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I developed a concept map for a patient and need narrative to be written as described below. I am attaching the concept map and the information about the patient.

Develop a narrative (2–4 pages) for your concept map.

  • Analyze the needs of your patient and their family, and determine how those needs will influence a patient-centered concept map.
    • Consider how your patient’s economic situation and relevant environmental factors may have contributed to your patient’s current condition or affect their future health.
    • Consider how your patient’s culture or family should influence your concept map.
  • Justify 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 both the health issue you are trying to correct and for the unique situation of your patient and their family.
  • Propose relevant and measurable criteria for evaluating the degree to which the desired outcomes of your concept map were achieved.
    • 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 their 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 their family, regardless of language, disabilities, or level of education.
Assessment 2
Carole Lund is a 44–year–old woman of mixed Native American and European descent, and a
new mother. She is concerned that she is not recovering from gestational diabetes.
Situation: Carole is here with her daughter, Kassandra, who is 10 weeks old. Carole was
diagnosed with gestational diabetes at week 30 of her pregnancy. She has carefully logged her
blood glucose since the diagnosis, and it shows 150–200 fasting, over 200 following meals.
What diabetes treatments did you receive during your pregnancy?
Well, they gave me a glucometer, so I started using that. I could see right away that the way I
was eating was a problem; I would usually work straight through the day and then have one
big meal in the evening, and that was making my numbers bounce all over. So I set alarms on
my laptop, so three times a day I would get interrupted, have a small meal, take a short walk,
and then test my blood sugar. That helped. And then I stopped drinking juice and soda, which
I should have done years ago, and that helped too. But I don’t think my numbers improved as
much as my OB/GYN wanted them to, but she said my blood sugar should return to normal
after delivery.
Did your obstetrician advise you to take insulin during your pregnancy?
She did, yeah, and we talked about it. I don’t like the idea of being dependent on a drug. I
called my mother. She’s still on the reservation, so she called the elders, and we all agreed that
injecting my body with an animal hormone was a bad idea. But then the doctor told me that
they make synthetic insulin now, but that means it’s made in a laboratory somewhere, and I’m
not sure that’s any better.
By then I was in my third trimester, and all the tests said Kassandra was big but healthy, so I
thought we would just ride it out. It was supposed to clear up after she was born. But it hasn’t,
and I know you have to be careful having a baby at my age. I want to do what’s best, but I
don’t want to believe that insulin is my only option.
Are there any challenges in your life which you think may be interfering with your ability to
follow a treatment plan?
It’s harder now than it was before she was born. It’s just the two of us in the apartment, which
is wonderful, but I don’t remember the last time I had a good night’s sleep. A lot of my work is
freelance, so I make my own hours, but that also means if I’m not working I don’t get paid. I
had family help while I was recovering from the C-section, and they helped cook healthy
meals for me, and kept me on my schedule. Now it’s all on me — work, caring for my
daughter, and managing my blood sugar. If I fall behind on anything, it will be looking after
my health.
Do you have any other concerns you’d like to have addressed?
I worry about Kassandra. She’s healthy and perfect, but I know that she’s at a greater risk for
developing Type 2 Diabetes. I want to do whatever I can to reduce that risk, to care for her,
and as she grows, to teach her how to care for herself.
https://nurseslabs.com/diabetes-mellitus-nursing-care-plans/
Nurses labs (2017, November 18). 13 diabetes mellitus nursing care plans. Retrieved
from https://nurseslabs.com/diabetes-mellitus-nursing-care-plans/
Nurses labs (2017, November 18). Ineffective coping – nursing diagnosis & care
plan. Retrieved from https://nurseslabs.com/ineffective-coping/
https://nurseslabs.com/diabetes-mellitus-nursing-care-plans/2/
https://nurseslabs.com/ineffective-coping/
Nursing Diagnosis 2:
Most Urgent Nursing Diagnosis:
Knowledge deficiency related to blood glucose
control and treatment as evidenced by lack of
adherence to the prescribed treatment (Nurses labs,
2017)
Ineffective health maintenance related to lack of
adherence to the medical treatment as evidenced
by uncontrolled blood glucose (Nurses labs,
2017)
Patient Info:
Carole Lund is a 44–year–old woman
of mixed Native American and
European descent, and a new mother.
Treatment: Present the
patient with a choice of oral
diabetic medications to be
discussed with her mother
and the elders in the
reservation. Education of the
gestational diabetes and the
risk of developing Diabetes
Melutis type II post partum
Treatment:
Nursing Diagnosis 3:
Lack of social support as evidenced by
expressed concern about being a single mom and
lacking adequate sleep (Nurses labs, 2017)
– provide information about gestational
diabetes and risks of developing DM
type for both mother and the infant
– offer appointments with diabetic
educator and dietician
-provide option of oral diabetic
medication
Treatment: Encourage
patient to take naps with
her daughter. Encourage
asking family and friends
for help. Discuss a plan
to develop a support
system.
Outcomes:
– patient verbalizes
understanding of the risks of
developing DM II
– patient agrees to oral treatment
– fasting blood glucose of less
than 140,
– postprandial blood glucose of
less than 200
Outcomes:
Outcomes:
– patient communicates her
needs with family and
friends
-patient uses available
resources and support
system
– patient uses available
resources and support system
– patient communicates her
needs with family and friends
– patients sleep pattern
improved

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