Analysis

NURS FPX 6011 Assessment 1 Diabetes Patient Concept Map

Carole Lunde is a 44-year-older woman of milxed Native American and European descent and a new mother. She has recently
been dlagnosed with dlabetes, which she was first dlagnosed with at 30 weeks of pregnancy. After belng told by her OB/GYN that
gestational diabetes should dear up after childbirth, She is concerned that she has not recovered due to continued elevated blood
glucose (BG). Carole’s BG has been over 200 postprandlal and 150-200 fasting.

After Carole was dlagnosed with gestational dlabetes, her doctor suggested she begin Insulin to reduce her BG. After consulting
with tribal leaders that Insulin was not a good thing due to being created with animal hormones, she declined treatment. Carole
refused therapy after it was revealed to her Insulin was a synthetic hormone because she did not want to become dependent on It.
Carole reports that her daughter Kassandra was born big but healthy despite elevated blood glucose during pregnancy.

Currently, Carole Iives off of the reservation with her ten-week-old daughter post-e-section. She Independently cares for her
daughter, does freelance work, and has no other financial assistance or support. During the Initlal postpartum perlod, Carole’s
mother helped her care for her Iliness and newbom. Her mother has since returned to the reservation. Between caring for her
daughter and working, her health is the least important in her lfe; however, she worrles about her daughter developing Dlabetes
Il. Even though Carole has not cared for herself, she ls open and receptive to learning more about diabetes to lower Kassandra’s
risk of contracting It.

Value and relevance of the evidence
Carole’s cultural bellefs, dlabetes knowledge Iimitations, and psychosocial varlables are roadblocks to effective health outcomes,
which Is why the data offered in the concept map is significant and relevant. It Is sald by (Telxelra et al,, 2017) that lack of
Information becomes an obstacle to user empowerment and treatment adherence. Her outcomes would vastly Improve If she had
the correct Information and assistance from her surroundings. (Telxelra et al,, 2017), also stated in the article that “Impalred sleep
Increases blood pressure, Increases appetite and may compromise Insulin sensitivity, and being assoclated with the Incidence of
dlabetes.” Carole’s high blood sugar levels and the likelhood of future problems could be due to a lack of sleep, her age, and
additional life stress.

NURS FPX 6011 Assessment 1 Diabetes Patient Concept Map
Carole is alone and lacks a solid support structure necessary for self-care. Self-care Is an acquired skill that is Influenced by one’s
surroundings. Nonetheless, family-centered care is founded on the belief that professionals cannot and do not know what Is best
for thelr dlients, such as a family. The Importance of a client’s role in thelr family significantly Impacts their ability to self-care, which
can have a long-term effect on a client’s commitment to behavioral changes and treatment regimens, and overall outcomes
(Kumar, 2007)

Carole’s future success in caring for herself and her kid depends on addressing the risk of dangerous blood glucose levels, a lack of
knowledge of dlabetes II, and treating her high blood sugars. Due to cultural barriers and her family being Isolated from the Native
American community, Inefficient family therapeutic regimen management is a nursing dlagnosis I would use. Native Americans
may not follow recommended treatment plans due to mistrust and misunderstanding of Western medicine. Therefore, galning the

trust of Carole and her family is essential in faciltating a better health outcome for her. Carole’s Native American background will
be utilized when creating her care plan. In her care plan, I will ensure anyone she authorizes ls Involved in her care. Family
members, tribal leaders, extended family, or other members of the community are part of the decision-making process for Indlan
patients (Patient and Family Educationall Services, n.d.). Asking patients who’d like to be Involved in their care can bulld trust
between the family and the patient (Patlent and Family Educational Services, n.d.). During my visit with Carole, I will avold making
direct eye contact, refrain from touching her halr, and thoroughly explain any treatments I may perform. By understanding that
she may communicate discomfort through storytelling or express silence, I am aware that listening closely without Interruption
and utilzing humor is another step in achleving trust to encourage positive outcomes. During Carole’s visit, I will also remember
that American Indlans view Ilness from a holistic perspective. Individuals, communitles, nature, and spirituallty are considered
Interwoven, affecting a person’s physical, spiritual, mental, and emotional health. Discord between these sources may be
Interpreted as the cause of illness (Patient and Family Educational Services, n.d.). During my visit with Carole’s group, I will explain
the benefits of referring her to different specialists, such as an Endocrinologist and Dletitian. I’d clarify that an endocrinologlst and
dieticians can provide her with additional dlabetes education, support, and dose monitoring of her blood sugar levels and possibly
treat her dlabetes with an oral medicine lke metformin. Endocrinologists frequently have dietican on staff who can better assist
her in following a dlabetic diet. It would also be helpfull to engage with tribal leaders to teach them about dlabetes so that dlabetes
awareness can become Ingralned in their culture and care. Encouraging Carole to communicate with her family and join support
groups can help her avold despalr and galn controll over her health. Family and community support can assist her with caring for
Kassandra so she may obtain adequate sleep and work as needed to be able yy.

NURS FPX 6011 Assessment 1 Diabetes Patient Concept Map
Carole could be referred to financial resource organizations like Women, Infants, and Children (WIC) to help her with some
financial concerns. WIC helps moms and children under five with nutritional education, health referrals, and breastfeeding support
and provides extra nourishment.

Type 2 dlabetes is a severe global public health issue that disproportionately affects the poor, especially Native Americans and
Alaskans. In 2009, people eligible for the Indlan Health Service (IHS) had a 16.1% age adjusted diabetes prevalence, more than
double that of non-Hispanlc white Individuals (jlang et al., 2013). Large-scale public health Interventions in Native American
communitles, such as the Dlabetes Prevention Program (DPP), have proven that lifestyle modifications can prevent or delay the
onset of dlabetes for people at risk (jlang et al, 2013). Healthy Iifestyle change in the Native American communty highly relies on
trust and community collaboration. This will ultimately promote a positive outcome.

Patlent Info

44-year-old Native American and European female ten weeks post-partum dlagnosed with gestational diabetes at 30 weeks
pregnant with persistent hyperglycemla.

References

Alfadhli, E. M, MD, FRCP. (2015). Gestational diabetes meltus, 36(4), 399-406. https://dolorg/10.15537/sm].2015.4.10307

Doenges, M. E. (2019). Nursing cave plans guldelines for indiwdualzing clent care across the Me span (10th ed.). F.A. Davis
Company.

Jlang, L., Manson, S. M., Beals, J., Henderson, W. G., Huang, H., Acton, K. J., & Roubideaux, Y.(2013). Translating the dlabetes
prevention program Into American Indlan and Alaska Native communities. Dlabetes Care, 35(7), 2027-2034.
https://dol.org/10.2337/dc12-1250

Kalbfieisch, P. J. (2009). Effective Health Communication In Native Populations In North America. Journal of Language and Sociall
Psychology, 28(2), 158-173. https://dol.org/10.1177/0261927X08330507

Kumar, C. P.(2007). Application of Orem’s self-care deficit theory and standardized nursing languages in a case study of a woman
with diabetes. International journal of Nursing Terminologles and Classifications, 18(3), 103-110. https://dol.org/10.1111/].1744-
618x 2007.00058.x

Mayo Clinic. (n.d.). Patient care & health information-Dlabetes. Retrieved June 4, 2022, from https://www.mayoclinic.org/diseases-
conditions/disbetes/dlagnosis.treatment

Mendes, L. C., Carvalho de Sousa, V. E., & s de Olivelra Lopes, M. V. (2011). Accuracy of dlagnosis of the defining characteristics of
Ineffective family therapeutic regimen management. Acta Paul Enferm, 242), 219-224.

NURS FPX 6011 Assessment 1 Diabetes Patient Concept Map
Patient and Family Educational Services. (n.d.). Communicating with your American Indlan/Alaska native patient [pdf]. Culture Cues.
https://www.lacrosseconsortlum.org/uploads/content_files/files/American5620Indlan.pdf

Stotz, S. A, Charron-Prochownik, D., Terry, M. A., Marshall, G., Fischl, A. R, & Moore, K. R. (2020). Stopping gestational dlabetes in
American Indian and Alaska native girls: Nutrition as a critical component to gestational diabetes risk reduction. Current
Developments in Nutrition. https://dol.org/10.1093/cdn/nzas081

Telxeira, A., Tsukamoto, R., Lopes, C., & Silva, R. E. (2017). Risk factors for unstable blood glucose level: Integrative review of the risk
factors related to the nursing dlagnosis. Revista Latino-Americana de Enfermagem, 25,0). https://dol.org/10.1590/1518-
8345.1688.2893