Concept Map: Patient Information Assignment

 See uploaded file for assignment requirement
Create a concept map of a chosen condition, disease, or disorder with glucose regulation or metabolic balance considerations. Write a brief narrative (2–3 pages) that explains why the evidence cited in the concept map and narrative are valuable and relevant, as well as how specific interprofessional strategies will help to improve the outcomes presented in the concept map.

Excess Fluid Loss

Excess fluid loss is a possible diagnosis for this patient due to fluid and electrolyte loss via vomiting. Excess fluid loss is diabetes caused by hyperglycemia results in glycosuria and osmotic diuresis. Because the kidney has a lower threshold for ketoacidosis precipitated by diabetes, the ketones and released in urine, further exacerbating electrolyte loss. The patient may also report larger sodium loss resulting from intravascular dehydration. Thus, patients report polydipsia which can be managed by fluid infusion (Seddik et al., 2019). Volume depletion in diabetes triggers the secretion of hormones such as catecholamines and vasopressin. The hormones direct their action towards improving intravascular volume which also precipitates insulin resistance. Concept Map: Patient Information Assignment.

Patients experiencing excess fluid loss from diabetes report polyuria, polydipsia, weight loss, and abdominal pain. Managing abdominal pain revolves around returning the body to homeostasis from possible metabolic acidosis. When physically examined, nurses can find patients showing hypotension, tachycardia, poor skin turgor, and weakness. The high rate of dehydration may closely be linked to DKA which is an emergency complication in diabetes (Seddik et al., 2019). Mental status issues may be identified correlating with the degree of acidosis and hyperosmolarity. Patients may also be hypothermic due to reduced peripheral blood flow and decreased utilization of metabolic substrates.

The therapeutic management of excess fluid loss resulting from diabetes can focus on ensuring volume status, establishing glycemic control, and ketosis and electrolyte balance. Therefore, intravenous fluids can be administered with a blood sample being taken for laboratory analysis of ketone bodies. Initiation of insulin therapy after evaluation of potassium level to be less than 3.3 mEq/L (Seddik et al., 2019). The expected outcome for this case includes normal plasma blood glucose, venous pH being greater than 7.3, and bicarbonate concentration exceeding 18mEq/L(Seddik et al., 2019).

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Imbalanced Nutrition

Diabetic ketoacidosis which may be demonstrated in this patient can be precipitated by imbalanced nutrition – where the patient’s nutritional demand exceeds daily intake. This may be related to decreased oral intake or a hypermetabolic state where excess stress hormones such as cortisol and catecholamines lead to excess body nutritional demands (Lipatov et al., 2019).Concept Map: Patient Information Assignment.  Thus, patients with inadequate nutrition may have increased urinary output, nausea, and diarrhea, recent weight loss, anorexia, and fatigue. Subjectively, patients may report decreased food intake.

Risk of Infection

DKA in diabetes can also be precipitated by infection risks. This may be demonstrated by high body temperature and fever reported by patients. Infection is one of the triggers of DKA with various microbiological agents documented to precipitate DKA in diabetic patients. The frequent gastrointestinal symptoms in DKA can be linked to gastrointestinal symptoms. Imperatively, patients report nausea, vomiting, and diarrhea which correlate with gastrointestinal tract infections. Viral infections have also been implicated although they are usually missed during DKA diagnosis (Smati et al., 2020). Early diagnosis and treatment of infections result in the achievement of patient care goals.

Interprofessional Collaboration

As part of the interprofessional team, the nurse taking care of the patient can collaborate with a dietician for a resumption of oral intake. The rationale for this is to adjust the patient’s diet requirements to meet the body’s nutritional needs. One of the nursing interventions can focus on auscultation bowel sounds to identify abdominal pain, bloating, or nausea. This is because imbalances in the fluids and electrolytes in hyperglycemia reduces gastric motility. Patients may experience delayed gastric emptying which can influence nursing interventions. Patient education can involve community health workers educating them on medication adherence and the importance of nutrition in achieving glycemic control and mitigating risk factors of DKA (Ahuja et al., 2019).

References

Ahuja, W., Kumar, N., Kumar, S., & Rizwan, A. (2019). Precipitating risk factors, clinical presentation, and outcome of diabetic ketoacidosis in patients with type 1 diabetes. Cureus, 11(5). Concept Map: Patient Information Assignment.

Lipatov, K., Kurian, K. K., Shaver, C., White, H. D., Ghamande, S., Arroliga, A. C., & Surani, S. (2019). Early vs late oral nutrition in patients with diabetic ketoacidosis admitted to a medical intensive care unit. World journal of diabetes, 10(1), 57.

Seddik, A. A., Bashier, A., Alhadari, A. K., AlAlawi, F., Alnour, H. H., Hussain, A. A. B., … & Railey, M. J. (2019). Challenges in the management of diabetic ketoacidosis in hemodialysis patients, case presentation and review of the literature. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 13(4), 2481-2487.

Smati, S., Moreau, P. M., Bourdiol, A., Ploteau, S., Hadjadj, S., & Cariou, B. (2020). Euglycaemic ketoacidosis during gestational diabetes with concomitant COVID-19 infection. Diabetes & Metabolism.

Create a concept map of a chosen condition, disease, or disorder with glucose regulation or metabolic balance considerations. Write a brief narrative (2–3 pages) that explains why the evidence cited in the concept map and narrative are valuable and relevant, as well as how specific interprofessional strategies will help to improve the outcomes presented in the concept map.

This assessment is one in which you will create a concept map to analyze and organize the treatment of a specific patient with a specific condition, disease, or disorder.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

• Competency 1: Design patient-centered, evidence-based, advanced nursing care for achieving high-quality patient outcomes.
  • Develop an evidence-based concept map that illustrates a plan for achieving high-quality outcomes for a condition that has impaired glucose or metabolic imbalance as related aspects.
  • Justify the value and relevance of the evidence used as the basis for a concept map.
• Competency 4: Evaluate the efficiency and effectiveness of interprofessional care systems in achieving desired health care improvement outcomes.
  • Analyze how interprofessional strategies applied to the concept map can lead to achievement of desired outcomes.
• Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with organizational, professional, and scholarly standards.
  • Construct concept map and linkage to additional evidence in a way that facilitates understanding of key information and links. Concept Map: Patient Information Assignment.
  • Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.

The assessment will be based on the case of a specific patient with a specific condition, disease, or disorder. Think about an experience you have had treating a patient with a condition, disease, or disorder that interests you, or one of the cases presented in the Vila Health: Concept Maps as Diagnostic Tools media simulation.

Optional Vila Health: Concept Maps as Diagnostic Tools

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 conducting a short interview with a patient and then assembling a concept map for use in that patient’s care plan.

St. Anthony Medical Center

Exam Room

You are a nurse at St. Anthony Medical Center. You have been asked to interview Carrie, an incoming patient. Carrie Alves is a 31-year-old woman who is concerned about problems with her menstrual cycle. Ask her some questions to find out more about her situation.

Interview:

Your intake form says that you’re experiencing irregularities in your menstrual cycle. Can you tell me more?

Alves: Yeah. I’m kind of freaked out. I used to be really regular, but for the past six months or so, my cycle’s been way, way off. I think I’ve only had three periods in that time frame, and the timing between them has been really random.

That sounds very upsetting.

Alves: Yes, definitely! At first, I was excited when I didn’t get my period- my husband and I have been trying to get pregnant for a while now, and I thought we’d succeeded. Then I took a pregnancy test and saw that wasn’t what was going on. Still, I thought maybe the change to my cycle was because my body was getting used to quitting birth control.

Are you experiencing any other symptoms?

Alves: I’m not sure. I guess I have a few other things going on, but I’m not sure if they’re related or not.

Such as?

Alves: I’ve had a lot of trouble sleeping lately. I have these really vivid dreams and then just pop awake and can’t get back to sleep. I guess I’m putting on weight… I was kind of afraid to weigh myself at home, but I’ve noticed my pants haven’t been fitting very well. Then I got weighed here and… sigh. Looks like I’m up 12 pounds.

I’ve also– and I know this is weird – I’ve been having really bad acne breakouts. I thought maybe that was from my hormones getting out of whack from getting off birth control, too, but it’s been going on for a while. I don’t know. And – this is also weird– I’ve had a bunch of hairs growing on my chin all the sudden. I pluck them, and they grow right back.

The Concept Map

Record Your Observations

After interviewing Carrie Alves, you should organize your observations and thoughts into a concept map that can clarify the situation.

Once you’ve planned your patient’s care, you will be able to download your concept map.

Conclusion

Using a concept map to plan a patient’s care can be essential when the case and the patient’s overall needs are complex. In this simulation, you’ve used the details of a patient’s case to draft a concept map for her care.

Click either the Word Doc or PDF button below to download the text for your concept map draft. You will use this text to create a final concept map for your assignment in this unit. Concept Map: Patient Information Assignment.

After you’ve downloaded your text, you will put it into a concept map template. You may use the template provided in the assignment, another template, or your own concept map format for your final map.

Click any heading in your concept map to reveal the complete content.

Scenario

You have already learned about evidence-based practice and quality improvement initiatives in previous courses. You will use this information to guide your assessments, while also implementing new concepts introduced in this course. For this assessment, you will develop a concept map and provide supporting evidence and explanations. You may use the case studies presented in the Vila Health: Concept Maps as Diagnostic Tools media, a case study from the literature or your practice that is relevant to the list of conditions below, or another relevant case study you have developed. This case study will provide you with the context for creating your concept map. You may also use the practice context from the case study or extrapolate the case study information and data into your own practice setting. Think carefully when you are selecting the case study for this assessment, as you may choose to build upon it for the second assessment as well.

Some example conditions, diseases and disorders that are relevant to metabolic balance and glucose regulation considerations are:

• Cancer.
• Diabetes (type 2).
• HIV/AIDS.
• Hyperthyroidism.
• Hypothyroidism.
• Metabolic syndrome.
• Obesity.
• Polycycstic ovary syndrome.
• Prediabetes.
• Pregnancy.

Instructions

Develop a concept map and a short narrative that supports and further explains how the concept map is constructed. You may choose to use the Concept Map Template (in the Resources) as a starting point for your concept map, but are not required to do so. The bullet points below correspond to the grading criteria in the scoring guide.  Concept Map: Patient Information Assignment.Be sure that your evidence-based plan addresses all of them. You may also want to read the Concept Map scoring guide and the Guiding Questions: Concept Map document to better understand how each grading criterion will be assessed.

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Part 1: Concept Map

• Develop an evidence-based concept map that illustrates a plan for achieving high-quality outcomes for a condition that has impaired glucose or metabolic imbalance as related aspects.

Part 2: Additional Evidence (Narrative)

• Justify the value and relevance of the evidence you used as the basis for your concept map.
• Analyze how interprofessional strategies applied to the concept map can lead to achievement of desired outcomes.
• Construct concept map and linkage to additional evidence in a way that facilitates understanding of key information and links.
• Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.

Additional Requirements

• Length of submission: Your concept map should be on a single page, if at all possible. You can submit the concept map as a separate file, if you need to. Your additional evidence narrative should be 2–3 double-spaced, typed pages. Your narrative should be succinct yet substantive.
• Number of references: Cite a minimum of 3–5 sources of scholarly or professional evidence that supports your concept map, decisions made regarding care, and interprofessional strategies. Resources should be no more than five years old.
• APA formatting:
  • For the concept map portion of this assessment: Resources and citations are formatted according to current APA style. Please include references both in-text and in the reference page that follows your narrative.
  • For the narrative portion of this assessment: use the APA Paper Template linked in the Resources. An APA Template Tutorial is also provided to help you in writing and formatting your analysis. You do not need to include an abstract for this assessment.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

• Concept Map Example [].

• Concept Map Scoring Guide

 Concept Map: Patient Information Assignment