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.