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NURS FPX 6011 Assessment 1 Evidence-Based Patient-Centered Concept Map

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    NURS FPX 6011 Assessment 1 Evidence-Based Patient-Centered Concept Map

    Student Name

    Capella University

    NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health

    Prof. Name

    Date

    Patient Scenario:

    Ana, a 67-year-old Hispanic woman, received a diabetes diagnosis a decade ago. Initially, she diligently monitored her blood sugar, adhered to a sugar-free diet, walked daily, and never missed a medication dose. However, in recent years, Ana has grown weary of managing her diabetes, expressing a belief that it’s inevitable due to her family history. Despite her recent initiation of insulin therapy due to elevated A1C levels, Ana reluctantly complied, stating her doctor insisted because her blood sugars were too high.

    Ana acknowledges her attempts to check blood sugar and take medication but notes challenges arising from unexpected childcare responsibilities for her grandkids due to COVID-related school closures. She feels overwhelmed and at times forgets to eat. Reviewing her medical record reveals missed appointments, unreturned calls, and a lack of reported blood glucose readings. Ana’s recent hospitalization for hypoglycemia, marked by confusion and low blood sugar, underscores her struggle.

    Patient Needs Analysis:

    The primary nursing diagnosis for Ana is the risk of unstable blood glucose levels, supported by episodes of hypoglycemia and difficulty in monitoring and maintaining a healthy diet. Ineffective health management is the second significant diagnosis, indicating Ana’s waning interest and hopelessness regarding diabetes management. A third diagnosis, Readiness for enhanced health management, aligns with Ana seeking care, recognizing the need for healthier choices.

    NURS FPX 6011 Assessment 1 Evidence-Based Patient-Centered Concept Map

    Ana’s situation is influenced by social determinants of health, exacerbated by COVID-related disruptions. Given two critical times identified by the American Diabetes Association for diabetes self-management education, Ana and her family are currently experiencing both. Interventions such as Depression screening and Diabetes Self-Management Education and Support (DSMES) aim to address these barriers.

    Communication Strategies:

    Encounters with Ana should focus on empowerment and avoid unintentional discouragement. Utilizing a patient-centered communication style, acknowledging her preferences, beliefs, and potential barriers is crucial. The language used should be neutral, nonjudgmental, strength-based, and person-centered, following recommendations to replace stigmatizing terms. Considering Ana’s familial ties, typical in Hispanic culture, addressing her stressors and cultural responsibilities is essential.

    Uncertainties revolve around individualized glycemic goals, the reluctance to start insulin, and the family’s ability to share childcare responsibilities. The impact of COVID-19 on routine appointments and diabetic education classes is uncertain, necessitating exploration of telemedicine options.

    Value and Relevance of Evidence:

    The patient-centered concept map relies on evidence from the American Diabetes Association, recognizing its role as a guide rather than a substitute for clinical judgment. The evidence-based grading system categorizes recommendations, with higher-level evidence indicating stronger support. Despite the challenges, the ADA Standards for Medical Care in Diabetes, continually refined over 30 years, serve as a reliable resource for healthcare professionals.

    Conclusion:

    Providing individualized care for Ana requires considering her values, beliefs, and lifestyle. Employing evidence-based practices ensures up-to-date and reliable guidance. Effective communication strategies are integral to supporting patient understanding and compliance with recommended interventions.

    References:

    American Diabetes Association Professional Practice Committee. (2022)a. 4. Comprehensive medical evaluation and assessment of comorbidities: Standards of medical care in diabetes-2022. Diabetes Care, 45(Supplement_1), S46-S59. https://doi.org/10.2337/dc22-S004

    American Diabetes Association Professional Practice Committee. (2022)b. 5. Facilitating behavior change and well-being to improve health outcomes: Standards of medical care in diabetes-2022. Diabetes Care, 45(Supplement_1), S60–S82. https://doi.org/10.2337/dc22-S005

    NURS FPX 6011 Assessment 1 Evidence-Based Patient-Centered Concept Map

    American Diabetes Association Professional Practice Committee. (2022)c. 1. Introduction: Standards of medical care in diabetes-2022. Diabetes Care, 45(Supplement_1), S1–S2. https://doi.org/10.2337/dc22-Sint

    American Diabetes Association Professional Practice Committee. (2022)d. 13. Older adults: Standards of medical care in diabetes-2022. Diabetes Care, 45(Supplement_1), S195–S207. https://doi.org/10.2337/dc22-S013

    Dickinson, J. K., Guzman, S. J., Maryniuk, M. D., O’Brian, C. A., Kadohiro, J. K., Jackson, R. A., D’Hondt, R. A., Montgomery, B., Close, K. L., & Funnell, M. M. (2017). The use of language in diabetes care and education. Diabetes Care, 40(12), 1790–1799. https://doi.org/10.2337/dci17-0041

    Ladwig, G. B., Ackley, B. J., Flynn Makic, M. B., Martinez-Kratz, M., & Zanotti, M. (2019). Mosby’s guide to nursing diagnosis (6th ed.). Elsevier, Inc.