NIGHTINGALE COLLEGE
DIRECT-FOCUSED CARE: CONCEPT MAPPING ASSIGNMENT WORKSHEET
NURSING PROCESS TEMPLATE: Glucose Regulation
Relevant-72y/o male pt lives with daughter
Assessment (Recognizing Cues)
who brought him to hospital upon noticing
Which patient information is relevant? What patient data is decreased mental status, sweating, agitation.
most important? Which patient information is of immediate Pt found hypoglycemic and hypertensive with
concern? Consider signs and symptoms, lab work, patient hx of coronary artery disease, HTN, Type 2
statements, H & P, and others. Consider subjective and objective Diabetes and early Alzheimer onset. Pt states
data. new onset of numbness and tingling on feet
and weight loss. BP 160/85 and blood sugar is
30. Most important-Establish onset of s/s and
if any tx to alleviate has been given.
Immediate concern-hypoglycemia.
Type 2 Diabetes is consistent with lowered
Analysis (Analyzing Cues)
mental status, diaphoresis and agitation as
Which patient conditions are consistent with the cues? Do the evidenced by a blood sugar reading of 30.
cues support a particular patient condition? What cues are a cause Hypoglycemia is a cause of concern.
for concern? What other information would help to establish the
Paresthesia may signify poorly managed
significance of a cue?
T2DM.
Pt may be using inappropriate dosing of
Analysis (Prioritizing Hypotheses)
insulin or oral agent and unable to meet
What explanations are most likely? What is the most serious dietary requirements possibly due to declining
explanation? What is the priority order for safe and effective care? cognitive ability with new onset of Alzheimer
disease. Priority order is alleviating
hypoglycemia.
Improve hypoglycemia with glucose gel and
Planning (Generate Solutions)
recheck bs q15 minutes until reading is 70-
What are the desirable outcomes? What interventions can achieve 140 and reassess presenting s/s. Teach
these outcomes? What should be avoided? (SMART Planning- daughter how to tell the s/s of hypoglycemia
specific, measurable, attainable, realistic/relevant, time-restricted-
and verbalize understanding before discharge.
Goal setting)
Demonstrate checking blood sugar AC HS
using glucometer w/return demo by discharge.
Teach mechanism of action of different types
of insulin, how to draw insulin if bs>140,
inject, rotate sites w/return demo by
discharge. Teach how to administer 15g-20g
fast carbs if bs<70, adhere to diabetic meals,
exercise by walking 30 mins qd and verbalize
understanding before d/c. Schedule A1C q3
months and remain<6.5. Teach pt to avoid
walking bare foot and assess feet daily for
cuts, verbalize understanding before d/c.
*Improve hypoglycemia with glucose gel and
Implementation (Take actions)
recheck bs q15 minutes until reading is 70-
How should the intervention or combination of interventions be 140 and reassess presenting s/s. *Teach
performed, requested, communicated, taught, etc.? What are the daughter since pt lives with her and his
priority interventions? (Mark with asterisk)
cognitive ability is likely compromised by
Alzheimer’s onset how to identify the s/s of
hypoglycemia and hyperglycemia, *check
blood sugar AC HS using glucometer, draw the
right type of insulin and right units, inject, and
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