A Concept Map for a Plan for Achieving High-Quality Outcomes for DM Type II
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A Plan for Achieving High-Quality Outcomes for DM Type II
In this paper, there is a presentation of an evidence-based approach to a nursing care plan whose goal is to achieve high-quality outcomes for patients presenting with type 2 diabetes mellitus. The concept map defines the urgent diagnoses that will direct the plan of management, the nursing interventions that will implement the management, and the expected outcomes that are of high quality. It is important to note that the expected outcomes will be well achieved if there is inter-professional communication and cooperation in the management of the patient (Massey et al., 2019). Therefore, the interventions will need to involve the input of people other than nurses, notably the physicians and the nutritional counselors. The concept map outlines the value and effectiveness of the interventions that will be employed in the management of a patient with type II DM.
In a type II DM patient that is receiving in-patient care, it will be important to establish her vitals and baseline workups to guide the management. Therefore, apart from recording the personal identification details for the patient, there will be a need to record her blood pressure, her baseline heart rate, respiratory rate, temperature, oxygenation levels, and random blood sugar levels (Massey et al., 2019).
The next step will be to identify the nursing diagnoses in the patient to aid in coming up with interventions that will constitute the contribution of the nurses to the inter-professional management (Araújo et al., 2018). The first nursing diagnosis in the patient with type II DM is abnormal blood sugars, especially hyperglycemia. However, hypoglycemia is usually encountered especially in the use of insulin therapy. The subjective data will help the nurse to come up with a diagnosis and the objective data will help in the confirmation before the intervention is started. In this case, the subjective data for hyperglycemia is polydipsia, polyuria, and polyphagia.
There might also be blurred vision and tingling sensation that may be present in cases of chronic hyperglycemia. In this case, there will be a need to measure the blood sugar levels with a glucometer and HbA1c levels to determine the blood sugar control levels. Interventions then will include the administration of oral hypoglycemic agents or the various forms of insulin (Fu & Wang, 2022). There should also be other interventions in terms of dietary counseling to ensure that there is the maintenance of the normal range of blood sugar (Gordon, 2019). Therefore, the targeted outcome is the maintenance of the normal range of blood glucose. Because of the high blood sugar levels, other complications arise and therefore vigilance and constant monitoring of blood sugar levels are advised (Gordon, 2019). Some of these complications include diabetic ketoacidosis, infections, and the development of a diabetic foot (Fu & Wang, 2022). Therefore, interventions such as educating the patient on the disease and monitoring for the development of infections are advised.
Inter-professional Collaboration.
The inpatient management of a diabetic patient requires the intervention of several stakeholders to ensure that there are positive outcomes. The stakeholders in such a patient include the nursing team, the physicians, the surgery team, the nutritional team, and the critical care team if necessary (Fu & Wang, 2022). Diagnosis and management of the patient will involve the consultation of a physician and the integration of the data collected to come up with the management plan. This plan will cover the necessary investigations such as the full hemogram and HbA1c levels, the dosage and type of drugs to be used, and monitoring for the development of complications. In case of the development of infection, there should be a plan of empiric antibiotics to use and the use of culture results to tailor the interventions to suit the patient. In case of the development of complications such as DKA, the critical care team will be involved for close monitoring. On the other hand, if there is the development of a diabetic foot, the surgical team would be involved in this management.
Value and relevance of the evidence
The evidence used in the development of the concept map involved peer-reviewed sources that have integrated the pathophysiology, diagnosis, investigation, management, and complication of type II DM. these sources are also up to date and have integrated the necessary research that has covered the condition (Fu & Wang, 2022). Furthermore, the sources cover multiple professional fields, therefore, portraying the inter-professional nature of the management of the condition. Since diabetes mellitus is one of the most prevalent non-communicable diseases affecting the various parts of the world, up-to-date research must be involved in the management (Gordon, 2019). Therefore, the peer reviews articles that have been sourced and their recency explain the relevance and the high value of the research.
References
Araújo, E. S. S., Silva, L. D. F. D., Moreira, T. M. M., Almeida, P. C. D., Freitas, M. C. D., & Guedes, M. V. C. (2018). Nursing care to patients with diabetes based on King’s Theory. Revista brasileira de enfermagem, 71, 1092-1098.
Fu, B. Y., & Wang, X. J. (2022). The role of nursing care in the type 2 diabetes treatment associated with chronic liver diseases. European Journal of Gastroenterology & Hepatology, 34(1), 104-111.
Gordon, C. (2019). Blood glucose monitoring in diabetes: rationale and procedure. British Journal of Nursing, 28(7), 434-439.
Massey, C. N., Feig, E. H., Duque-Serrano, L., Wexler, D., Moskowitz, J. T., & Huffman, J. C. (2019). Well-being interventions for individuals with diabetes: A systematic review. Diabetes research and clinical practice, 147, 118-133.
Silva, S. D. O., Machado, L. M., Schimith, M. D., Silva, L. M. C. D., Silveira, V. D. N., & Bastos, A. C. D. (2018). Nursing consultation for people with diabetes mellitus: experience with an active methodology. Revista Brasileira de Enfermagem, 71, 3103-3108.
Świątoniowska, N., Sarzyńska, K., Szymańska-Chabowska, A., & Jankowska-Polańska, B. (2019). The role of education in type 2 diabetes treatment. Diabetes research and clinical practice, 151, 237-246.