Student Name
Capella University
NURS-FPX 6021 Biopsychosocial Concepts for Advanced Nursing Practice 1
Prof. Name
Date
Concept Map
A concept map in healthcare serves as a visual tool that illustrates the relationships among medical concepts. It helps healthcare professionals organize, synthesize, and understand complex clinical information, allowing for improved patient care planning and decision-making.
Scenario
Mrs. Smith, a 52-year-old African American woman with a known history of Type 2 Diabetes Mellitus, was admitted to the ICU at St. Anthony Medical Center due to critically elevated blood glucose levels. Upon admission, she was also diagnosed with Acute Renal Failure. She reported fasting blood glucose readings around 200 mg/dL and postprandial levels exceeding 350 mg/dL. Mrs. Smith also experienced symptoms of puffy legs, blurred vision, fatigue, reduced urination frequency, breathlessness, and weakness on exertion.
During her hospital stay, the medical team closely monitored her condition and administered medications to stabilize her glucose levels while supporting kidney function. After several days of intensive care, her condition improved sufficiently for discharge.
As her assigned home health nurse from St. Anthony Medical Center Home Health Agency, I continued follow-up care at her home. She reported improved fasting blood glucose levels of 125 mg/dL and post-meal readings of 140 mg/dL, attributing this progress to adherence to medications and dietary awareness. Her kidney function normalized, urinary output improved, and leg swelling decreased. Despite these improvements, she expressed difficulty maintaining a consistent diet due to limited support from her daughter, who had other family and work responsibilities.
North American Nursing Diagnosis Association (NANDA)
NANDA is a professional organization that standardizes nursing language, facilitating accurate communication and helping nurses identify appropriate diagnoses for patient care (NANDA, 2024).
Patient Information (Acute Phase)
| Patient Information | Description |
|---|---|
| Name | Mrs. Smith |
| Age | 52 years |
| Ethnicity | African American |
| Diagnosis | Type 2 Diabetes Mellitus, Acute Renal Failure |
| Hospital | St. Anthony Medical Center |
| Current Status | Discharged, under home health follow-up |
Nursing Diagnosis, Assessment, Interventions, and Outcomes
| Nursing Diagnosis | Assessment Findings | Interventions | Outcomes |
|---|---|---|---|
| 1. Acute Renal Failure related to Diabetes Mellitus | Elevated creatinine, reduced urine output, fluid overload, electrolyte imbalances (Schoen & Delanaye, 2022) | Administer prescribed medications, monitor fluid balance, enforce strict glycemic control, dietician consultation (Rodriguez et al., 2021) | Improved renal function, normalized creatinine, restored urinary output, stabilized electrolytes (Schoen & Delanaye, 2022) |
| 2. Risk for Infection related to compromised immune system | Elevated WBC, presence of catheters or wounds, fever, impaired skin integrity (Rodriguez et al., 2021) | Maintain aseptic technique, wound care, timely antibiotic administration, patient education on hygiene (American Diabetes Association, 2022) | Reduced infection risk, improved wound healing, stabilized WBC count (Rodriguez et al., 2021) |
| 3. Impaired Gas Exchange related to fluid overload | Dyspnea, tachypnea, decreased oxygen saturation, abnormal lung sounds (Calimag et al., 2022) | Monitor respiratory status, provide oxygen therapy, promote fluid balance, elevate head of bed (Calimag et al., 2022) | Improved oxygen saturation, resolved lung abnormalities, enhanced respiratory function (Calimag et al., 2022) |
Relevance of Evidence as Basis of Concept Map
The concept map for Mrs. Smith’s care is developed using evidence-based data from reputable sources including NANDA, ADA guidelines, and peer-reviewed journals. Using NANDA-approved nursing diagnoses allows the healthcare team to accurately identify Mrs. Smith’s primary health issues: Acute Renal Failure secondary to diabetes. This standardized approach promotes effective communication among healthcare professionals and supports targeted interventions (NANDA, 2024).
According to the American Diabetes Association (2022), optimal management of diabetes-related renal complications requires strict blood glucose control, dietary modification, and adherence to prescribed medications. These interventions are intended to stabilize glycemic levels, improve renal function, and reduce complications. Peer-reviewed research further supports best practices in diabetes care, renal management, and patient-centered outcomes, ensuring that interventions are evidence-based and current (Calimag et al., 2022; Schoen & Delanaye, 2022).
Conflicting Perspective
While the concept map is grounded in established evidence, the medical field is dynamic. Conflicting research findings and emerging perspectives may necessitate adjustments to nursing interventions. Continuous appraisal of new literature ensures care strategies remain safe, effective, and aligned with updated clinical recommendations.
Role of Interprofessional Strategies in Achieving Outcomes
Effective care for Mrs. Smith requires coordinated interprofessional strategies. Collaboration between nurses, physicians, dieticians, pharmacists, social workers, and other healthcare professionals ensures comprehensive care tailored to her needs.
Key interprofessional strategies include:
- Regular Team Meetings: Discuss patient progress, evaluate interventions, and adjust care plans collaboratively (Melo et al., 2022).
- Patient and Family Education: Engage Mrs. Smith and her family in decision-making to enhance adherence and self-management. Education sessions can address misconceptions about diabetes management and renal care (Calimag et al., 2022).
- Integration of Social Support: Collaborate with social workers and community health resources to address social determinants of health, such as diet support, medication affordability, and transportation to appointments.
These strategies enhance continuity of care, improve long-term outcomes, and reduce the risk of complications.
Knowledge Gaps
The concept map highlights knowledge gaps in Mrs. Smith’s care, including:
- Psychosocial support needs and coping mechanisms.
- Cultural beliefs affecting healthcare decisions.
- Home environment factors impacting self-care and adherence.
- Coordination of long-term care across different healthcare settings.
Further research on culturally competent care and evidence-based transition strategies can strengthen interventions and interprofessional collaboration, ensuring optimal outcomes.
Conclusion
The concept map for Mrs. Smith integrates evidence-based practice, standardized nursing diagnoses, and interprofessional strategies to manage diabetes-related renal failure effectively. Addressing knowledge gaps in psychosocial support, cultural considerations, home care, and long-term management is critical for optimal patient outcomes. Continual updates to the concept map with emerging evidence will facilitate seamless care transitions and support Mrs. Smith’s overall well-being.
References
Agarwal, R., Filippatos, G., Pitt, B., Anker, S. D., Rossing, P., Joseph, A., Kolkhof, P., Nowack, C., Gebel, M., Ruilope, L. M., & Bakris, G. L. (2021). Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: the FIDELITY pooled analysis. European Heart Journal, 43(6). https://doi.org/10.1093/eurheartj/ehab777
American Diabetes Association. (2022). Home | ADA. Diabetes.org. https://diabetes.org/
Calimag, A. P. P., Chlebek, S., Lerma, E. V., & Chaiban, J. T. (2022). Diabetic ketoacidosis. Disease-a-Month, 69(3). https://doi.org/10.1016/j.disamonth.2022.101418
Macias, E., Gutiérrez-Pizarraya, A., & Ramón Morillo-Verdugo. (2022). Influence of polypharmacy in the simultaneous presence of high pharmacotherapeutic complexity, drug interactions and non-adherence to medication in patients with HIV infection. Project 3-HIT. https://doi.org/10.1016/j.eimce.2022.09.007
Melo, L. C., Lima, F. R., Bracarense, C. F., Ferreira, J. F. M. F., Ruiz, M. T., Parreira, B. D. M., & Goulart, B. F. (2022). Inter-professional relationships in the Family Health Strategy: Perception of health management. Revista Brasileira de Enfermagem, 75. https://doi.org/10.1590/0034-7167-2021-0636
NURS FPX 6021 Assessment 1 Concept Map
NANDA. (2024). Welcome to NANDA International Defining the Knowledge of Nursing | Just another WordPress site. Nanda.org. https://nanda.org/
Rodríguez, N., Martínez-Jiménez, I., García-Ojalvo, A., Mendoza-Marí, Y., Guillén-Nieto, G., Armstrong, D., & Berlanga-Acosta, J. (2021). Wound chronicity, impaired immunity and infection in diabetic patients. MEDICC Review, 24(1), 44. https://doi.org/10.37757/mr2021.v23.n3.8
Scheen, A. J., & Delanaye, P. (2022). Acute renal injury events in diabetic patients treated with SGLT2 inhibitors: A comprehensive review with a special reference to RAAS blockers. Diabetes & Metabolism, 48(2). https://doi.org/10.1016/j.diabet.2021.101315