NURS FPX 6021 Assessment 1 Concept Map

Name

Capella university

NURS-FPX 6021 Biopsychosocial Concepts for Advanced Nursing Practice 1

Prof. Name

Date

Narrative 

Scenario

With elevated glucose levels and acute renal failure, 52-year-old Black female Mrs. Smith, who had a history of Type II Diabetes Mellitus, was taken to the intensive care unit at St. Anthony Medical Centre. She had fasting blood sugar levels of about 200, which jumped to over 350 after meals, and an elevated hemoglobin A1C of 8.5%. In addition, Mrs. Smith reported experiencing weakness, hazy vision, exhaustion, decreased urine, leg edema, and shortness of breath (Capella University, n.d.). As her ICU nurse, you conducted a thorough assessment to develop a concept map for her care, focusing on her urgent needs, including managing her acute renal failure and hyperglycemia.

After stabilization, Mrs. Smith was discharged home and assigned to home health care for six weeks. During your first visit as her home health nurse, she reported improved fasting blood sugars and kidney function (Capella University, n.d.). However, she expressed concerns about limited support at home, relying mostly on her daughter, who visits occasionally. You updated her care plan to include monitoring her blood glucose, ensuring proper nutrition, and assessing her support system, with the goal of maintaining her recovery and preventing further complications.

Value and Relevance of Evidence 

The evidence supporting the concept map for Mrs. Smith’s care is both relevant and robust, deriving from established guidelines for managing Type II Diabetes Mellitus (T2DM) and acute renal failure. ElSayed et al. (2022), underscore the importance of nursing diagnoses such as “risk for unstable blood glucose levels” and “impaired physical mobility,” aligning with the American Diabetes Association (ADA) standards. These standards emphasize rigorous glucose control and regular monitoring to mitigate complications, underscoring their relevance to Mrs. Smith’s elevated HbA1c levels and fluctuating blood glucose. Such evidence highlights the need for targeted interventions and reinforces the critical nature of these diagnoses in Mrs. Smith’s care plan.

Evidence from Gutiérrez et al. (2022), supports the incorporation of patient education, consistent blood glucose monitoring, and dietary management into Mrs. Smith’s care. These interventions are consistent with best practices endorsed by the ADA and the American Association of Diabetes Educators (AADE), which stress the role of self-management and family involvement in chronic disease management (Green et al., 2020). These practices are particularly pertinent given Mrs. Smith’s condition, where effective glucose management and education can significantly impact her outcomes.

NURS FPX 6021 Assessment 1 Concept Map

It is crucial to consider conflicting perspectives. Some studies suggest that overly stringent glucose control may increase the risk of hypoglycemia, particularly in patients with renal impairment. This perspective highlights the need for individualized care plans that balance glucose control with the risk of hypoglycemia. The guidelines from (ADA, 2020) emphasize the importance of individualized care plans to balance glucose control and the risk of hypoglycemia, particularly for patients with conditions like renal impairment.

According to Wang and Wang (2023), the ADA and other organizations provide general guidelines, but the specific needs of patients like Mrs. Smith require tailored approaches. Thus, the evidence used in the concept map provides a solid foundation for Mrs. Smith’s care by integrating established guidelines and best practices. Despite some conflicting data on glucose control, the overall framework supports a comprehensive approach to managing her diabetes and renal health, reflecting high standards of patient care and safety.

Interprofessional Strategies 

Interprofessional strategies are crucial in managing complex cases like Mrs. Smith’s, particularly when addressing her diabetes and acute renal failure. Key strategies include coordinated care planning, where nurses, dietitians, and endocrinologists collaborate to develop and monitor a tailored treatment plan. According to Gutiérrez et al. (2022), this approach is supported by NANDA International-approved nursing diagnoses such as “risk for unstable blood glucose levels” and “impaired physical mobility.” These strategies are appropriate for Mrs. Smith’s case because they integrate diverse expertise to address both her metabolic condition and its complications.

The desired outcomes include achieving stable blood glucose levels, preventing further renal damage, and improving Mrs. Smith’s overall mobility and quality of life. By applying interprofessional collaboration, the team can ensure comprehensive care—dietitians can manage her nutritional needs, nurses can monitor her glucose levels, and endocrinologists can adjust her medication as necessary. However, potential challenges include ensuring consistent communication among team members and managing any conflicting recommendations (Sidani & Patel, 2023). Addressing these challenges requires clear communication protocols and regular team meetings to align care strategies. By bridging these gaps, interprofessional collaboration enhances the likelihood of achieving desired outcomes, ultimately leading to improved patient health and safety.

Additional Evidence

To ensure clear communication and facilitate understanding, the concept map for Mrs. Smith’s case is structured to visually link key diagnoses with relevant evidence, interventions, and outcomes. Each section of the map is interconnected with specific evidence-based strategies, such as the use of insulin therapy and dietary modifications, which are supported by current diabetes management guidelines (Green et al., 2020). For instance, “risk for unstable blood glucose levels” is linked to evidence from the ADA guidelines, emphasizing the importance of glycemic control through tailored medication and lifestyle interventions (ADA, 2020).

Each diagnosis in the map is associated with relevant evidence, allowing the reader to trace the rationale behind each intervention and expected outcome easily. Clear labeling of these connections enhances the readability of the map, ensuring that the relationship between evidence and practice is transparent. This structured approach not only simplifies complex information but also strengthens the care plan by grounding it in best practices.

Conclusion

The evidence-based approach for managing Mrs. Smith’s care effectively integrates established guidelines and best practices for Type II Diabetes Mellitus and acute renal failure. Despite the need to balance glucose control with the risk of hypoglycemia, the comprehensive care plan—rooted in ADA guidelines and supported by recent studies—demonstrates a robust framework for improving her health outcomes. By incorporating interprofessional strategies and patient education, the plan addresses her unique needs and promotes sustained recovery and quality of life.

References

ADA. (2020). Find a diabetes education program | ADA. Diabetes.org. https://diabetes.org/tools-resources/diabetes-education-programs 

Capella University. (n.d.). Capella University: Online accredited degree programs. Capella.edu. https://www.capella.edu/ 

NURS FPX 6021 Assessment 1 Concept Map

ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Hilliard, M. E., Isaacs, D., Johnson, E. L., Kahan, S., Khunti, K., Leon, J., Lyons, S. K., Perry, M. L., Prahalad, P., Pratley, R. E., Seley, J. J., Stanton, R. C., & Gabbay, R. A. (2022). Classification and diagnosis of diabetes: Standards of care in diabetes. Diabetes Care, 46(Supplement_1), S19–S40. https://doi.org/10.2337/dc23-s002 

Green, D. S., Feder, S. L., Odom, J. N. D., Batten, J., En Long, V. J., Harris, Y., Wilpers, A., Wong, T., & Whittemore, R. (2020). Family caregiver support of patient self-management during chronic, life-limiting illness: A qualitative metasynthesis. Journal of Family Nursing, 27(1), 55–72. https://doi.org/10.1177/1074840720977180 

Gutiérrez, D. Á. F., Brito, P. R. B., Curvo, S. D., León, A. C., Alberto, C. E. M., & Jaime, A. A. (2022). Cross‐mapping medical records to NANDA‐I to identify nursing diagnoses in a vulnerable population. International Journal of Nursing Knowledge. https://doi.org/10.1111/2047-3095.12371 

Sidani, S., & Patel, K. (2023). Interprofessional education in diabetes care—findings from an integrated review. Diabetology, 4(3), 356–375. https://doi.org/10.3390/diabetology4030030 

NURS FPX 6021 Assessment 1 Concept Map

Wang, R., & Wang, Z. (2023). Precision medicine: Disease subtyping and tailored treatment. Cancers, 15(15), 3837–3837. https://doi.org/10.3390/cancers15153837