources lack relevance or credibility, are poorly integrated, or are incorrectly formatted.	Integrates relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style.	Integrates relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style. Citations are error-free.

Assessment Case Study: Evidence-Based Patient-Centered Concept Map

VILA HEALTH ® ACTIVITY

• Introduction
• Supervisor Email
• Diabetes Patient
• Concept Map
• Results & Conclusion

Introduction

Concept maps are an important tool in patient–centered care planning. A concept map helps to synthesize facts about a patient’s health needs and personal circumstances with available evidence and analysis. Such a tool becomes more useful when a patient has complex health, economic, and cultural needs.

In this simulation, you will be given a patient to interview and then assemble a concept map for use in that patient’s care plan.

Supervisor Email

You continue in your role as a nurse at the Uptown Wellness Clinic. You receive an email from the charge nurse, Janie Poole.

Email

From: Janie Poole

Subject: Patient Profiles

Good morning,

We have a new patient coming in today.

Her name is Carole Lund. Carole is a new mother who had gestational diabetes during her pregnancy. She has continued to track her blood glucose postpartum, and is worried that it does not appear to be stabilizing.

It probably will be helpful to create a concept map for Carole to show her this care plan in a visual way. Talk to your patient and start planning her care. Thanks!

— Janie Poole

Diabetes Patient

Reason for Referral:

Carole Lund is a 44–year–old woman of mixed Native American and European descent, and a new mother. She is concerned that she is not recovering from gestational diabetes.

Situation:

Carole is here with her daughter, Kassandra, who is 10 weeks old. Carole was diagnosed with gestational diabetes at week 30 of her pregnancy. She has carefully logged her blood glucose since the diagnosis, and it shows 150–200 fasting, over 200 following meals.

What diabetes treatments did you receive during your pregnancy?

Well, they gave me a glucometer, so I started using that. I could see right away that the way I was eating was a problem; I would usually work straight through the day and then have one big meal in the evening, and that was making my numbers bounce all over.

So I set alarms on my laptop, so three times a day I would get interrupted, have a small meal, take a short walk, and then test my blood sugar. That helped. And then I stopped drinking juice and soda, which I should have done years ago, and that helped too. But I don’t think my numbers improved as much as my OB/GYN wanted them to, but she said my blood sugar should return to normal after delivery.

Did your obstetrician advise you to take insulin during your pregnancy?

She did, yeah, and we talked about it. I don’t like the idea of being dependent on a drug. I called my mother. She’s still on the reservation, so she called the elders, and we all agreed that injecting my body with an animal hormone was a bad idea. But then the doctor told me that they make synthetic insulin now, but that means it’s made in a laboratory somewhere, and I’m not sure that’s any better.

By then I was in my third trimester, and all the tests said Kassandra was big but healthy, so I thought we would just ride it out. It was supposed to clear up after she was born. But it hasn’t, and I know you have to be careful having a baby at my age. I want to do what’s best, but I don’t want to believe that insulin is my only option.

Are there any challenges in your life which you think may be interfering with your ability to follow a treatment plan?

It’s harder now than it was before she was born. It’s just the two of us in the apartment, which is wonderful, but I don’t remember the last time I had a good night’s sleep. A lot of my work is freelance, so I make my own hours, but that also means if I’m not working I don’t get paid.

I had family help while I was recovering from the C-section, and they helped cook healthy meals for me, and kept me on my schedule. Now it’s all on me — work, caring for my daughter, and managing my blood sugar. If I fall behind on anything, it will be looking after my health.

Do you have any other concerns you’d like to have addressed?

I worry about Kassandra. She’s healthy and perfect, but I know that she’s at a greater risk for developing Type 2 Diabetes. I want to do whatever I can to reduce that risk, to care for her, and as she grows, to teach her how to care for herself.

Concept Map

Well, it sounds like this is a more complex case than we thought at first. I’m going to need you to put together a concept map for your patient’s care plan.

I need a brief description of your patient, and then up to five diagnoses (there may not be that many). Go in order of urgency, and make sure you list the professional or scholarly evidence you used to formulate the diagnosis. Just use in–text citations, please; we want to keep this short and sweet.

Thanks for taking this on!

Western Medical Enterprises Applicant Questionnaire

Directions: Please provide responses to the two sections below. The expectation is that each response is from 1-2 pages in length (not including the information already present in this document which is approximately 1 page). You are expected to support your assertions, ideas, or opinions with at least two scholarly or professional resources where appropriate using current APA style and formatting.

Section I: Leadership and Collaboration Experience

Briefly describe an instance where you were required to lead and motivate a team of professionals to collaborate. It does not need to be in a health care setting. If you have not lead a team of professionals before, use a different example.

Next, analyze your approach to the challenge using specific examples. It is not important whether or not your efforts were successful. What is important is the approach you take to appraising your leadership and collaboration decisions and actions. Do the following:

1. Analyze your leadership of the project. Consider the following:
   • What was the purpose or shared vision of the team?
   • The effectiveness of your leadership approach and style. Did you get “buy in” from stakeholders?
   • Decision making processes and outcomes? What were your good decisions? What would you have done differently?
   • How did you communication your vision, values, decisions, information, et cetera?
2. Analyze your approach to fostering collaboration and motivation among stakeholders. Consider:
   • How well you facilitated member or participant collaboration and engagement with one another. Did participants communicate effectively?
   • Actions you took to motivate people to realize your vision or tactics. Did the team or participants feel motivated and energized by you? Why or why not?

[Enter Your Response for Section 1 Here]

Section II: Ethics Experience

Briefly describe an ethical dilemma that that demonstrates your application of ethical principles in the health care setting. Next, analyze your response or actions (even if there were none) to the event against one of the reference points below. Were your (in)actions or choices supported by the chosen framework? Be specific and include two references citing one or more of the following.

• Any workplace code of ethics (consider choosing one from a place you work or have worked).
• The Professional code of ethics for your profession.

AND one of the following:

• Ethical Decision-Making in a Caring Environment: The Four Principles and Leads.
• American College of Healthcare Executives Code of Ethics.

[Enter Your Response to Section 2 Here]

***End of Document*** See Assessment 2 Patient-centred Care Report