Nurs FPX 6021 Gibsonalycia Assessment 11

 

Mrs. Smith Care Plan Concept Map

Part 1: Concept Map

 

Part 2: Additional Evidence (Narrative)

The concept map includes two care plans linked together to show the need for transition of care and link the outcomes of acute and chronic care. I developed the care plan above using evidence-based information from journal articles, books, and guidelines. Therefore, I believe that the plan is evidence-based. To justify that my plan was based on valuable evidence, I have developed table 1 below to summarize the worth of these sources. Even though I used level VI and VII sources of evidence, they were worthwhile because their evidence was relevant to my clinical issue and they contained newer perspectives of care in acute and chronic care settings.

Table 1: Justification of the worthiness of my sources

Source	Worth	Value
American Diabetes Association (2020)	Used to apply the current diabetes guidelines according to American Diabetes Association	Level I (evidence-based clinical practice guidelines)
Carpenito (2020)	Handbook of nursing diagnosis that was used to determine appropriate NANDA diagnoses for this patient	A tertiary source from different sources with varied levels of evidence
Marques et al., (2022)	A journal article that applied Orem’s self-care theory to provide different perspectives of nursing diagnosis and care among elderly adults	Level VI (Evidence from a qualitative study)
Torrens et al. (2020)	Provided evidence-based information on the role of nurses in overcoming diabetes care barriers. It came in handy when deciding on intervention for the community care plan	Level – moderate (scoping review) A secondary source
Wallia et al. (2020)	Provided different care perspectives in an acute setting that was useful in drawing the care plan in the ICU	A narrative review Level VII

The plan emphasizes the roles of two key professionals, including a nephrologist and a nurse (critical care nurse and community health nurse). The plan links acute care in the ICU to chronic care in the community through a smooth transition, especially for renal, cardiac, and diabetic care. The need to maintain the outcomes of acute care contribute to the goals of chronic care. This patient has unresolved edema that would need to be addressed in her home care because of the risk of injury and infections. Patient safety and comfort are given priority in this care plan. I focused much on preventing complications and achieving self-care, as determined by my sources. Therefore, I believe that the sources are credible because they are current, relevant, and authoritative.

ORDER A PLAGIARISM-FREE PAPER HERE

References

American Diabetes Association. (2020). 15. Diabetes care in the hospital: Standards of Medical Care in diabetes-2020. Diabetes Care, 43(Suppl 1), S193–S202. https://doi.org/10.2337/dc20-S015

Carpenito, L. J. (2020). Handbook of nursing diagnosis (15th ed.). Wolters Kluwer Health.

Marques, F. R. D. M., Charlo, P. B., Pires, G. A. R., Radovanovic, C. A. T., Carreira, L., & Salci, M. A. (2022). Nursing diagnoses in elderly people with diabetes mellitus according to Orem’s Self-Care Theory. Revista Brasileira de Enfermagem, 75Suppl 4(Suppl 4), e20201171. https://doi.org/10.1590/0034-7167-2020-1171

Torrens, C., Campbell, P., Hoskins, G., Strachan, H., Wells, M., Cunningham, M., Bottone, H., Polson, R., & Maxwell, M. (2020). Barriers and facilitators to the implementation of the advanced nurse practitioner role in primary care settings: A scoping review. International Journal of Nursing Studies, 104(103443), 103443. https://doi.org/10.1016/j.ijnurstu.2019.103443

Wallia, A., Prince, G., Touma, E., El Muayed, M., & Seley, J. J. (2020). Caring for hospitalized patients with diabetes mellitus, hyperglycemia, and COVID-19: Bridging the remaining knowledge gaps. Current Diabetes Reports, 20(12), 77. https://doi.org/10.1007/s11892-020-01366-0

Instructions
For this assessment, you will develop a concept map and a short narrative that supports and further explains how the concept map is constructed. The bullet points below correspond to the grading criteria in the scoring guide. Be sure that your evidence-based plan addresses all of the bullet points. You may also want to read the Concept Map scoring guide and Guiding Questions: Concept Map [DOCX] to better understand how each grading criterion will be assessed.

Part 1: Concept Map
Develop an evidence-based concept map that illustrates a plan for achieving high-quality outcomes for acute and chronic stages for a patient with renal failure related to diabetes in both an acute care facility and in the community.
You can achieve this by following the Vila Health scenario.
You will have a total of two concept maps. One will show the acute care facility with three diagnoses, and the other will show a home health community setting with three diagnoses.
Part 2: Additional Evidence (Narrative)
Justify the value and relevance of the evidence you used as the basis for your concept maps.
Analyze how interprofessional strategies applied to the concept map can lead to the achievement of desired outcomes.
Construct the concept maps and linkage to additional evidence in a way that facilitates a reader’s understanding of key information and links. This will be done by adding links in each section of the concept map that will show your value, relevance, and evidence.
Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.
Submission Requirements
Length of submission: Each concept map should be on a single page, if at all possible. You will add links to each section of your concept map for additional evidence and narratives that support your concept maps.
Number of references: Cite a minimum of 3–5 sources of scholarly or professional evidence that support 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, format resources and citations 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: An APA Template Tutorial [DOCX] is provided to help you in writing and formatting your analysis. You do not need to include an abstract for this assessment.
You are an ICU nurse (black male) at St. Anthony Medical Center. You have been assigned Mrs. Smith (black female), a 52-year-old with a history of Type II Diabetes Mellitus, who was admitted this morning with high glucose levels and Acute Renal Failure.

I see that your HA1C is at 8.5. Can you give me a history of your blood glucose readings over the last 2 weeks?

HIDE RESPONSE

Mrs. Smith: My fasting blood sugars have been running around 200 with it getting as high as 350+ after each meal. I can tell that I wasn’t feeling very good, and I am swelling in my legs more than usual. I also have some blurred vision and I am very tired.

Are you experiencing any other symptoms?

HIDE RESPONSE

Mrs. Smith: Yes, I think so but I’m not sure if they are related.

What are some of the other things going on?

HIDE RESPONSE

Mrs. Smith: I have not voided as often as before, and I feel a little short of breath when I get up to walk to the mailbox. I also feel weak and even a little nauseous.

 

You are a home health nurse for St. Anthony Medical Center Home Health Agency. You have been assigned Mrs. Smith (black female), a 52-year-old with a history of Type II Diabetes Mellitus, who was discharged from ICU this morning after being admitted with high glucose levels and Acute Renal Failure. She is to be followed by Home Health for 6 weeks.

 

Good afternoon Mrs. Smith! I see that your blood sugar levels were very high prior to being admitted to ICU. Can you tell me what they are running since this morning?

HIDE RESPONSE

Mrs. Smith: Yes, I can. My fasting blood sugar was 125 this morning, and I checked it 2 hours after breakfast with a result of 140. I am so glad to be home! I am being more careful on my diet since I came home. Hopefully, I will know enough to keep my diet good, so my blood sugars stay normal.

How are you voiding now?

HIDE RESPONSE

Mrs. Smith: My kidneys are working great! I am able to get up to void without any problems. I void several times a day now and it is a pale-yellow color with no odor. Can you see that my ankles aren’t too swollen? They look much better. I can wear socks and even put some shoes on now 😊

Do you have someone in the home that helps you with your meals and care?

HIDE RESPONSE

Mrs. Smith: a. Well…my daughter tries to come by every evening, but she has 3 kids and work, so I don’t expect her to come every day. If she is unable to come and cook, I usually just make a sandwich or have a bowl of cereal. Those are easy for me to make, but I don’t cook as much as I used to.