NURS FPX 6021 Assessment 1 Concept Map
Student Name
Capella University
NURS-FPX 6021 Biopsychosocial Concepts for Advanced Nursing Practice 1
Prof. Name
Date
Introduction to Narrative
This assessment introduces concept maps based on the Vila Health scenario for a patient with acute renal failure and type 2 diabetes mellitus. The concept maps in the narrative are created for two different settings: the patient’s acute care setting at St. Anthony Medical Center Home Health Agency and the home health community setting following the patient’s discharge from the acute care setting.
Value and Relevance of the Evidence
The two concept maps for Mrs. Smith in acute and chronic healthcare settings were developed by utilizing beneficial and pertinent evidence-based articles. Since they were all published within the last five years, all of the articles used are current. Additionally, the articles are published in pertinent medical, nursing, and health fields. The Terauchi et al. (2020) article highlights the use of insulin and anti-diabetic medications to treat diabetes pharmacologically. This article argues that Mrs. Smith can adequately manage her diabetes by using insulin and other prescription anti-diabetic drugs.
In a different paper, Sardu et al. (2020) recommend using oxygen to treat dyspnea in addition to employing techniques like head elevation to promote better breathing effort and ideal lung expansion. Similarly, evidence-based sources recommend utilizing diuretics, avoiding excessive fluid intake, and elevating the limbs to treat peripheral edema brought on by acute kidney failure (Chhablani et al., 2020; Patschan et al., 2019; Singh & Revand, 2022). These evidence-based resources are the source of these interventions since they are most appropriate for Mrs. Smith’s situation.
NURS FPX 6021 Assessment 1 Concept Map
In the same way, the articles included in the second idea map are accurate and up-to-date. These documents provide evidence of their value and relevance to the situation of Mrs. Smith that was discussed. Powers and others (2020) have produced an evidence-based resource that emphasizes the importance of self-management education and support for patients with diabetes. These approaches help patients control their diabetes without the use of prescription drugs. Patients who receive diabetes self-management education might learn about healthy eating habits, exercise regimens, and other lifestyle modifications.
Mrs. Smith can benefit from this invaluable resource as she needs more information about a healthy diet. Moreover, overcoming the social isolation that many diabetics experience requires making use of these social support networks and neighborhood services. The intervention created for Mrs. Smith to address the diagnosis of her tendency toward social isolation is supported by this article. Sujan et al. (2021) encourage family involvement in disease management, particularly with diabetes mellitus, because it is a chronic ailment that needs numerous forms of assistance from peers, family, and social support groups.
A further resource by Lambrinou et al. (2019) highlights the critical role dieticians play in creating healthy diet programs and attending to the nutritional demands of diabetes. This strategy encourages the dietician to work with Mrs. Smith to develop simple, diabetes-friendly meal plans that she can prepare on her own. Briggs et al. (2020) emphasize in their study that by using social support and community groups, diabetics can keep up inspiration, consistency, and motivation in their diabetes management.
Interprofessional Strategies
In order to provide patient-centered care for chronic illnesses like diabetes and renal failure, interprofessional cooperation is crucial. The multidisciplinary team members must also collaborate with other members of the discipline, like the dietitians in Mrs. Smith’s case study. Drugs prescribed by physicians for diabetes and peripheral edema are administered by nurses. To guarantee that they administer them without making any mistakes, they must work in tandem with physicians. Similarly, nurses work in tandem with social workers and dieticians to attend to Mrs. Smith’s nutritional and social needs.
The nurses need to talk to the patient’s family in order to speed up the diabetes treatment process even further. The knowledge gaps in interprofessional techniques that still exist are caused by lack of understanding about the members of Mrs. Smith’s family who can help manage her health in the event that her daughter is unable to visit. In addition, her food choices have yet to be investigated in order to create plans that accommodate her tastes and demands. A more profound comprehension of these variables might have improved the analysis.
Additional Evidence
A scenario for Mrs. Smith, a 52-year-old black lady admitted to the intensive care unit of the St. Anthony Medical Center Home Health Agency, is depicted in the first concept map. The patient initially complained of weakness, hazy vision, shortness of breath, elevated blood sugar, and trouble voiding due to peripheral edema. In addition to acute renal failure, the patient also had type 2 diabetes. Using the NANDA worldwide diagnosis, three nursing diagnoses—type-2 diabetes causing hyperglycemia, impaired gas exchange, and poor renal function —were created. Nursing assessments and therapies appropriate for each of these evidence-based nursing diagnoses were made. Evidence supports these approaches even more.
Following Mrs. Smith’s six-week discharge from the ICU, she transitions to home healthcare for six weeks in a community setting. Post-hospital discharge, her blood glucose levels are effectively managed, urinary output normalized, and ankle swelling reduced. However, ongoing management of her chronic conditions necessitates adherence to treatment plans and a healthy lifestyle. Mrs. Smith expresses a need for further education on healthy eating habits. Still, she faces challenges as she is unable to cook healthy meals herself, and her daughter, a mother of three, cannot accommodate her dietary requirements.
NURS FPX 6021 Assessment 1 Concept Map
Patient-centered communication, actively listening to Mrs. Smith’s concerns, and using language in layman’s terms are all integrated communication tactics that promote clear communication. By using these techniques, the patient was able to express her personal and medical concerns about diabetes and acute renal failure clearly and concisely.
Conclusion
One of the comorbidities that diabetes mellitus is commonly associated with is acute renal failure. Mrs. Smith’s situation was similar and necessitated long-term home health care after intensive care in the intensive care unit. The concept map outlines the interventions that are based on evidence-based sources and require good interprofessional and communication tactics.
References
Briggs, F. H., Adler, N. E., Berkowitz, S. A., Chin, M. H., Gary-Webb, T. L., Navas-Acien, A., Thornton, P. L., & Haire-Joshu, D. (2020). Social determinants of health and diabetes: A scientific review. Diabetes Care, 44(1), 258–279. https://doi.org/10.2337/dci20-0053
Chhablani, J., Wong, K., Tan, G. S., Sudhalkar, A., Laude, A., Cheung, C. M. G., Zhao, P., Uy, H., Lim, J., Valero, S., Ngah, N. F., & Koh, A. (2020). Diabetic macular edema management in Asian population: Expert panel consensus guidelines. Asia-Pacific Journal of Ophthalmology, 9(5), 426–434. https://doi.org/10.1097/apo.0000000000000312
Duncan, B. B., Cousin, E., Naghavi, M., Afshin, A., França, E. B., Passos, V. M. de A., Malta, D., Nascimento, B. R., & Schmidt, M. I. (2020). The burden of diabetes and hyperglycemia in Brazil: A global burden of disease study 2017. Population Health Metrics, 18(S1). https://doi.org/10.1186/s12963-020-00209-0
NURS FPX 6021 Assessment 1 Concept Map
Ernawati, U., Wihastuti, T. A., & Utami, Y. W. (2021). Effectiveness of diabetes self-management education (DSME) in type 2 diabetes mellitus (T2DM) patients: Systematic literature review. Journal of Public Health Research, 10(2), 198–202. https://doi.org/10.4081/jphr.2021.2240
Lambrinou, E., Hansen, T. B., & Beulens, J. W. (2019). Lifestyle factors, self-management and patient empowerment in diabetes care. European Journal of Preventive Cardiology, 26(2), 55–63. https://doi.org/10.1177/2047487319885455
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. https://doi.org/10.3390/jpm12040643
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
Powers, M. A., Bardsley, J. K., Cypress, M., Funnell, M. M., Harms, D., Hess-Fischl, A., Hooks, B., Isaacs, D., Mandel, E. D., Maryniuk, M. D., Norton, A., Rinker, J., Siminerio, L. M., & Uelmen, S. (2020). Diabetes self-management education and support in adults with type 2 diabetes: A consensus report of the American Diabetes Association, the Association of Diabetes Care & Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAS, the American Association of Nurse Practitioners, and the American Pharmacists Association. Journal of the American Pharmacists Association, 60(6). https://doi.org/10.1016/j.japh.2020.04.018
NURS FPX 6021 Assessment 1 Concept Map
Raza, A., Estepa, A., Chan, V., & Jafar, M. S. (2020). Acute renal failure in critically ill COVID-19 patients with a focus on the role of renal replacement therapy: A review of what we know so far. Cureus. https://doi.org/10.7759/cureus.8429
Sardu, C., Gambardella, J., Morelli, M. B., Wang, X., Marfella, R., & Santulli, G. (2020). Hypertension, thrombosis, kidney failure, and diabetes: Is COVID-19 an endothelial disease? A comprehensive evaluation of clinical and basic evidence. Journal of Clinical Medicine, 9(5), 1417. https://doi.org/10.3390/jcm9051417
Singh, S. K., & Revand, R. (2022). Physiological basis of lower limb edema. Approach to Lower Limb Oedema, 25–43. https://doi.org/10.1007/978-981-16-6206-5_3
Subrata, S. A. (2021). The nursing outlook of the self- and family management support programs among Indonesians with diabetes: An umbrella review. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 15(1), 109–119. https://doi.org/10.1016/j.dsx.2020.12.018
Sujan, Md. S. H., Tasnim, R., Islam, Md. S., Ferdous, Most. Z., Apu, Md. A. R., Musfique, Md. M., & Pardhan, S. (2021). COVID-19-specific diabetes worries amongst diabetic patients: The role of social support and other co-variates. Primary Care Diabetes. https://doi.org/10.1016/j.pcd.2021.06.009
Terauchi, Y., Nakama, T., Spranger, R., Amano, A., Inoue, T., & Niemoeller, E. (2020). Efficacy and safety of insulin glargine/lixisenatide fixed‐ratio combination ( iGlarLixi 1:1) in Japanese patients with type 2 diabetes mellitus inadequately controlled on oral antidiabetic drugs: A randomized, 26‐week, open‐label, multicentre study: The Lixilan JP‐O2 randomized clinical trial. Diabetes, Obesity and Metabolism, 22(S4), 14–23. https://doi.org/10.1111/dom.14036