NURS 314SG – Physiologic and Pharmacologic Considerations for Health Promotion
Concept Care Map – Quiz 6
Theresa Samuels, a 72-year-old-retired African American woman, arrives to the community health center for her three-month follow-up appointment. T.S., has a medical history of diabetes, type 2, osteoporosis, secondary hypertension, and dyslipidemia. Due to the death of her only daughter from COVID-19, 4 months ago, T.S., has become the sole caregiver of her three teenage grandchildren. Troubled with unexpected finances, T.S., conveys to the nurse the immense pressure and stress she has been experiencing since the death of her daughter.
The patient had her bloodwork completed at LabCorp prior to her appointment. The nurse conducts a comprehensive assessment and notes the following objective and subjective data:
Objective data:
Blood pressure = 140/90
Heart rate = 92
Respiratory rate = 22
Pulse oximetry = 94% on room air
Present weight and height= 210 lb. (95.2 kg) / 5’5
Physical Assessment
- HEENT=Pupils equal, reactive, responsive to light and accommodation.
- Cards = Regular rate and rhythm; S1S2; Grade 1/6 systolic murmur; 2+ pitting edema bilateral lower extremities; +2 pedal pulses bilaterally; +2 radial pulse bilaterally; no carotid bruit auscultated.
- Resp = Respiratory rate 22 bpm; mild wheeze noted in bases bilaterally; all other lung fields clear to auscultation
- GI = Bowels normal; present in all 4 quadrants
- Skin = Skin is dry and intact; not rashes or skin lesion noted
- GU = Voids frequently; urine output is <30mL/hr; tea-color urine
- Neuro = Intact; oriented to person/place/time/situation (X4); motor and sensory function within normal limits
Labs
- Hemoglobin A1C = 7.5%
- Cortisol level = 35 mcg/dL
- Fasting blood glucose = 132mg/dL
- Erythrocyte sedimentation rate (ESR) = 45 mm/hr
Subjective data:
- Complains of muscle aches and pains with movement, and some tingling in the lower extremities
- She states that her vision is blurry at times
- Most of the time she is compliant with her medications but will sometimes avoid taking Hydrodiuril to keep from having to go to the bathroom so often
- Sleeping 3 – 4 hours a night
- Eats a candy bar if her blood glucose is less than 120 mg/dL
Medication Reconciliation
| Crestor 40 mg Daily | Diltiazem 180 mg PO Daily |
| Lotensin 10 mg PO Daily | Metformin ER 500 PO Daily |
| Cholecalciferol 25 mcg PO Daily | Calcium 1000 mg PO Daily |
| Hydrodiuril 12.5 mg PO Daily | NPH 10 units BID |
During the health assessment, the nurse offers T.S., the yearly influenza vaccine; but T.S., declines, stating, “The flu shot will cause me to get the flu and I just don’t have the time to be sick.”
| CASE MAP GRADING RUBRIC | Student Name: | |||||
| Pathophysiological process:
|
0 points
Below Standard |
1-2 points
Partially Meets Standard |
3-4 points
Meets Standard |
5 points
Exceeds Standard |
||
| Explains the pathophysiological process of obesity and connects (interrelates) the disorder to:
· (Alteration in glucose regulation) Diabetes Mellitus · (Alteration in perfusion) Hypertension, Hyperlipidemia, Atherosclerosis · Stress Adaptation and Sleep Disorder |
Vague and confusing. Does not explain the pathophysiological process of obesity and does not connect to other pathophysiological processes.
Multiple (more than 5) mistakes in terminology and shows lack of understanding of many concepts. |
Somewhat organized
Few (3-5) mistakes in terminology and shows some understanding of many concepts |
Thoughtfully organized
Identifies important concepts and shows an understanding of many concepts. Minimal (no more than 2) mistakes in terminology demonstrating good understanding of many concepts. |
Well organized.
Connects main concepts and characteristics. No mistakes in terminology and shows complete understanding of many concepts.
|
||
| Assessment Findings (Recognizing Cues):
|
0 points
Below Standard |
1-2 points
Partially Meets Standard |
3-4 points
Meets Standard |
5 points
Exceeds Standard |
||
| Identifies the pertinent assessment findings to include but not limited to subjective and objective data, laboratory values, and diagnostics associated with each disease processes. | Vague and confusing. None of the pertinent assessment findings are included. Multiple mistakes in terminology. | Somewhat organized. Includes some pertinent assessment findings. Few mistakes in terminology. | Thoughtfully organized. Includes most pertinent assessment findings.
Easy to follow. Minimal mistakes in terminology. |
Well organized.
Includes all pertinent assessment findings. No mistakes in terminology.
|
||
| Interpreting Assessment Findings (Analyze Cues) | 0 points
Below Standard |
1-2 points
Partially Meets Standard |
3-4 points
Meets Standard |
5 points
Exceeds Standard |
||
| Explain the pertinent assessment findings above and describe how they relate to the client’s health condition. | Vague and confusing. Does not explain any of the pertinent assessment findings or describe how they relate to the client’s health condition. No understanding of connections demonstrated. Multiple mistakes in terminology and shows lack of understanding of many concepts. | Connections are somewhat clear and convey some meaning.
Explain some of the pertinent assessment findings and describe how some are related to the client’s health condition. Connections demonstrate minimal understanding. Few mistakes in terminology and shows some understanding of many concepts. |
Thoughtfully organized. Explains most of the pertinent assessment findings and describes how most are related to the client’s health condition. Connections demonstrate a partial understanding. Occasional mistakes in terminology demonstrating good understanding of many concepts. | Well organized. Explains all the pertinent assessment finding and describes how all are related to the client’s health condition. No mistakes in terminology and shows comprehensive understanding of all concepts.
|
||
| Health Promotion (Generate Solutions):
|
0 points
Below Standard |
1-2 points
Partially Meets Standard |
3-4 points
Meets Standard |
5 points
Exceeds Standard |
||
| Develops patient teaching for each disease process, incorporates the concepts of health, wellness, and illness, and the social constructs that influences healthy outcomes.
Describe the medications (prototype) for each of the associated the disease processes, relates the potential and actual risk factors, and implements principles of safety.
|
Multiple mistakes in terminology and shows lack of understanding of many concepts. | Few mistakes in terminology and shows some understanding of many concepts. | Identifies important concepts but makes some incorrect connections. Occasional mistakes in terminology demonstrating good understanding of many concepts. | Identifies all important concepts and shows an understanding of the relationship among the disorders. | ||
| Format, Grammar/Spelling and References | 0 points | 2.5 points | 5 points | |||
| Uses appropriate template as instructed by faculty. Writing should be free of errors in grammar and spelling. APA Style Reference Page included as a separate word document. | Inappropriate template used OR multiple errors in grammar/spelling OR Reference Page not in APA style/not included. | Correct template used; some errors in grammar/spelling; reference page included but with errors in APA format | Uses appropriate template as instructed by faculty. Writing is free of errors in grammar and spelling. APA Style Reference Page included as a separate word document. | |||
| TOTAL | /25 POINTS | |||||
Please note: This is a sample with some direction that students may use a guide. Please follow the directions in the rubric closely before submitting your concept map.
