NURS FPX 6021 Assessment 1 Concept Map
Phillip September 30, 2023 No Comments

NURS FPX 6021 Assessment 1 Concept Map

NURS FPX 6021 Assessment 1 Concept Map

Student Name

Capella University

NURS-FPX 6021 Biopsychosocial Concepts for Advanced Nursing Practice 1

Prof. Name

Date

 

Concept Map:

Patient Info 

Name: Walter B. Harris| Gender: Female | Age: 72 

Vitals: Temp: 37 °C (98.6 °F), BP: 162/94, Pulse: 92, Respiratory rate: 26 and shallow 

Chief complaint: Shortness of breath (SOB) and difficulty breathing 

Medical history: Hypertension, hyperlipidemia, and chronic obstructive pulmonary disease (COPD) 

Nursing Diagnosis

Impaired gas exchange related to destruction of the alveoli, narrowing of  bronchioles, and trapping of air resulting in loss of lung elasticity 

Subjective data: Difficulty breathing and SOB 

Objective data: Crackles and wheezing heard upon auscultation, dyspnea,  tachypnea, nasal flaring, use of accessory muscles, late signs of cyanosis (Linton,  2015), and oxygen saturation is 90% on room air 

Nursing Diagnosis 

Ineffective airway clearance related to bronchoconstriction, increased mucus  production 

Subjective data: The patient states she has been sleeping in a recliner chair for the  past three nights because of difficulty breathing 

Objective data: Wheezing heard upon auscultation, dyspnea, tachypnea, and use  of accessory muscles (Linton, 2015) 

Nursing Diagnosis 

Activity intolerance related to hypoxia (imbalance between oxygen supply and  demand) 

Subjective data: “I find it difficult to breathe. I can’t catch my breath when I walk a  few feet.” — Jane Doe 

Objective data: Late signs of cyanosis, crackles and wheezing heard upon  auscultation, and use of accessory muscles (Linton, 2015)  

Nursing Interventions 

Independent intervention (II): Monitor the patient’s arterial blood gases, oxygen  saturation, vital signs, and color and assess for manifestations such as restlessness,  anxiety, lethargy, and confusion 

Rationale: This process will help detect potential hypoxemia or hypercapnia  (LeMone et al., 2015) 

Collaborative intervention (CI): Supervise oxygen (O2) at 2 L/min through nasal  cannula as ordered. Instruct the patient and kin not to increase the O2 level

Rationale: Oxygen therapy is used to treat hypoxia and is prescribed for chronic  and acute breathing problems (Rees, 2017). However, a sudden increase in the O2 level can lead to respiratory failure (Linton, 2015) 

II: Position the patient in an upright or high Fowler’s position (Linton, 2015)

Rationale: This posture promotes lung ventilation (LeMone et al., 2015) 

II: Instruct and teach the patient to perform the pursed-lip breathing technique

Rationale: This technique slows the respiratory rate and reduces air trapping and  fatigue (LeMone et al., 2015) 

Expected Outcomes 

Arterial blood gases and vital signs will be consistent with patient norms,  indicating improvement in gas exchange (Linton, 2015) 

The pursed-lip breathing technique will reduce dyspnea (Linton, 2015) 

Nursing Interventions 

II: Demonstrate pursed-lip and diaphragmatic breathing and encourage the  patient to practice them periodically 

Rationale: These techniques reduce air trapping and fatigue and help maintain  open airways (LeMone et al., 2015) 

II: Position the patient in an upright or high Fowler’s position 

Rationale: This posture promotes lung ventilation (LeMone et al., 2015) 

CI: Encourage deep breathing and the use of an incentive spirometer

Rationale: Using an incentive spirometer prevents complications such as  pneumonia and atelectasis (LeMone et al., 2015) 

CI: Collaborate with a respiratory therapist to teach the patient how to cough  effectively 

Rationale: This technique helps open distal alveoli and remove secretions  (LeMone et al., 2015) 

II: Provide emotional support to the patient 

Rationale: This intervention will be therapeutic, make the patient feel  comfortable, and help her cope with the diagnosis (Kazanowski, 2017; LeMone et  al., 2015) 

Expected Outcomes 

The patient will have open airways. Signs of clear and open airways are normal  depth and rate of respiration, normal breathing sounds, and effective coughing of  secretions (Linton, 2015) 

Nursing Interventions 

II: Teach and encourage the use of the pursed-lip breathing technique while  performing activities 

Rationale: This technique can lower breathlessness and improve respiratory  function (Ackley, Ladwig, Makic, 2016) 

II: Advise the patient to take rest periods before and after activities

Rationale: Resting reduces fatigue and lowers the demand for oxygen (LeMone et  al., 2015) 

CI: Recommend a pulmonary rehabilitation program 

Rationale: Pulmonary rehabilitation can lower exertional dyspnea and perceived  intensity of breathlessness (Ackley et al., 2016) 

CI: Collaborate with a respiratory therapist for cough control and improved  breathing 

Rationale: This will help improve or maintain oxygenation in the patient (Boon,  2018) 

CI: Supervise oxygen (O2) at 2 L/min through nasal cannula as ordered. Instruct the  patient and kin not to increase the O2 level 

Rationale: Oxygen therapy is used to treat hypoxia and is prescribed for chronic  and acute breathing problems (Rees, 2017). However, a sudden increase in the O2 level can lead to respiratory failure (Linton, 2015) 

Expected Outcomes 

The vital signs of the patient will show normal fluctuation during physical activity,  which is a measure of activity tolerance (LeMone et al., 2015)

CONCEPT MAP

Introduction 

This paper presents an evidence-based concept map that illustrates a nursing care plan to achieve high-quality outcomes for a  patient experiencing SOB and difficulty breathing. The concept map contains urgent diagnoses, possible nursing interventions, and  opportunities for interprofessional collaboration as well as rationales and possible high-quality outcomes. The narrative justifies the  value and relevance of the evidence used in the concept map and provides additional evidence, conflicting data, and the scope of  interprofessional collaborations in achieving high-quality outcomes. 

Additional Evidence 

Jane Doe is a 72-year-old female experiencing SOB and difficulty breathing. The suspected diagnoses are based on the  patient’s medical history and physical examination. The evidence used in the concept map is a combination of subjective (patient reported distress) and objective (symptoms or characteristics related to a condition observed in the patient) data obtained after an investigation. Doe also suffered from emphysema in the past. Fatigue, SOB, edema, and wheezing are common symptoms of COPD.  The diagnoses in the concept map are related to various conditions related to COPD such as emphysema and chronic bronchitis.

This evidence suggests that the client’s current distress could be related to COPD. However, symptoms such as wheezing, edema, SOB,  and fatigue can also be observed in a person suffering from congestive heart failure (LeMone et al., 2015). Even though COPD and  congestive heart failure have several risk factors and symptoms in common, the causes and treatments are different.

 Inter-professional Strategies 

An inter-professional collaboration between health care professionals, patients, and their caregivers is required for high-quality  outcomes. Successful collaborations require positive reinforcement and mutual feedback in an objective and non-discriminatory setting (Amalakuhan & Adams, 2015). COPD will benefit from a combination of pharmacological and non-pharmacological  interventions guided by an interprofessional collaborative practice. The concept map clearly identifies interventions that can be  performed independently and those that need inter-professional collaboration. For instance, it is necessary to collaborate with a  respiratory therapist to teach and assist a patient in coughing effectively. Similarly, referring the patient to a pulmonary rehabilitation  program can help lower exertional dyspnea and the perceived intensity of breathlessness.

NURS FPX 6021 Assessment 1 Concept Map

The concept map also facilitates  communication in an inter-professional team by identifying the types of nursing interventions required, thereby preventing conflict. Health care professionals must collaborate with caregivers and COPD patients to achieve high-quality outcomes. This  collaboration should effectively optimize non-pharmacological interventions such as providing smoking cessation counseling for  patients who find it difficult to quit the habit, promoting pulmonary rehabilitation programs, and administering appropriate  vaccinations.

Inter-professional collaborations should also focus on helping patients gradually incorporate more physical activity into their lifestyles and managing comorbidities common in COPD in addition to the interventions discussed in the concept map. Health  care professionals, caregivers, and COPD patients must work together to deliver the prescribed pharmacotherapy (Amalakuhan &  Adams, 2015). 

Value and Relevance of Evidence 

An evidence-based concept map with inter-professional strategies allows health care professionals to collaborate and analyze patient data as well as think critically (Aein & Aliakbari, 2017). According to Cook, Dover, Dickson, and Colton, concept map  development is an alternative to a traditional nursing care plan for evidence-based practices. The traditional linear format of a nursing  care plan may not have the scope to record a holistic picture of patients’ requirements. It does not facilitate visualization of the  interrelated nature of patient data.

NURS FPX 6021 Assessment 1 Concept Map

On the other hand, a concept map allows for a systematic visualization of psychological,  physiological, and pathophysiological relationships and interactions, which promotes quality analysis (as cited in Aein & Aliakbari,  2017).The findings of a study conducted by Gerdeman, Lux, and Jacko show that medical students approached concept mapping as an instrument to improve clinical judgment and make better clinical decisions. Finally, the minimal use of text in a concept map  facilitates easy searching for terms related to the disorder or condition being treated (as cited in Aein & Aliakbari, 2017).

Conclusion 

COPD is a group of progressive lung diseases such as emphysema and bronchitis. Interprofessional strategies to treat COPD  can improve outcomes, and collaboration between health care professionals can aid in providing comprehensive care to patients.  Concept mapping is useful in improving critical thinking among professionals. A concept map helps in recording a holistic picture of  the patient’s needs and facilitates visualization of the data. Therefore, a concept map is an essential tool to develop nursing care plans  to achieve high-quality outcomes. 

References 

Ackley, B. J., Ladwig, G. B., & Makic, M. B. F. (2016). Nursing diagnosis handbook: An evidence-based guide to planning care  (11th ed.). Retrieved from  

https://books.google.co.in/books?id=s3OKCwAAQBAJ&lpg=PP1&pg=PP1#v=onepage&q&f=false 

Aein, F., & Aliakbari, F. (2017). Effectiveness of concept mapping and traditional linear nursing care plans on critical thinking skills  in clinical pediatric nursing course. Journal of Education and Health Promotion, 6(13).  

Amalakuhan, B., & Adams, S. G. (2015). Improving outcomes in chronic obstructive pulmonary disease: The role of the  interprofessional approach. International Journal of Chronic Obstructive Pulmonary Disease, 10(1), 1225–1232.  Boon, C.W. (2018). Oxygenation. In Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. M. (Eds.), Essentials for nursing practice  (9th ed., pp. 865–916). Retrieved from  

NURS FPX 6021 Assessment 1 Concept Map

https://books.google.co.in/books?id=wDtRDwAAQBAJ&lpg=PP1&pg=PR3#v=onepage&q&f=false Kazanowski, M. K. (2017). End-of-life-care concepts. In Ignatavicius, D. D., Workman, M. L., & Rebar, C. R. (Eds.), Medical surgical nursing: Concepts for interprofessional collaborative care (9th ed., pp. 103–116). Retrieved from  https://books.google.co.in/books?id=Qzg1DwAAQBAJ&lpg=PA244&dq=incentive%20spirometer%20prevent%20pneumonia &pg=PA112#v=onepage&q&f=false 

LeMone, P., Burke, K., Dwyer, T., Levett-Jones, T., Moxham, L., & Reid-Searl, K. (2015). Medical-Surgical nursing: Critical  thinking for person-centred care (2nd Australian ed.). Retrieved from  

https://books.google.co.in/books?id=MDXiBAAAQBAJ&lpg=PP1&dq=LeMone%2C%20Burke%2C%20Dwyer%2C%20Lev ett-Jones%2C%20Moxham%2C%20Reid 

NURS FPX 6021 Assessment 1 Concept Map

Searl%2C%202015&pg=PP1#v=onepage&q=LeMone,%20Burke,%20Dwyer,%20Levett-Jones,%20Moxham,%20Reid Searl,%202015&f=false 

Linton, A. D. (2015). Introduction to medical-surgical nursing (6th ed.). Retrieved from  

https://books.google.co.in/books?id=o5jTBgAAQBAJ&lpg=PP1&pg=PP1#v=onepage&q&f=false 

Rees, H. (2017). Care of patients requiring oxygen therapy or tracheostomy. In Ignatavicius, D. D., Workman, M. L., & Rebar, C. R. (Eds.), Medical-surgical nursing: Concepts for interprofessional collaborative care (9th ed., pp. 529–546). Retrieved from  https://books.google.co.in/books?id=Qzg1DwAAQBAJ&lpg=PA244&dq=incentive%20spirometer%20prevent%20pneumonia &pg=PA529#v=onepage&q&f=false