29 Sep Concept Map Develop a concept map for the individu
Concept Map Develop a concept map for the individual patient, based upon the best available evidence for treating your patient’s health, economic, and cultural needs. Narrative 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. Overview Reason for Referral: 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 maybe 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 address? 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
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