NURS FPX 6021 Assessment 1 Concept Map

Name

Capella university

NURS-FPX 6021 Biopsychosocial Concepts for Advanced Nursing Practice 1

Prof. Name

Date

Intensive Care Unit 

St. Anthony Medical Center Home Health Agency 

Narrative

This narrative explains the concept maps developed for a patient, Mrs. Smith, in two different healthcare settings, the Intensive Care Unit (ICU) and St. Anthony Medical Center Home Health Agency. In this narrative, we cover the additional evidence that provides linkages between the concept maps for a comprehensive understanding of each concept map and its significance in nursing care. Moreover, we discuss the value and relevance of the evidence used to create these concept maps. Lastly, we detail how interprofessional collaboration is imperative to achieve desired outcomes for the patient in all healthcare settings. 

Additional Evidence 

First Concept Map

An ICU nurse receives a 52-year-old female patient with a history of Type II Diabetes Mellitus. She is currently presenting complaints of increased fasting glucose levels, peripheral edema, blurred vision, tiredness and weakness, decreased urine output, shortness of breath, and nausea. Physicians have diagnosed her with Acute Renal Failure (ARF) and high blood glucose levels. The concept map covers three primary nursing diagnoses for this patient – altered nutrition: less than body requirements, impaired gas exchange, and excess fluid volume. 

Second Concept Map 

The patient is now discharged from the ICU and transitions to the Home Care Agency, where a nurse receives her with a recent history of hospitalization for ARF and high blood glucose levels. While the patient reported an improved fasting glucose level, increased urinary output, decreased peripheral edema, and enhanced well-being, she identified concerns such as reduced family interaction and limited cooking abilities. Based on the patient’s subjective data, we have developed nursing diagnoses on the risk of social isolation, risk of medication noncompliance, and risk of malnutrition. 

Relevance and Value of Evidence

The sources of evidence employed in making the concept map are relevant and provide valuable insights related to ARF and its complications. 

• The article by Ramakrishnan and Shankar (2020) offers valuable insights into the nutritional support strategies for patients with AKI in critical care settings. This applies to our scenario as Mrs. Smith was admitted to the ICU. It offers evidence-based recommendations to support healthcare providers in delivering appropriate nutritional support and improving patients’ quality of care.
• Koratala et al. (2022) provide information about fluid overload leading to pulmonary edema. Since Mrs. Smith is suffering fluid overload, this resource helps diagnose pulmonary edema as a common complication. Understanding diagnostic approaches outlined in the article can assist in timely and appropriate assessment to improve Mrs. Smith’s outcomes. 
• Another study that explores factors contributing to respiratory distress in ARF patients is essential to identify and manage her conditions, such as shortness of breath during her hospitalization (Panitchote et al., 2019). 
• Chadwick (2022) study highlights the importance of leg elevation in managing peripheral edema, a symptom presented by Mrs. Smith. The study explains that leg elevation can help reduce swelling by improving circulation and easing discomfort. Thus, this study is valuable and relevant to provide strategies for symptomatic management. 

NURS FPX 6021 Assessment 1 Concept Map

• Patil and Salunke (2020) explain the relationship between fluid overload and ARF.  For Mrs. Smith, who is diagnosed with ARF and is presenting signs of fluid overload, this article provides essential information on the nursing assessment and management strategies for her condition. This information is valuable for effective patient care and effective treatment plans. 
• The article by Arms and McCumber (2023) is valuable as it provides information on assessing and managing social isolation. This issue is relevant in Mrs. Smith’s case as she is experiencing limited social support. The articles offer direction for home health nurses to intervene effectively in the risks of social isolation, enhancing patients’ overall well-being. 
• Dijkstra et al. (2021) are valuable resources for healthcare professionals to support patients with medication non-compliance. Understanding these concepts helps the home health agency support Mrs. Smith with managing medication regimens effectively. 

Interprofessional Strategies 

Interprofessional interventions in our concept maps will provide more comprehensive care and improve patient outcomes (McLaney et al., 2022). For example, nurses collaborating with physicians for medication management, dietitians for nutritional plans, physical therapists for chest physiotherapy and activities, and community workers to leverage community resources in patient care ensures a holistic approach to addressing Mrs. Smith’s needs and preferences for managing ARF and diabetes. However, several knowledge gaps and uncertain areas exist, such as the effectiveness of these strategies and the impact of patient’s socioeconomic factors. Moreover, effective coordination and communication among the team members remains a significant uncertain area, which can lead to poor execution of these strategies, eventually impacting patient outcomes. 

References 

Arms, T., & McCumber, S. (2023). Social isolation: Levels of response for nurse practitioners. The Journal for Nurse Practitioners, 19(1), 104391. https://doi.org/10.1016/j.nurpra.2022.06.016 

Chadwick, S. E. (2022). The use of leg elevation in the treatment of chronic peripheral oedema. British Journal of Community Nursing, 27(Sup10), S28–S32. https://doi.org/10.12968/bjcn.2022.27.Sup10.S28 

Dijkstra, N. E., Vervloet, M., Sino, C. G. M., Heerdink, E. R., Nelissen-Vrancken, M., Bleijenberg, N., De Bruin, M., & Schoonhoven, L. (2021). Home care patients’ experiences with home care nurses’ support in medication adherence. Patient Preference and Adherence, 15, 1929–1940. https://doi.org/10.2147/PPA.S302818 

NURS FPX 6021 Assessment 1 Concept Map

Koratala, A., Ronco, C., & Kazory, A. (2022). Diagnosis of fluid overload: From conventional to contemporary concepts. Cardiorenal Medicine, 12(4), 141–154. https://doi.org/10.1159/000526902 

McLaney, E., Morassaei, S., Hughes, L., Davies, R., Campbell, M., & Di Prospero, L. (2022). A framework for interprofessional team collaboration in a hospital setting: Advancing team competencies and behaviours. Healthcare Management Forum, 35(2), 112–117. https://doi.org/10.1177/08404704211063584 

Panitchote, A., Mehkri, O., Hastings, A., Hanane, T., Demirjian, S., Torbic, H., Mireles-Cabodevila, E., Krishnan, S., & Duggal, A. (2019). Factors associated with acute kidney injury in acute respiratory distress syndrome. Annals of Intensive Care, 9(1), 74. https://doi.org/10.1186/s13613-019-0552-5 

Patil, V. P., & Salunke, B. G. (2020). Fluid overload and acute kidney injury. Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine, 24(Suppl 3), S94–S97. https://doi.org/10.5005/jp-journals-10071-23401 

NURS FPX 6021 Assessment 1 Concept Map

Ramakrishnan, N., & Shankar, B. (2020). Nutrition support in critically ill patients with AKI. Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine, 24(Suppl 3), S135–S139. https://doi.org/10.5005/jp-journals-10071-23397