Glucose regulation and perfusion concept maps

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Research and complete concept maps of interrelated concepts that will be featured in the scenario.
A deeper understanding of these concepts and exemplars will help improve your performance when you complete the scenario for the second time. The concept maps are labeled with the concepts and exemplars: Glucose Regulation, Perfusion, and Clinical Judgment.

For the glucose regulation and perfusion concept maps:

For each box, consider adding the following information to BOTH clinical judgment maps to earn full points.
Pathophysiology: What is the underlying pathophysiology for the given exemplars?
Recognize Cues: Consider signs and symptoms, lab work, patient statements, H&P, and others. Include subjective and objective data.
Generate Solutions: What are the desirable outcomes? List SMART goals.
Take action: How should the intervention(s) be performed, requested, communicated, taught, etc.?
Evaluating Outcomes: What signs will point to improving/declining/unchanged status?

 

Sample Solution

Concept Maps: Glucose Regulation, Perfusion, and Clinical Judgment

Concept Map 1: Glucose Regulation

Central Concept: Glucose Regulation

Sub-Concepts:

  • Insulin: Hormone that promotes glucose uptake into cells.

    • Exemplars: Type 1 diabetes (deficiency), insulin resistance (decreased effectiveness).
    • Pathophysiology: Type 1: Autoimmune destruction of insulin-producing cells. Insulin resistance: Decreased cellular sensitivity to insulin.
    • Recognize Cues: Polydipsia, polyuria, polyphagia, fatigue, hyperglycemia, glycosuria.
    • Generate Solutions: Maintain euglycemia, prevent complications. SMART goals: HbA1c < 7%, fasting blood glucose 70-130 mg/dL.
    • Take Action: Administer insulin, adjust diet and exercise, monitor blood glucose.
    • Evaluate Outcomes: Blood glucose levels, HbA1c, symptoms.

  • Glucagon: Hormone that raises blood glucose levels.

    • Exemplars: Hypoglycemia, glycogen storage diseases.
    • Pathophysiology: Insufficient glucagon secretion, impaired glucagon action, depleted glycogen stores.
    • Recognize Cues: Diaphoresis, tremors, dizziness, confusion, hypoglycemia.
    • Generate Solutions: Correct hypoglycemia, prevent recurrence. SMART goals: Blood glucose > 70 mg/dL.
    • Take Action: Administer glucagon, oral carbohydrates, monitor blood glucose.
    • Evaluate Outcomes: Blood glucose levels, symptoms.

  • Non-insulin-dependent factors: Diet, exercise, stress, medications.

    • Exemplars: High-carbohydrate diet, sedentary lifestyle, chronic stress, steroids.
    • Pathophysiology: Increased glucose intake, decreased glucose utilization, increased glucagon secretion.
    • Recognize Cues: Weight gain, fatigue, hyperglycemia, medication side effects.
    • Generate Solutions: Improve diet and exercise, manage stress, adjust medications. SMART goals: Weight loss, increased physical activity, stress reduction.
    • Take Action: Provide dietary counseling, encourage exercise, stress management techniques, medication review.
    • Evaluate Outcomes: Weight, physical activity levels, blood glucose levels.

Concept Map 2: Perfusion

Central Concept: Perfusion

Sub-Concepts:

  • Oxygen delivery: Blood flow, oxygen-carrying capacity of blood.

    • Exemplars: Hemorrhage, anemia, heart failure.
    • Pathophysiology: Decreased blood flow, decreased red blood cell count, impaired heart function.
    • Recognize Cues: Altered skin color, cool/clammy skin, tachycardia, tachypnea, fatigue, confusion, hypoxia.
    • Generate Solutions: Improve oxygen delivery, maintain tissue oxygenation. SMART goals: Maintain oxygen saturation > 92%, improve hemodynamic status.
    • Take Action: Administer fluids, oxygen therapy, blood transfusions, medications (e.g., vasopressors), address underlying cause.
    • Evaluate Outcomes: Vital signs, oxygen saturation, skin assessment, mental status.

  • Nutrient delivery: Blood flow, nutrients in blood.

    • Exemplars: Malnutrition, sepsis, burns.
    • Pathophysiology: Inadequate nutrient intake, increased metabolic demands, impaired absorption.
    • Recognize Cues: Weight loss, muscle wasting, fatigue, edema, delayed wound healing, electrolyte imbalances.
    • Generate Solutions: Address nutritional deficiencies, improve nutrient delivery. SMART goals: Increase calorie intake, improve protein intake, correct electrolyte imbalances.
    • Take Action: Provide nutritional support (e.g., enteral feeding), address underlying cause, monitor labs.
    • Evaluate Outcomes: Weight, nutrition labs, wound healing, electrolyte levels.

  • Waste removal: Blood flow, kidney function, liver function.

    • Exemplars: Shock, kidney failure, liver failure.
    • Pathophysiology: Decreased blood flow, impaired kidney/liver function.
    • Recognize Cues: Altered level of consciousness, oliguria/anuria, edema, jaundice, elevated BUN/creatinine, elevated liver enzymes.
    • Generate Solutions: Remove waste products, support organ function. SMART goals: Improve urine output, maintain fluid balance, normalize electrolyte levels.
    • Take Action: Administer fluids, diuretics, dialysis, medications, address underlying cause.
    • Evaluate Outcomes: Vital signs, urine output, labs, mental status.

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