THINK LIKE A NURSE! Think Out Loud. Cognitive Maps Graphic or pictorial arrangements of related key...
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Transcript of THINK LIKE A NURSE! Think Out Loud. Cognitive Maps Graphic or pictorial arrangements of related key...
![Page 1: THINK LIKE A NURSE! Think Out Loud. Cognitive Maps Graphic or pictorial arrangements of related key concepts Helps organize knowledge in a format that.](https://reader030.fdocuments.net/reader030/viewer/2022032516/56649c755503460f949285c8/html5/thumbnails/1.jpg)
THINK LIKE A NURSE!
Think Out Loud
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Cognitive Maps
• Graphic or pictorial arrangements of related key concepts
• Helps organize knowledge in a format that is compatible with the way we create meaning
• Personal expression of meaning for the subject matter
• Tool to teach students how to think
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Concept Maps
• Aids in clarifying a small number of key ideas – not all inclusive
• Encourages reflective thinking • Anchoring of new ideas or concepts with
previously acquired knowledge creates meaningful learning and leads to sound decision-making
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Concept Maps
• Presents a clear picture of what the student is thinking
• Provides a general road map for reading; brings it to life
• Missing linkages indicate need for more information
• Pre-mapping for clinical helps provide direction
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Concept Maps
• Assists in organizing data• Can improve use of language• Improves communication of ideas
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Concept Maps
• Specific structure is context – dependent
• No right or wrong - Individual• Instructor needs to encourage
creativity• Good for small groups ex. post-
conference
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Concept Maps
• Concepts are organized with the most general or most important concepts at the top or center of the map. Progressively more specific or less important concepts are placed under the more inclusive concepts.
• ID relevant concepts and develop a hierarchical structure choose links in ways to show valid relationships.
• Structure can vary
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Case Study
• P.J. is an 81 year old widowed male.
• c/o sore right foot, trouble walking for “few years”, worse in the last month.
• Hx: Type 2 DM, HTN, diabetic neuropathy, former smoker
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• 3 children, all live out of state.
• c/o recent poor appetite.
• 2 dime sized ulcers on right foot, yellow, black toes. + sensation to bilateral feet.
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Assessment
• Denies severe pain, 2/10 at toes.• BP 180/92, HR 88 and regular, RR
20 and unlabored, T 36.7• S1, S2. • DP/PT pulse 1+ left, not able to
doppler or palpate on right.
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• Bilateral feet cool, R>L• Cap refill R > 3 sec., L = 3 sec.• Scattered expiratory wheezes RUL,
RA, SpO2 = 95%.• AAOX3, pleasant, conversant.• c/o hunger, “haven’t eaten yet
today” (time is now 6:10pm)• Denies bowel/bladder problems.
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Group Concept Map Design Risk Factors
81 y.o. Type 2 DM HTN X-Smoker Stress
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Pathophysiology
81 y.o. Type 2 DM HTN X-Smoker Stress Decreased Increased lipid VasoconstrictionElasticity/ productionFragile vessels
Decreased perfusion
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Diagnosis/Presenting Problem
81 y.o. Type 2 DM HTN X-Smoker Stress Decreased Increased lipid VasoconstrictionElasticity/ productionFragile vessels
Decreased perfusion
PVD
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Assessment Findings
81 y.o. Type 2 DM HTN X-Smoker Stress Decreased Increased lipid Vasoconstriction WidowedElasticity/ production 3 children, don’t Fragile vessels live close
Decreased perfusion AAOX3, pleasant, conversant
180/92, 88 PVD 2 dime sized, yellow ulcers R footS1, S2; reg. Feet cool, R>L; temp 36.7 R toes X5 black, hard, uneven + sensation bilat. feet 2/10 pain R toes with palp.RA SpO2 = 95% 1+ DP/PT left, No pulses R foot Exp. wheezes RUL Cap refill R foot >3 sec., L = 3 sec.RR 20 Hungry, has not eaten today BTs X4 quads
Denies bowel/bladder prob.; has not voided Poor appetite Lives alone
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Diagnostics
81 y.o. Type 2 DM HTN X-Smoker Stress BS = 168Decreased Increased lipid Vasoconstriction WidowedElasticity/ production 3 children, don’t Fragile vessels HDL = 38, LDL = 242 live close
Decreased perfusion AAOX3, pleasant, conversant
180/92, 88 PVD 2 dime sized, yellow ulcers R foot ABI R = .15S1, S2; reg. Feet cool, R>L; temp 36.7 ABI L = .40Na/K = 142/3.9 R toes X5 black, hard, uneven + sensation bilat. Feet H/H = 38/12.2 2/10 pain R toes with palp.RA SpO2 = 95% 1+ DP/PT left, No pulses R foot Exp. wheezes RUL Cap refill R foot >3 sec., L = 3 sec.RR 20 Hungry, has not eaten today BTs X4 quadsBUN/CR= Denies bowel/bladder prob.; has not voided18/1.0 Poor appetite Lives alone
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Medications
81 y.o. Type 2 DM HTN X-Smoker Stress BS = 168 Glucotrol 5 mg qdDecreased Increased lipid Vasoconstriction WidowedElasticity/ production 3 children, don’t Fragile vessels HDL = 38, LDL = 242 Lipitor 20 mg qd live close
Decreased perfusion AAOX3, pleasant, conversant
180/92, 88 Metoprolol PVD 2 dime sized, yellow ulcers R foot ABI R = .15S1, S2; reg. 25 mg bid Feet cool, R>L; temp 36.7 ABI L = .40Na/K = 142/3.9 R toes X5 black, hard, uneven + sensation bilat. Feet H/H = 38/12.2 2/10 pain R toes with palp.RA SpO2 = 95% 1+ DP/PT left, No pulses R foot Trental 400mg tid
Exp. wheezes RUL Cap refill R foot >3 sec., L = 3 sec.RR 20 Hungry, has not eaten today BTs X4 quadsBUN/CR= Denies bowel/bladder prob.; has not voided18/1.0 Poor appetite Lives alone
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Care Plan
81 y.o. Type 2 DM HTN X-Smoker Stress BS = 168 Glucotrol 5 mg qdDecreased Increased lipid Vasoconstriction WidowedElasticity/ production 3 children, don’t Fragile vessels HDL = 38, LDL = 242 Lipitor 20 mg qd live close
Decreased perfusion AAOX3, pleasant, conversant 180/92, 88 Metoprolol PVD 2 dime sized, yellow ulcers R foot ABI R = .15S1, S2; reg. 25 mg bid Feet cool, R>L; temp 36.7 ABI L = .40Na/K = 142/3.9 R toes X5 black, hard, uneven + sensation bilat. Feet H/H = 38/12.2 2/10 pain R toes with palp.RA SpO2 = 95% 1+ DP/PT left, No pulses R foot Trental 400mg tid Exp. wheezes RUL Cap refill R foot >3 sec., L = 3 sec.RR 20 Hungry, has not eaten today BTs X4 quadsBUN/CR= Denies bowel/bladder prob. 18/1.0 Has not voided
Poor appetite Lives aloneInadequate tissue perfusion r/t PVD aeb black toes, cool feet, ABI results.- Granulation tissue will be evident at foot ulcers by __________.
- Elevate R foot; injury precautions; monitor CSM, pulse, pain.