NURS FPX 6021 Assessment 1 Concept Map

Name

Capella university

NURS-FPX 6021 Biopsychosocial Concepts for Advanced Nursing Practice 1

Prof. Name

Date

Concept Map: Acute Care Setting 

Concept Map: Home Health Community Setting

Introduction to Narrative

This assessment introduces the concept maps centered on the Vila Health scenario for patients with type two diabetes mellitus and acute kidney failure. In this narrative, the concept maps are developed for two settings: an acute care setting for the patient and the home health community setting after the patient is discharged from the acute care setting at St. Anthony Medical Center Home Health Agency.

Value and Relevance of the Evidence

The evidence-based articles used in creating the two concept maps for Mrs. Smith in acute and chronic healthcare settings are valuable and highly relevant to the case scenario. All the articles used are current, as they were published within the last five years. Moreover, the articles are published in relevant health, nursing, and medicine fields. The article by Terauchi et al. (2020) emphasizes using insulin and antidiabetic drugs to improve diabetes by pharmacological approach. This article justifies the use of insulin and other prescribed anti-diabetic medications for Mrs. Smith to manage her diabetes effectively.

Similarly, evidence-based sources suggest the treatment of peripheral edema due to acute kidney failure by using diuretics and preventing excessive intake of fluids along with positioning the elevated limbs (Chhablani et al., 2020; Patschan et al., 2019; Singh & Revand, 2022). Another article by Sardu et al. (2020), suggests using oxygen to address the shortness of breath and implementing strategies like elevating the head to facilitate improved respiratory effort and optimal lung expansion.  These interventions are derived from these evidence-based resources as they best fit Mrs. Smith’s case.

NURS FPX 6021 Assessment 1 Concept Map

Similarly, the second concept map’s articles are authentic and current. These articles show their value and relevance to the case discussed about Mrs. Smith. The evidence-based resource by Powers et al. (2020), highlights the need and significance of self-management education and support for diabetic patients. These interventions guide patients in managing diabetes without pharmacological methods. Through education on self-management of diabetes, patients can acquire guidelines on a healthy diet, physical activity, and other lifestyle changes. This valuable resource is relevant to Mrs. Smith as she requires further knowledge on healthy diet. Another resource by Lambrinou et al. (2019), emphasizes the significant role of dieticians in addressing the dietary needs of diabetics and making healthy diet plans.

This approach inspires the collaboration of the dietician with Mrs. Smith to create diabetes-friendly meal plans that she can easily make herself. The article by Briggs et al. (2020), stresses using social support and community groups for diabetics to stay inspired, consistent, and motivated in their diabetes management. Moreover, these community resources and social support groups are vital to overcoming the social isolation among diabetics. This article supports the intervention developed for Mrs. Smitb to address the diagnosis of her vulnerability to social isolation. The article by Sujan et al. (2021), supports family involvement in disease management, especially in diabetes mellitus, as a chronic condition requires multiple support from family members, peers, and social support group members.

Interprofessional Strategies

In managing chronic diseases like diabetes and renal failure, interprofessional collaboration is vital to provide patient-centered care. Nurses are the bridging personnel that deliver care treatments physicians prescribe to patients. They must also coordinate with other discipline members, such as nutritionists in Mrs. Smith’s case study. The medications physicians prescribe for diabetes and peripheral edema are administered by nurses (Chhablani et al., 2020). They must collaborate with physicians to ensure they administer them without any errors. Similarly, nurses collaborate with dieticians and social workers to address Mrs. Smith’s dietary and social needs. Moreover, the nurses must coordinate with the patient and her family to streamline the diabetes management process (Powers et al., 2020).

The knowledge gaps that persist in interprofessional strategies are related to  Mrs. Smith’s limited knowledge about her family members who can participate in managing their condition when her daughter is unable to attend. Moreover, her dietary preferences are yet to be explored to create plans that suit her preferences and health needs. Further knowledge of these factors could have improved the analysis (Powers et al., 2020).  

Additional Evidence 

The first concept map comprises an acute care setting scenario for Mrs. Smith, a 52-year-old black woman admitted to the St. Anthony Medical Center Home Health Agency in the ICU. The patient’s presenting complaints were high blood glucose levels, shortness of breath, difficulty in voiding due to peripheral edema, blurred vision, and weakness. The patient had type-2 diabetes along with acute kidney failure. Three nursing diagnoses were developed using NANDA international diagnoses, including hyperglycemia, impaired renal function, and impaired gas exchange. Nursing assessments and interventions suitable to each nursing diagnosis were developed for these evidence-based diagnoses (Barreiro et al., 2020). These interventions are further substantiated by evidence.

The second concept map is created for Mrs. Smith after her six-week discharge from the ICU to a community healthcare setting under home healthcare for six weeks. After discharge from the hospital, their blood glucose levels are well-managed, her urinary output is standard, and the swelling in her ankle is reduced. Her chronic conditions need to be managed by a healthy lifestyle and adherence to treatment plans. The patient also shares the need for further knowledge on a healthy diet. However, the patient cannot cook healthy meals, and her daughter, as a mom of three kids, cannot meet her dietary needs. Based on these situations, three diagnoses are developed, including Diabetes self-management education and support to teach lifestyle modification and healthy diet, imbalanced nutrition, and lack of social support inclining towards social isolation (Power et al., 2020). The interventions developed for these diagnoses are based on evidence-based resources and are relevant to the patient scenarios. 

The communication strategies that are integrated to ensure clear communication are using layman’s language understandable by Mrs. Smith, active listening to her concerns, and communicating with a patient-centered approach. Through these strategies, the patient communicated clearly by sharing her personal and health concerns related to diabetes and acute kidney disease failure (Mheidly & Fares, 2020).

Conclusion

Diabetes mellitus is often associated with other comorbidities, such as acute kidney failure. In Mrs. Smith’s case, her condition was similar and required ultimate care in the ICU followed by chronic home healthcare. The concept map discusses the interventions that are based on evidence-based sources and require effective interprofessional and communication strategies.

References

Barreiro, R. G., Lopes, M. V. de O., & Cavalcante, L. D. P. (2020). Middle-range theory for the nursing diagnosis of low self-efficacy in health. Revista Brasileira de Enfermagem, 73(5). https://doi.org/10.1590/0034-7167-2019-0370 

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

Mheidly, N., & Fares, J. (2020). Leveraging media and health communication strategies to overcome the COVID-19 infodemic. Journal of Public Health Policy, 41(4), 410–420. https://doi.org/10.1057/s41271-020-00247-w  

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 

NURS FPX 6021 Assessment 1 Concept Map

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 

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 indonesian 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 

NURS FPX 6021 Assessment 1 Concept Map

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