NURS FPX 6021 Assessment 1 Concept Map

Concept Map of Glucose Regulation of Patient Problem

This paper consists of an evidence-based concept map that helps healthcare professionals to understand the nursing care plan regarding the glucose regulation of a chosen patient care population to enhance the quality of outcomes. The concept map contains urgent diagnoses and various strategies nurses can follow and collaboration approaches. The concept map helps to justify the value and relevance of the related evidence and address any conflicting information and the scope of interprofessional collaborations in achieving high-quality outcomes (Askelson et al., 2021).  

NURS FPX 6021 Assessment 1 Concept Map

Justification of the Value and the Relevance of Evidence 

The evidence is related to the patient named Henley who is 69 years old and has a family history of abnormal glucose levels and blood sugar. The patient suffers from risk of unstable glucose level. The data address obtained after an investigation shows that Henley has been having a higher blood glucose that has been exceeding 140 to 180 mg/dL (Pantha, 2021). The leaders suggested that non-intensive care patient must be treated adequately and their blood glucose level must be maintained at pre-meals level at less than 140 mg/dL. The analysis showed that the common cause of increase glucose level was lack of diabetes management knowledge, lack of development of blood glucose knowledge, inadequate monitoring of blood glucose, and insulin deficiency in the patient (Pan et al., 2018). The goals and outcomes of nurses now are to ensure the patient retains a blood glucose level of less than 180 mg/dL and the fasting blog glucose level less than 140 mg/dL. The nurses performed two types of diagnosis techniques such as problem-focused diagnosis and “risk nursing diagnosis”. The purpose of using these techniques is to identify and highlight signs and symptoms in the current patient and these symptoms are easiest to describe. Nurses have seen many problems in the patient throughout shifts. The problem-focused diagnosis will help to not only describe the patient problem but will also identify the related factors. For example, the reduced cardiac output shows that the patient has been suffering from chronic constipation and had an impaired gas exchange (Gebresillassie, 2020). Moreover, some risk factors in the pateints such as risk of imbalanced glucose and insulin levels and impaired oral mucous membrane integrity require nurses to use their clinical judgments and reasoning (Zhou, 2021).

The nursing assessment show that the interprofessional strategies such as enhanced collaboration between health care professionals and the patient are vital to obtain the high-quality outcomes. However, the improvement of successful collaboration needs a positive attitude to improve the level of mutual feedback for creating non-discriminatory cultures (Askelson et al., 2021). 

Using the NANDA-I-approved nursing diagnosis, nurses are able to make diagnosis as nurse’s assigned meaning to patient data. For instance, nurses felt that the client was stressful, anxious, fearful, sleep depreciated and short of breath. The patient’s response also shows that nurses were able to diagnose that shows that the patient has risk for lung cancer disease and impaired lung function (Archer, 2022). It is different from medical diagnosis that is formulated after a physician’s examination of the patient. Nursing diagnoses shows that the psychological response of the patient was adverse. Nurses’ beliefs and life principles also play a role in nurses’ diagnoses. Therefore, the cardiovascular and pulmonary responses of the patient were not good enough that showed neurobehavioral stress that hindered the growth and development of the patient’s health (Zhou, 2021). 

 Since the patient has been given inadequate dose of insulin to glucose, he suffered from hyperglycemia. As a result, his adrenergic activity had increased which also caused tremors, dizziness, headache, fatigue, hunger, and visual changes (Askelson et al., 2021). This also contributed to the development of type 2 diabetes and the dysfunction in peripheral tissues. In the patient. Therefore, the nursing assessment will include the eating patterns of the patient such as adherence to the diet related to this clinical condition to improve the glucose fluctuations. The nurses will also monitor peripheral neuropathy sings in patients’ body by studying their pulse, color, and feet sensations (Gebresillassie, 2020). Moreover, the assessment of patient’s current knowledge is also vital because that will advise him the right physical activity to lessen their blood glucose level. This strategy is also a vital element of diabetes management in patients and also reduces the chances of cardiovascular problems such as stroke and heart attack (Bignyak, 2021). The alcohol consumption of the patient should be reduced to zero with adequate food intake to block the release of glucose from liver that causes hyperglycemia. Moreover, nurses came up with this diagnosis by thoroughly taking an appropriate history of patients and their symptoms. They collected the relevant information first and conducted actions like testing and consultation for reaching a diagnosis decision. For reaching a final diagnosis, nurses did a physical examination of the pateints with the help of pathologists and a physician (Gebresillassie, 2020).

This strategy will benefit the patient with a combination of pharmacological and non-pharmacological interventions. In this concept map, the clear indication of these issues has been provided in addition to the need to improve inter-collaboration. For example, the diabetes type 2 therapists must collaborate with the patient as well as with pulmonary rehabilitation specialist to reduce the risk of further diseases. The collaboration should also be optimized thorough non-pharmacological interventions to encourage the patient to reduce smoking habits and help him to receive psychological counseling to make positive lifestyle changes (Pan et al., 2018). 

Nursing interventions include as advocated by scholars like Archer (2022) are assisting the patient to identify the right eating behaviors and managing the levels of basal and pyramidal insulin. This will help the patient to keep his glucose levels within a specified normal range (Valenzuela et al., 2020). Moreover, the administration of insulin medications is also vital in this matter and the patient may be given insulin for his low blood sugar glucose levels. This is essential in type 2 diabetic patient to help him maintain a stable insulin level. Moreover, the BP monitoring will be of more than 160 mm Hg that will help nurses to reduce hypertension in patients like Henley (Zhou, Perel, Mensah & Ezzati, 2021). Finally, the intervention was proposed to educate the patient related to the vitality of following strictly the revised meal plan and not to eat spicy or junk food meals. This wills also hell him to maintain secure blood glucose levels (Archer, 2022). 

The treatment related to hyperglycemia and lowering blood sugar levels in patients is explained by the evidence-based guidelines Ripsin (2009) who suggests intensive lifestyle interventions that recommends 150 minutes each week of physical activity and eating low-fat diet. The evidence shows that low calorie diet also helps patients to reduce symptoms such as hypertension and dyslipidemia and also increase insulin secretion. In order to normalize the blood glucose level of the patient, insulin is also given to the patient for better glycaemic control (Blonde et al., 2017).  

Unfortunately, evidence from the study of Blonde et al. (2017) shows that many people with type 2 diabetes have failed to gain significant positive results of the above-suggested treatment to improve the blood glucose and sugar levels of the patient. The study states that many patients were not able to maintain the appropriate target blood glucose levels. This could result in serious risk associated with such patients who can have unavoidable consequences of this physical issue. This is one of the conflicting views of the researchers and is also accepted by the physicians responsible for providing the patient with interventions after a physician diagnosis. This shows that Glycaemic control is suboptimal in a large proportion of people who are already having problems with diabetes type 2 diseases.  

How Interprofessional Strategies can be applied to Concept Map and Knowledge Gaps 

Interprofessional strategies to improve communication, collaboration, and quality outcomes will help organization to improve clinical decisions (Galaviz et al., 2018). This implies that the professionals must make the minimal use of text in a concept map and will help to allow searching for the related information in an easy manner. For example, if someone wants to learn more data from the concept map related to nursing interventions for hyperglycemia, then they need to search for the related interventions heading and find about the disorder’s treatment (Bignyak, 2021).  This progressive blood sugar and glucose disease can cause metabolism issues and several heart-related diseases (Amal raj, 2021). Therefore, in order to overcome the challenges of health, concept mapping can help interprofessional people to provide the comprehensive care to patients. 

NURS FPX 6021 Assessment 1 Concept Map

Moreover, the study by Pranata (2021) provides evidence of the experts’ consensus on the viable precision health care interprofessional strategies for older adults with imbalanced glucose levels in blood due to diabetes. Total ten medical experts were selected who gave interviews through Delphi technique. The experts had more than five years of teaching experience as well as serving as physicians in healthcare organizations. The measureable and effective strategies for precision healthcare implementation show that older people are more at a risk of developing diabetes mellitus. The 7-step strategy was adopted that included self-management assessment, cardiovascular management level, brainstorming sessions between patients to share glycaemic issues, and setting goals and writing them down. The experts agreed that the precision health care strategies can serve as a latest methodology to enhance the level of self-management of diabetes type 2 to improve glucose levels. 

This concept map will enhance the critical decision-making of the professionals and will provide a good picture of the patient’s needs (Pan, 2018). However, the knowledge of nurses needs to be updated to understand the need for this integration of medical interventions and strategies with clinical practice to enhance comprehension for future physicians (Gebresillassie, 2020). The lack of education can make it difficult for professionals to understand the concept map and can hinder the promotion and development of professional behaviors such as team cohesion and interpersonal professionalism (Gebresillassie, 2020).  However, regarding uncertainty or unknown problems in the way of effective interprofessional collaboration that can impact the care plan adversely, nurses feel that the biggest challenge faced by the professional relates to accountability and conflict management to make the best decisions. Coaching is the key aspect to reduce such uncertainties to achieve the desired outcomes of interprofessional collaboration (Amal raj, 2021). These challenges are observed to be existing in both management and administrative teams.

Communicating the plan of care effectively includes using strategies such as explain the “why” factor and enforcing the strategic plan in future communications of the professionals. Clarifying the messages and response using audiovisual aids is also vital for improving its effectiveness. Showing proper respect to stakeholders is also vital for communicating the plan (Gebresillassie, 2020). 

References

Amal raj, M. S. (2021). Faculty Experiences with Concept Mapping as an Educational Strategy in Nursing Education (Doctoral dissertation, Capella University).

Archer J, Robinson L, Brown T. The impact of health care funding on interprofessional collaboration and integrated service delivery in primary and allied care: Protocol for a scoping review. JMIR Res Protoc. 2022 May 13;11(5): e36448. doi: 10.2196/36448. PMID: 35559853; PMCID: PMC9143773.

Askelson N, Ryan G, McRee AL, Farris PE, Shannon J, Hanson J, Kenyon DB, Daly E, Avdic L. Using concept mapping to identify opportunities for HPV vaccination efforts: Perspectives from the Midwest and West Coast. Eval Program Plann. 2021 Dec; 89:102010. doi: 10.1016/j.evalprogplan.2021.102010. Epub 2021 Sep 16. PMID: 34555736; PMCID: PMC8557125.

Bignyak, P. I. (2021). Correction of electrolyte balance in surgical patients with urgent surgical interventions. Reports of Vinnytsia National Medical University, 25(4), 620-622.

https://doi.org/10.31393/reports-vnmedical-2021-25(4)-19

Blonde L, Aschner P, Bailey C, Ji L, Leiter LA, Matthaei S; Global Partnership for Effective Diabetes Management. Gaps and barriers in the control of blood glucose in people with type 2 diabetes. Diab Vasc Dis Res. 2017 May;14(3):172-183. doi: 10.1177/1479164116679775. Epub 2017 Feb 1. PMID: 28467203; PMCID: PMC5418936.

Galaviz KI, Weber MB, Straus A, Haw JS, Narayan KMV, Ali MK. Global diabetes prevention interventions: A systematic review and network meta-analysis of the real-world impact on incidence, weight, and glucose. Diabetes Care. 2018 Jul;41(7):1526-1534. doi: 10.2337/dc17-2222. PMID: 29934481; PMCID: PMC6463613.

Gebresillassie BM, Debay YB. Characteristics, treatment, and outcome of patients with hypertensive crisis admitted to University of Gondar Specialized Hospital, northwest Ethiopia: A cross-sectional study. J Clin Hypertens (Greenwich). 2020 Dec;22(12):2343-2353. doi: 10.1111/jch.14056. Epub 2020 Sep 23. PMID: 32966697; PMCID: PMC8029926.

Pantha S, Jones M, Gray R. Stakeholders’ perceptions of how nurse-physician communication may impact patient care: protocol for a concept mapping study. J Interprof Care. 2021 May 20:1-3. doi: 10.1080/13561820.2021.1923466. Epub ahead of print. PMID: 34014127.

Pranata, S., Wu, S. F. V., Chu, C. H., & Nugroho, K. H. (2021). Precision health care strategies for older adults with diabetes in Indonesia: a Delphi consensus study. Medical Journal of Indonesia, 30(3), 221-7. DOI: https://doi.org/10.13181/mji.oa.215525.

Valenzuela PL, Carrera-Bastos P, Gálvez BG, Ruiz-Hurtado G, Ordovas JM, Ruilope LM, Lucia A. Lifestyle interventions for the prevention and treatment of hypertension. Nat Rev Cardiol. 2021 Apr;18(4):251-275. doi: 10.1038/s41569-020-00437-9. Epub 2020 Oct 9. PMID: 33037326.

Zhou B, Perel P, Mensah GA, Ezzati M. Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension. Nat Rev Cardiol. 2021 Nov;18(11):785-802. doi: 10.1038/s41569-021-00559-8. Epub 2021 May 28. PMID: 34050340; PMCID: PMC8162166.

810-0215