Name
Capella University
NURS-FPX 6021 Biopsychosocial Concepts for Advanced Nursing Practice 1
Prof. Name
Date
This narrative presents an evidence-based nursing strategy outlined through concept maps, illustrating care plans for individuals experiencing acute and chronic renal failure across acute care and community settings. One concept map delineates the approach for a patient named Mrs. Smith, who was admitted to an acute care hospital with acute renal failure, while another depicts the management plan for a chronic renal failure patient dependent on hemodialysis residing within a home health community.
The two concept maps designed for Mrs. Smith in acute and chronic healthcare settings have been meticulously crafted using contemporary evidence-based articles sourced from reputable medical, nursing, and health journals. These articles, all published within the past five years, offer valuable insights directly pertinent to Mrs. Smith’s case. Research by Yaman (2022) elucidates the connection between renal dysfunction and compromised tissue perfusion, highlighting overlapping symptomatology and shared pathophysiological mechanisms. Findings from Butturini et al. (2022) and Cai et al. (2021) shed light on the risk factors associated with acute kidney failure, such as impaired gas exchange and ineffective tissue perfusion. The article by James et al. (2020) support the interprofessional collaboration to manage chronic condition like diabetes and its complications like acute kidney failure.
Furthermore, Suwardianto (2021) underscores the importance of supplemental oxygen administration and respiratory exercises to optimize breathing. Additionally, research evidence supports the implementation of mobilization assistance and progressive activity plans in patients like Mrs. Smith to improve physical function and promote recovery. Studies have consistently demonstrated the benefits of early mobilization and progressive activity in preventing deconditioning, enhancing functional independence, and improving overall outcomes in patients with acute and chronic conditions. For instance, a study by Alaparthi et al. (2020) found that early mobilization interventions, including assistance with activities such as transferring and ambulation, were associated with improved functional outcomes in hospitalized patients. These findings underscore the importance of mobilization assistance in preventing functional decline and promoting independence.
Similarly, research by Asma et al. (2024) highlights the efficacy of progressive activity plans in improving physical function and quality of life in patients undergoing rehabilitation. By collaborating with physical therapy to tailor activity plans to individual abilities and goals, patients like Mrs. Smith can safely and gradually increase activity levels, leading to improvements in strength, endurance, and overall functional capacity.In the second concept map, all interventions are derived from evidence-based research studies tailored to Mrs. Smith’s needs. Nutritional education and meal planning assistance play a pivotal role, as research underscores their efficacy in empowering patients to make informed dietary choices, manage hyperglycemia, and improve overall well-being (Tamura et al., 2020; Powers et al., 2020).
Additionally, the value of regular skin assessments and pressure redistribution techniques cannot be overstated, given their role in preventing pressure ulcers, a common complication in chronic conditions like diabetes and renal failure. By adhering to evidence-based guidelines and implementing strategies such as pressure-relieving devices, Mrs. Smith’s risk of skin breakdown is mitigated, preserving skin integrity and enhancing overall comfort (Moore et al., 2020). Moreover, patient and family education on self-management and coping strategies holds immense relevance in Mrs. Smith’s care journey, fostering adherence to treatment regimens and facilitating coping with the challenges of chronic renal failure. Leveraging community resources and social support networks further empowers Mrs. Smith to overcome social isolation, improve diabetes management, and achieve better health outcomes in the long term (Campbell et al., 2021).
Interprofessional strategies applied to the concept maps for Mrs. Smith can play a pivotal role in achieving desired outcomes by fostering collaboration, communication, and coordination among healthcare team members. In Mrs. Smith’s case, involving a diverse team comprising nurses, physicians, physical therapists, dieticians, and social workers ensures a holistic approach to her care, addressing various aspects of her health and well-being. For example, mobilization assistance and progressive activity plans in the acute care concept map necessitate close collaboration between nursing staff and physical therapists (Barnard et al., 2020).
By working together, they can tailor interventions to Mrs. Smith’s abilities, monitor her progress, and adjust the plan as needed to optimize her mobility and physical function. This interprofessional collaboration enhances the effectiveness of interventions, promotes patient safety, and facilitates timely interventions. Similarly, in the second concept map of community home health setting, collaboration among nurses, dieticians, and social workers is essential for implementing interventions such as nutritional education and meal planning assistance, as well as patient and family education on self-management (Afandi et al., 2023). By leveraging the expertise of each team member, Mrs. Smith can receive comprehensive support in managing her chronic condition, improving her nutritional status, and enhancing her coping skills and social support network.
Despite the benefits of interprofessional collaboration, there may be knowledge gaps or areas of uncertainty that could impact the effectiveness of the applied strategies. For instance, there may be uncertainty regarding the most appropriate timing and intensity of mobilization activities in the acute care setting, particularly in patients with complex medical conditions like Mrs. Smith. Additionally, further information may be needed to determine the optimal frequency and duration of nutritional education sessions or the most effective methods for addressing social isolation in patients with chronic illnesses.
In summary, the concept maps for Mrs. Smith highlight the significance of evidence-based interventions and interprofessional teamwork in addressing her healthcare needs. By implementing tailored strategies, healthcare teams can optimize Mrs. Smith’s outcomes. However, addressing knowledge gaps and uncertainties is crucial for enhancing the effectiveness of interventions. Through collaboration and continuous improvement, Mrs. Smith can receive holistic care and improve her quality of life.
Afandi, A., Candrayani, M., Ardiana, A., & Fariasih, C. (2023). Interprofessional collaboration in patients diabetes mellitus: A case study. Jurnal Kesehatan Komunitas Indonesia, 3(1), 126–136. https://doi.org/10.58545/jkki.v3i1.67
Alaparthi, G. K., Gatty, A., Samuel, S. R., & Amaravadi, S. K. (2020). Effectiveness, safety, and barriers to early mobilization in the intensive care unit. Critical Care Research and Practice. https://doi.org/10.1155/2020/7840743
Asma, S., Gilani, M. H. Z., Aroofa, H., Safdar, G., Raza, A., & Ataullah, A. (2024). Effects of progressive resistance exercise training on endurance and functional mobility in children with spina bifida: Progressive resistance exercise training in spina bifida. The Healer Journal of Physiotherapy and Rehabilitation Sciences, 4(2), 937–947. https://doi.org/10.55735/hjprs.v4i2.237
Barnard, R., Jones, J., & Cruice, M. (2020). Communication between therapists and nurses working in inpatient interprofessional teams: Systematic review and meta-ethnography. Disability and Rehabilitation, 42(10), 1–11. https://doi.org/10.1080/09638288.2018.1526335
Butturini, E., Carolina, A., Magalhães, R. F., Pinto, E. F., Cynthia, Antunes, M. A., Baldavira, C. M., Ramos, K., Teodoro, W. R., Gama, M., Felix, N. S., Pelosi, P., Rocco, & Silva, P. L. (2022). Effects of different fluid management on lung and kidney during pressure‐controlled and pressure‐support ventilation in experimental acute lung injury. Physiological Reports, 10(17). https://doi.org/10.14814/phy2.15429
Cai, X., Wu, G., Zhang, J., & Yang, L. (2021). Risk factors for acute kidney injury in adult patients with COVID-19: A systematic review and meta-analysis. Frontiers in Medicine, 8. https://doi.org/10.3389/fmed.2021.719472
Campbell, D. J. T., Campbell, R. B., DiGiandomenico, A., Larsen, M., Davidson, M. A., McBrien, K., Booth, G. L., & Hwang, S. W. (2021). Using a community-based participatory research approach to meaningfully engage those with lived experience of diabetes and homelessness. BMJ Open Diabetes Research & Care, 9(1), e002154. https://doi.org/10.1136/bmjdrc-2021-002154
James, M. T., Bhatt, M., Pannu, N., & Tonelli, M. (2020). Long-term outcomes of acute kidney injury and strategies for improved care. Nature Reviews Nephrology, 16(4), 193–205. https://doi.org/10.1038/s41581-019-0247-z
Moore, Z., Patton, D., Avsar, P., McEvoy, N. L., Curley, G., Budri, A., Nugent, L., Walsh, S., & O’Connor, T. (2020). Prevention of pressure ulcers among individuals cared for in the prone position: Lessons for the COVID-19 emergency. Journal of Wound Care, 29(6), 312–320. https://doi.org/10.12968/jowc.2020.29.6.312
Powers, M. A., Bardsley, J. K., Cypress, M., Funnell, M. M., Harms, D., Hess-Fischl, A., Hooks, B., Isaacs, D., Mandel, E. D., Maryniuk, M. D., Norton, A., Rinker, J., Siminerio, L. M., & Uelmen, S. (2020). Diabetes self-management education and support in adults with type 2 diabetes: A consensus report of the American Diabetes Association, the Association of Diabetes Care & Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of Pas, the American Association of Nurse Practitioners, and the American pharmacists association. Journal of the American Pharmacists Association, 60(6), 1–18. https://doi.org/10.1016/j.japh.2020.04.018
Suwardianto, H. (2021). Critical nursing care with nursing problems, impaired gas exchange and inhibition of spontaneous ventilation in patient with coronary heart disease: A case study. STRADA Jurnal Ilmiah Kesehatan, 10(1), 632–638. https://doi.org/10.30994/sjik.v10i1.679
Tamura, Y., Omura, T., Toyoshima, K., & Araki, A. (2020). Nutrition management in older adults with diabetes: A review on the importance of shifting prevention strategies from metabolic syndrome to frailty. Nutrients, 12(11), 3367. https://doi.org/10.3390/nu12113367
Yaman, A. (2022). Severe rhabdomyolysis and acute renal failure treated by continuous venovenous hemodiafiltration in a child with diabetic ketoacidosis. Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine, 26(1), 136–138. https://doi.org/10.5005/jp-journals-10071-2409
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