CONCEPT MAP WORKSHEET
DESCRIBE DISEASE PROCESS AFFECTING PATIENT (INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS)
“Gestational diabetes mellitus (GDM) is an impaired tolerance to glucose with the first onset or recognition during
pregnancy. The ideal blood glucose level during pregnancy should range between 60 to 99 mg/dL before meals or
fasting, and less than or equal to 120 mg/Dl.2 hr. after meals. Findings of diabetes mellitus can disappear a few weeks
following delivery. However, approximately 50% of clients will develop type 2 diabetes mellitus later in life.”
(Holman et al., 2019)
DIAGNOSTIC TESTS PATIENT INFORMATION EXPECTED PHYSICAL FINDINGS
(REASON & RESULTS)
None of the following test were Amelia Sung, Female “Hypoglycemia: nervousness, headache,
observed in the vsims - no Adm DX: labor induction due to weakness, irritability, hunger, blurred
results were given. gestational diabetes vision.”
DOB: 7/11/1984 (36y) “Hyperglycemia: polydipsia, polyuria,
Glucose screening Height: 157 cm nausea, abdominal pain, flushed dry skin,
test/1-hr glucose Weight: 83 kg fruity breath.”
tolerance test: 50g oral Allergies: Shellfish Shaking
glucose load, followed Adm on: 8/15/2020 Rapid pulse
by plasma glucose Clammy pale skin
analysis 1 hr later Excess weight gain during pregnancy
performed at 24 to 48 (Holman et al., 2019)
weeks of gestation;
fasting not necessary; a
positive blood glucose
screening is 130-140
mg/dL or greater;
additional testing with a
3-hr oral glucose
tolerance test (OGTT) is
indicated.”
Presence of ketones in
urine
(Holman et al., 2019)
ANTICIPATED NURSING INTERVENTIONS
Monitor clients blood glucose
Monitor vital signs
Monitor the fetus
Educate patient about lifestyle changes following delivery.
Vaginal examination
Provide emotional support for the patient.
Assess urine for the presence of ketones
(Holman et al., 2019)
, INTRODUCTION RN, Labor and Delivery Unit
Your name, position (RN), unit you
are working on
SITUATION I am caring for Amelia Sung, she is a 36-year-old female patient who was
Patient’s name, age, specific reason admitted yesterday with labor induction due to her gestational diabetes.
for visit
BACKGROUND The patient was diagnosed with labor induction due to gestational diabetes,
Patient’s primary diagnosis, date of she was admitted on 08/17/20.
admission, current orders for patient
Assessment Patients vital signs were all within normal limits. FHR was 120 with moderate
Current pertinent assessment data variability and early decelerations since patient started pushing. She asked for
using head to toe approach, an epidural and we gave that to her. She fully dilatated 3 hours ago and
pertinent diagnostics, VS started pushing. Currently the baby’s head is starting to crown.
RECOMMENDATION I recommend continuous monitor for the patient and to prepare the patient
Any orders or recommendations you for a cesarean delivery. You will need to consult the surgery unit, NICU and
may have for this patient anesthesia. Continue to monitor her vital signs and ensure patient is
comfortable.
PATIENT EDUCATION WORKSHEET:
NAME OF MEDICATION: Oxytocin
CLASSIFICATION: oxytocics
PROTOTYPE DRUG: Oxytocin
SAFE DOSE/DOSE RANGE/SAFE ROUTE: IV 10 units infused at 20-40 mU/min
PURPOSE FOR TAKING THIS MEDICATION: to induce labor
PATIENT EDUCATION WHILE TAKING THIS MEDICATION:
“Advise patient to expect contractions similar to menstrual cramps after administration has started.”
Advise patient to remain in bed.
CLINICAL WORKSHEET
Date: 08/17/20 Student Name: Assigned Vsim:
PT Initials: AS Diagnosis: HCP Isolation: N/A IV Type: Critical Labs: Other
Labor Dr. Jeff Smith Peripheral Services:
induction due IV 94+ mg/dl NICU
to gestational O+ blood
diabetes
Age: Length of Consults: Fall risk: Bed Location:
36 stay: Health care rest Left
unknown provider forearm
NICU
Surgery unit
M/F Female Allergies: Transfer: N/A Fluid/Rate: Consults
Code Status: Shellfish Lactated needed:
Full code- fall ringers at Health care
risk 125 mL/hr. provider
NICU
DESCRIBE DISEASE PROCESS AFFECTING PATIENT (INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS)
“Gestational diabetes mellitus (GDM) is an impaired tolerance to glucose with the first onset or recognition during
pregnancy. The ideal blood glucose level during pregnancy should range between 60 to 99 mg/dL before meals or
fasting, and less than or equal to 120 mg/Dl.2 hr. after meals. Findings of diabetes mellitus can disappear a few weeks
following delivery. However, approximately 50% of clients will develop type 2 diabetes mellitus later in life.”
(Holman et al., 2019)
DIAGNOSTIC TESTS PATIENT INFORMATION EXPECTED PHYSICAL FINDINGS
(REASON & RESULTS)
None of the following test were Amelia Sung, Female “Hypoglycemia: nervousness, headache,
observed in the vsims - no Adm DX: labor induction due to weakness, irritability, hunger, blurred
results were given. gestational diabetes vision.”
DOB: 7/11/1984 (36y) “Hyperglycemia: polydipsia, polyuria,
Glucose screening Height: 157 cm nausea, abdominal pain, flushed dry skin,
test/1-hr glucose Weight: 83 kg fruity breath.”
tolerance test: 50g oral Allergies: Shellfish Shaking
glucose load, followed Adm on: 8/15/2020 Rapid pulse
by plasma glucose Clammy pale skin
analysis 1 hr later Excess weight gain during pregnancy
performed at 24 to 48 (Holman et al., 2019)
weeks of gestation;
fasting not necessary; a
positive blood glucose
screening is 130-140
mg/dL or greater;
additional testing with a
3-hr oral glucose
tolerance test (OGTT) is
indicated.”
Presence of ketones in
urine
(Holman et al., 2019)
ANTICIPATED NURSING INTERVENTIONS
Monitor clients blood glucose
Monitor vital signs
Monitor the fetus
Educate patient about lifestyle changes following delivery.
Vaginal examination
Provide emotional support for the patient.
Assess urine for the presence of ketones
(Holman et al., 2019)
, INTRODUCTION RN, Labor and Delivery Unit
Your name, position (RN), unit you
are working on
SITUATION I am caring for Amelia Sung, she is a 36-year-old female patient who was
Patient’s name, age, specific reason admitted yesterday with labor induction due to her gestational diabetes.
for visit
BACKGROUND The patient was diagnosed with labor induction due to gestational diabetes,
Patient’s primary diagnosis, date of she was admitted on 08/17/20.
admission, current orders for patient
Assessment Patients vital signs were all within normal limits. FHR was 120 with moderate
Current pertinent assessment data variability and early decelerations since patient started pushing. She asked for
using head to toe approach, an epidural and we gave that to her. She fully dilatated 3 hours ago and
pertinent diagnostics, VS started pushing. Currently the baby’s head is starting to crown.
RECOMMENDATION I recommend continuous monitor for the patient and to prepare the patient
Any orders or recommendations you for a cesarean delivery. You will need to consult the surgery unit, NICU and
may have for this patient anesthesia. Continue to monitor her vital signs and ensure patient is
comfortable.
PATIENT EDUCATION WORKSHEET:
NAME OF MEDICATION: Oxytocin
CLASSIFICATION: oxytocics
PROTOTYPE DRUG: Oxytocin
SAFE DOSE/DOSE RANGE/SAFE ROUTE: IV 10 units infused at 20-40 mU/min
PURPOSE FOR TAKING THIS MEDICATION: to induce labor
PATIENT EDUCATION WHILE TAKING THIS MEDICATION:
“Advise patient to expect contractions similar to menstrual cramps after administration has started.”
Advise patient to remain in bed.
CLINICAL WORKSHEET
Date: 08/17/20 Student Name: Assigned Vsim:
PT Initials: AS Diagnosis: HCP Isolation: N/A IV Type: Critical Labs: Other
Labor Dr. Jeff Smith Peripheral Services:
induction due IV 94+ mg/dl NICU
to gestational O+ blood
diabetes
Age: Length of Consults: Fall risk: Bed Location:
36 stay: Health care rest Left
unknown provider forearm
NICU
Surgery unit
M/F Female Allergies: Transfer: N/A Fluid/Rate: Consults
Code Status: Shellfish Lactated needed:
Full code- fall ringers at Health care
risk 125 mL/hr. provider
NICU
