Create a concept map graphic and write a 2-4 page narrative on the patient scenario presented in Assessment Case Study: Evidence-Based Patient-Centered Concept Map. Base your report on the information provided in the case study and your own research of 3-5 evidence-based resources.

In this assessment, you will apply evidence-based practice and personalized care concepts to ensure quality care and improve the health of a single patient. The concept map that you will create is an example of a visual tool that you can use for patient and family education.

Scenario

The charge nurse at the wellness center has sent you an email to request that you review a patient file before the patient arrives at the clinic. She has asked you to put together a concept map for your patient’s care plan. The concept map is intended to help you think through the best strategy for your patient’s care and for subsequent use for patient education. In addition, the nurse needs a narrative report that describes your patient with up to five diagnoses, in order of urgency.

Your Role

You are a nurse at a community wellness center who has received a request for patient case review and preparation for an upcoming appointment.

Instructions

Review the Assessment Case Study: Evidence-Based Patient-Centered Concept Map media activity.

Create your concept map and narrative as separate parts of your document. Be sure to note where you must include your evidence-based support and clarify your strategies for communicating information to the patient and the patient’s family.

Integrate relevant evidence from 3-5 current scholarly or professional sources to support your assertions.

Part 1: Concept Map

• Develop a graphical concept map for the patient based on the best available evidence for treating your patient’s health, economic, and cultural needs. 
  • Many organizations use the spider style of concept maps (see the Taylor and Littleton-Kearney article for an example).
  • The Assessment Case Study: Evidence-Based Patient-Centered Concept Map, which includes an example of a concept map, may help you prepare your assessment.
  • If a particular style of concept map is used in your current care setting, you may use it in this assessment.

Part 2: Narrative Report

• Develop a narrative (2-4 pages) for your concept map.
• Analyze the needs of a patient and his or her family to ensure that the intervention in the concept map will be relevant and appropriate for their beliefs, values, and lifestyle. 
  • Consider how your patient’s economic situation and relevant environmental factors may have contributed to your patient’s current condition or could affect future health.
  • Consider how your patient’s culture or family should inform your concept map.
• Determine the value and relevance of the evidence you used as the basis of your concept map. 
  • Explain why your evidence is valuable and relevant to your patient’s case.
  • Explain why each piece of evidence is appropriate for the health issue you are addressing and for the unique situation of your patient and the family.
• Propose relevant and measurable criteria for evaluating the outcomes the patient needs to achieve. 
  • Explain why your proposed criteria are appropriate and useful measures of success.
• Explain how you will communicate specific aspects of the concept map to your patient and the family in an ethical, culturally sensitive, and inclusive way. Ensure that your strategies: 
  • Promote honest communications.
  • Facilitate sharing only the information you are required and permitted to share.
  • Are mindful of your patient’s culture.
  • Enable you to make complex medical terms and concepts understandable to your patient and his or her family, regardless of language, abilities, or educational level.

Additional Requirements

• Organization: Use the following headings for your Diabetes Patient Concept Map assessment: 
  • Concept Map.
  • Patient Needs Analysis.
  • Value and Relevance of the Evidence.
  • Proposed Criteria for Patient Outcome Evaluation.
  • Patient and Family Communication Plan.
• Length: Your concept map should fit on one page (possibly a horizontal layout) and your narrative report will be 2-4 double-spaced pages, not including title and reference pages.
• Font: Times New Roman, 12 points.
• APA Format: Your title and reference pages must follow current APA format and style guidelines. The body of your paper does not need to conform to APA guidelines. Do make sure that it is clear, persuasive, organized, and well written, without grammatical, punctuation, or spelling errors. You also must cite your sources according to APA guidelines.

 

Discussion Prompt

Post your answers to the 6 questions corresponding to this week’s content on primary care medication management. Provide your responses and rationales. Support your rationales with high-level evidence. (See Post Expectations)

A 70-year-old woman is in your office complaining of recently having trouble maintaining her balance after taking diazepam (valium). She occasionally takes diazepam when she feels anxious and has trouble sleeping. She has a 15-year history of taking diazepam.

Q1. Explain the cause of this patient’s difficulty in maintaining her balance?

Q2. Diazepam experiences a significant first-pass effect. What is the first-pass effect, and how can first-pass metabolism be circumvented?

A 75-year-old woman develops symptoms of a cold and buys an over-the-counter cold medication at the grocery store. The medication contains diphenhydramine, acetaminophen, and phenylephrine. She takes the recommended adult dose but soon after taking the medication she becomes very confused and disoriented.

Q3. What is likely causing the signs of confusion?

A 26-year-old woman who has never been pregnant is seeking preconception care as she is planning to pursue pregnancy in a couple of months. Currently, she has no symptoms to report and on review of body systems, there were no concerns. Her past medical history is significant for a history of rheumatic fever as a child. She subsequently underwent valve replacement with a mechanical heart valve. She is followed by a cardiologist who has already evaluated her cardiac function and she has received clearance from her cardiologist to pursue pregnancy. Records from her cardiologist include a recent cardiac echocardiography report that reveals a normal ejection fraction indicating normal cardiac function.

She has no alterations in her daily activities related to her heart. She has no other significant medical or surgical history. She is a non-smoker, drinks occasionally but has stopped as she is attempting to conceive, and does not use any non-prescription drugs.

Current Medications: Her current medications include only prenatal vitamins, which she has begun in anticipation of pregnancy, and warfarin. She has no known drug allergies.

Vital Signs: On examination, her pulse is 80 beats per minute, blood pressure is 115/70 mm Hg, respiratory rate is 18 breaths per minute, and she is afebrile.

Measurements: Weight = 152 pounds, Height = 5′5 ″, BMI= 25.29

Q4. How is warfarin metabolized? Does warfarin cross the placental barrier?

Q5. Explain the hepatic drug metabolism of children 1 year and older. How do they compare with the hepatic drug metabolism of infants and adults?

Q6. Explain protein binding in the neonate.

PLEASE PROVIDE A HIGH LEVEL OF EXPLANATION FOR EACH QUESTION

  

Topic: Multidimensional Care for Sarah 

Directions

Sarah is a 69-year-old female that presented to the emergency department with shortness of breath. Her past medical history includes anxiety and PTSD. Her pulse oximetry on room air is 82% and she complains of numbness in her fingers. You notify the provider, and he orders oxygen at 2 L via nasal canulla NC. Sarah’s chest x-ray reveals no abnormalities. Her arterial blood gas result are below:

pH: 7.40

PaCO2: 28 mm Hg

PaO2: 78 mm Hg

HCO3: 26 mEq/L

Sarah is admitted to a general medical floor. You are the nurse assigned to Sarah.

1. What potential problems can occur based on the above      findings?
2. How would you provide multidimensional care for Sarah?
3. Describe the roles of other departments in Sarah’s      treatment plan.

INCLUDE FOUR REFRENCES

WRITE FROM NURSING PERSPECTIVE 

APA FORMAT and TEXT CITATION

NO CONSIDERATION FOR PLAGIARISM

 

Critical reflection of your growth and development during your practicum experience in a clinical setting has the benefit of helping you to identify opportunities for improvement in your clinical skills, while also recognizing your strengths and successes. 

Use this Journal to reflect on your clinical strengths and opportunities for improvement, the progress you made, and what insights you will carry forward into your next practicum

To Prepare

• Refer to the “Advanced Nursing Practice Competencies and Guidelines” found in the Week 1 Learning Resources, and consider the quality measures or indicators advanced nursing practice nurses must possess in your specialty of interest.
• Refer to your “Clinical Skills Self-Assessment Form” you submitted in Week 1, and consider your strengths and opportunities for improvement.
• Refer to your Patient Log in Meditrek, and consider the patient activities you have experienced in your practicum experience. Reflect on your observations and experiences.

In 450–500 words, address the following:

Learning From Experiences

•  Revisit the goals and objectives from your Practicum Experience Plan. Explain the degree to which you achieved each during the practicum experience.
• Reflect on the three (3) most challenging patients you encountered during the practicum experience. What was most challenging about each?
• What did you learn from this experience?
• What resources did you have available?
• What evidence-based practice did you use for the patients?
• What new skills are you learning?
• What would you do differently?
• How are you managing patient flow and volume? 

Communicating and Feedback

• Reflect on how you might improve your skills and knowledge and how to communicate those efforts to your Preceptor.
• Answer the questions: How am I doing? What is missing?
• Reflect on the formal and informal feedback you received from your Preceptor. 
• this is the preceptor feedback 

 Works independently, yet humble and asks questions and shares recommendations for treatment options, such as medication management and titration and wrap around community service to minimize risk of re-admission.  

Major strengths of student:
Clinical Skills and Knowledge, Empathy, Dedication. Integral member of our multidisciplinary team. Develops strong therapeutic relationship with her patients.