Create a concept map of a chosen condition, disease, or disorder with glucose regulation or metabolic balance considerations. Write a brief narrative (2-3 pages) that explains why the evidence cited in the concept map and narrative are valuable and relevant,

Concept Map of Diabetic and Hypertensive Patient

This paper provides an analysis of a concept map of a known diabetic and hypertensive patient. The concept map contains the patient’s biodata, nursing diagnoses, treatment and interventions, interprofessional collaboration, and the desired outcomes. This analysis includes a justification of the value and relevance of evidence and the interprofessional approaches utilized to ensure desired outcomes are achieved.

Additional Evidence

The patient, R.K., is a fifty-year-old male. He is a known hypertensive and diabetic patient. His presenting complaints are fatigue, polyuria, orthostatic hypotension, paresthesia, anorexia, and erectile dysfunction. His vitals demonstrate an elevated temperature of 38oC, a normal respiratory rate of 19 breaths per minute, and elevated blood pressure of 150/86. Furthermore, laboratory tests reveal serum osmolality of 350mOsm/kg, plasma glucose level of 620 mg/dl, and bicarbonate levels of 16 mEq/L.

The three nursing diagnoses are made based on subjective and objective data findings. Findings such as orthostatic hypotension, fatigue, polyuria, altered mentation, serum osmolality of 350 mOsm/kg, plasma glucose level of 620 mg/dl, bicarbonate levels of 16 mEq/L indicate a risk for fluid volume deficit (Alghamdi et al., 2021). Osmotic diuresis can result from hyperglycemia. This leads to the loss of water and other electrolytes from the body. The fluid deficit leads to an increase in plasma osmolality (Alghamdi et al., 2021). The elevated plasma osmolality and a hyperglycemic state indicate the hyperosmolar hyperglycemic state (Alghamdi et al., 2021). According to Duarte et al. (2018), persistent anorexia, diarrhea, low body mass index, and poor muscle tone indicate imbalanced nutrition. This could be caused by a lack of enough quantities of the recommended daily intake (Duarte et al., 2018). Imbalanced nutrition applies to all food nutrients, including carbohydrates, proteins, and fats.

According to Cannarella et al. (2021), erectile dysfunction, diminished peripheral pulses, and a score of 8 when subjected to the International Index of Erectile Function questionnaire indicate a risk for sexual dysfunction related to peripheral neuropathy. Sexual dysfunction in patients with type 2 diabetes mellitus is a manifestation of peripheral vascular disease (Cannarella et al., 2021). Therefore, Mr. R.K. should receive individualized care that fulfills his needs.

Interprofessional Strategies

 The interprofessional team involved includes nutritionists, physicians, nurses, and pharmacists. The whole team should emphasize patient education and promote the use of evidence-based clinical interventions. Nutritionists should provide knowledge on appropriate nutritional practices. This includes the recommended daily calories and the quantity to be consumed per meal (Johnson & Carragher, 2018). They should also enlighten patients on foods with a low glycemic index and encourage their consumption. This will help to address the patient’s imbalance. Nurses should ensure that the right quantity of medication is administered at the right time (Johnson & Carragher, 2018). This increases adherence levels and leads to tight glycemic control, hence better clinical outcomes. The nursing team is also involved in patient education concerning appropriate drug use and the importance of compliance.

Pharmacists are involved in providing information about medications. This includes the contraindications, potential interactions, and adverse effects. They should educate patients on appropriate drugs, such as insulin injection techniques (Johnson & Carragher, 2018). They uphold patient compliance by utilizing visual aids such as drug calendars and charts (Johnson & Carragher, 2018). Physicians are involved in the prompt diagnosis of diabetes mellitus and early initiation of therapy (Johnson & Carragher, 2018). This leads to a better clinical prognosis. They should also educate the patient on the importance of compliance and tight glycemic control. The interprofessional team should apply evidence-based approaches to ensure that the best treatment plan is selected.

Value and Relevance of Evidence

Poorly managed diabetes mellitus can lead to acute diabetes emergencies and long-term macrovascular and microvascular complications. The risk for fluid volume deficit is an urgent nursing diagnosis that should be addressed promptly. Orthostatic hypotension, fatigue, polyuria, altered mentation, serum osmolality of 350 mOsm/kg, plasma glucose level of 620 mg/dl, and bicarbonate levels of 16 mEq/L are indicators of fluid volume deficit (Alghamdi et al., 2021). Furthermore, elevated plasma osmolality and a hyperglycemic state indicate the hyperosmolar hyperg