Concept Map and Evidenced-Based Practice Paper
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Concept Map and Evidenced-Based Practice Paper and Presentation Introduction The following presents a brief report on one patient seen duringpracticum Next a medical diagnosis is discussed along with relatedpathophysiology risk factors clinical manifestations goals andinterventions A professional nursing journal article that describesnursing research or evidenced-based practice that is relevant to thispatient and selected nursing diagnosis is summarized and related to thepatient A Concept Map located in the appendix illustrates the nursingprocess that includes the client\'s signs symptoms one NANDA nursingdiagnosis goal interventions
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Retrieved July 15, 2 9 from http://www.nlm.nih.gov/medlineplus/ency/article/ 313.htmWarren-Boulton, E., Greenberg, R., Lising, M., & Gallivan, J. She was unaware of theneed for foot care and wanted to know what else to watch out for. Type 2 diabetes. Interventions dependent on nursing interventions includednurse teaching of the patient to monitor blood glucose, and nurseassistance to help patient make changes in diet and exercise, understandfoot care and continuing care needs. An update on primary care management of type 2 diabetes. Warren-Boulton, Greenberg, Lising, and Gallivan (1999) andFunnell (2 3) reported on the importance of changing diet and exercisehabits to manage type 2 diabetes. The National Institutes ofHealth (NIH) conducted a randomized clinical trial, referred to as theDiabetes Prevention Program (DPP). (2 9). Retrieved July 15, 2 9 from http://www.mayoclinic.com/health/type-2- diabetes/DS 585/DSECTION=symptomsMedline Plus. Article Summary Funnell (2 3) presented an article that describes nursing researchand evidenced-based practice that is relevant to this patient and selectednursing diagnosis of type 2 diabetes. Nursing implications are that people should consider the benefits ofdiet and weight loss and regular physical activity to prevent, delay, ortreat this disease. Patient response to interventions dependent on nursinginterventions were also positive; she wanted the nurse to help her as muchas possible and was eager to learn how to monitor blood glucose, and whatchanges in diet and exercise needed to be made. She did not want to take medications but waswilling to hear about them. Patient response to thepossibility of a support group was also positive and she asked if there wasone with Hispanic members. Medical Diagnosis The Medical Diagnosis for this patient is type 2 diabetes.Pathophysiology involved in this disease is related to the body's inabilityto regulate the amount of glucose in the blood (eMedicine Health, 2 9).The liver produces the glucose in the blood and this blood glucose level isregulated by insulin and other hormones; the pancreas produces the insulinwhich allows glucose to move from the blood into the fat cells, liver, andmuscle to be used for fuel that results in energy. Even modest changes in diet and exercise affect type 2diabetes symptoms. Preventing type 2 diabetes with weight loss and exercise. The author reported on a study todetermine the effects of diet and exercise on the prevention of type 2diabetes in those at risk for this disease. She was admitted due to extreme levels of fatigue andfear that she was diabetic since her mother had type 2 diabetes. She wasconcerned for herself and her aging mother. This journal article is related to the treatment interventions for thetarget patient and supported the interventions included in the Concept Map. The patient presented with symptoms ofsevere fatigue, blurred vision, weight loss, frequent urination, increasedthirst and hunger, and darkened skin areas. Independent interventions included the patient self-testing for glucose levels, and patient efforts to change diet and exercisehabits. Participants reduced their risk of developing type 2diabetes by 58% with changes in their eating and exercise habits. A professional nursing journal article that describesnursing research or evidenced-based practice that is relevant to thispatient and selected nursing diagnosis is summarized and related to thepatient. Risk factors related tothis disease include being older than 45 years, high blood pressure,history of gestational diabetes, HDL cholesterol less than 35 mg/dL,triglyceride levels more than 25 mg/dL., race/ethnicity of HispanicAmerican, African American, or native American, and impaired glucosetolerance previously identified by a doctor (Medline Plus, 2 9). Interventions Four interventions that are collaborative, independent, and/ordependent nursing interventions were provided. Evidenced-based practices include management of diet and exercise, whichare primary interventions used to treat type 2 diabetes. Diabetes. The patient expressedher concern about type 2 diabetes and not knowing what to do about it.NANDA Nursing Diagnosis: Knowledge Deficit (treatment regimen) . The patient responded very favorably to thenotion of independent interventions of self-testing for glucose levels, andefforts to change diet and exercise habits. Retrieved July 15, 2 9 from http://www.emedicinehealth.com/script/main/art.asp?articlekey=58855&pf= 3&page=1Funnell, M. (2 9). The study included 1, 79 participants who sought to lose at least 7%of their body weight, 1 to 2 pounds per week and reach the exercise goal ofcompleting a minimum of 15 minutes of physical activity each week toinclude activities such as swimming, bike riding, fast walking, aerobicdance, or skating. A Concept Map, located in the appendix, illustrates the nursingprocess that includes the client's signs/symptoms, one NANDA nursingdiagnosis, goal, interventions, and evaluation. Study limitations were that the study only includedthose at risk for the disease instead of those with type 2 diabetes. Funnell provided study findings thatthese changes result in decreased risk for and management of this disease,supporting the interventions for this patient.Evaluation/Patient Response Patient response to the need for collaborative intervention withongoing care from diabetes care providers every three months was positive;she expressed her concern and desire to have ongoing support for hercondition. Concept Map and Evidenced-Based Practice Paper and Presentation Introduction The following presents a brief report on one patient seen duringpracticum. Next, a medical diagnosis is discussed along with relatedpathophysiology, risk factors, clinical manifestations, goals, andinterventions. (2 3). Specific Goal One goal that is specific, measurable, time limited, and able to bemet during day of care or discharge from ICU was the reduction of glucoselevels. She hadno previous diagnosis of diabetes but had a family history of type 2diabetes (mother). Future appointments were scheduledwith the nurse to evaluate self-monitoring of glucose levels, diet, andexercise goals. The nurse also provided resourceinformation about support groups and information about the use ofmedications should diet and exercise be ineffective in the maintenance ofglucose levels. (2 9). She wasbriefed about the ongoing care needs. The goal ofreducing glucose levels while the patient was at the hospital was reachedand the patient was given information about the additional goals. Nurse Practitioner: A Guide to Women's Health, 1 .Mayo Clinic. The patient is a 46-year old Hispanicfemale who was sought treatment for symptoms of extreme fatigue. ReferenceseMedicine Health. Following this the patient was provided with additionaltreatment interventions to manage her condition. Anoral glucose tolerance test was administered. OneNANDA Nursing Diagnosis: Knowledge Deficit (treatment regimen) . Patient Description The following presents a brief report on one patient seen duringpracticum with a discussion of admitting and current diagnoses, history,course of events while hospitalized, surgeries, procedures, treatments, IVdrips, and list of medication names. The immediate treatment goal was to lower glucose levelsand long-term goals were to prevent diabetes-related complications such asheart disease, blindness, kidney failure, or amputations of limbs (MedlinePlus, 2 9). Findings from an oralglucose tolerance test results were that levels were higher than 2 mg/dLafter two hours. Nurse Practitioner, 24(12), 14. Thepatient stated that she had no history of the symptoms she now has and theybegan approximately one month ago. M. Type 2 diabetes. Appendix Concept Map [pic] (1999). These included thecollaborative intervention of ongoing care from diabetes care providersevery three months for examinations related to blood pressure, foot andskin, neurological issues, an opthalmoscopy exam, and glycosylatedhemoglobin. These symptoms are included inthose presented by a patient with type 2 diabetes (May cklinic, 2 9). Clinical Manifestations Clinical manifestations for this patient included: subjective symptomsof fatigue, increased thirst and hunger, and frequent urination; objectiveassessment findings of blurred vision and darkened skin areas; anddiagnostic test results from an oral glucose tolerance test results thatlevels were higher than 2 mg/dL after two hours.
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