Patient Education (In Pt.) & Discharge Planning
(home needs)
Diet & Exercise Modification: Because of A.R.’s
diagnosis of chronic hypertension, it is very important
her blood pressure be continuously managed. Her
hypertension is easily manageable as there
are many modifiable life changes sh...
Concept Map
Student Name: Brittney Gaw History of Present Illness (HPI), Pathophysiology of Admitting Dx (Cite References) Medical, Surgical,
Instructor: Professor Johanah Carrera Social History and OB History
Medical History
Patient Education (In Pt.) & Discharge Planning Patient Information
1. Carpal Tunnel Bilaterally: Carpal tunnel syndrome is a type of medical condition that is known to cause
(home needs) (1) pain, numbness, and a tingling sensation of the hand and arm (Faust & Jennings, 2016). This condition is caused
Diet & Exercise Modification: Because of A.R.’s Name: A.R. when the median nerve of the wrist and arm is too often compressed when it travels through the wrist of the
diagnosis of chronic hypertension, it is very important Age: 30 affected individual (Faust & Jennings, 2016).
her blood pressure be continuously managed. Her Height/Weight: 65 inches/ 168 2. GERD: GERD, or gastroesophageal reflux disease is a medical condition that occurs when an individual’s
hypertension is easily manageable as there lbs. stomach acid consistently flows back upwards into the esophagus (MacGill, 2018). This acid that flows back
are many modifiable life changes she can into the esophagus can cause heartburn among other symptoms and is most notably known for causing tissue
make that can help improve her high levels Allergies: NKDA damage to the lining of the esophagus (MacGill, 2018).
of blood pressure such as exercise and 3. Chronic Hypertension: A persistent elevation of blood pressure >140 mmHg systolic/90 mmHg diastolic
Gestational Age: 32 weeks (Copstead & Banasik, 2013).
implementing a diet regimen that uses less
4. Scoliosis: A medical disorder that causes an abnormal curve of the backbone or spine (Davis, 2019). It tends
amounts of sodium and is rich in potassium,
to be more common in females than men, but the underlying cause of this condition is currently unknown
magnesium, calcium, fiber, and protein, (Davis, 2019).
such as the DASH diet. 5. Anxiety: According to the American Psychological Association (APA), anxiety is defined as “an emotion
Chief Complaint
Contractions, rupture of membrane or characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure”
Patient Education S/S: Because A.R. has bleeding. (Felman, 2020). Experiencing anxiety is a normal and both healthy emotion; however, when a person regularly
a history of pre-eclampsia with her previous A.R. stated that she was not feeling well due to experiences disproportionate amounts of anxiety, it can develop into a medical disorder (Felman, 2020).
pregnancy, she may be at risk for that and high blood pressure.
Surgical History
even eclampsia with this current pregnancy 1. Dilation & Curettage – from her two previous therapeutic abortions
as well. She should be educated on the Admitting Diagnosis
signs and symptoms of these conditions NSVD, or C-Section Social History
which are proteinuria, severe headaches, Medical Conditions Patient A.R. is a cigarette smoker. She also has a history of THC use early in her pregnancy. She denies any
changes in vision, blurred or double vision, -Hypertension of Pregnancy alcohol use.
decreased urine output, shortness of breath, -Positive Influenza Obstetric History
decreased urine output, increased blood GTPAL
pressure, swelling of the face and hands, G4; T1; P0; A2 (therapeutic abortion); L1
right upper abdominal pain. A.R. has a history of gestational diabetes and postpartum pre-eclampsia with her last pregnancy.
Cultural considerations, ethnicity, A.R.’s last delivery was NSVD. Her baby weighed 6lbs3oz and was female.
occupation, religion, family support,
Discharge: As of the provided patient info for A.R., insurance. (1) (14)
there is no set discharge date for this patient. Patient A.R. is a 30-year old Caucasian female who is
A.R. should be referred to: married. She states that she has support at
home from her husband and family. Patient
A dietician A.R. currently has a 4-year old daughter who
she has stated she misses with being Erickson’s Developmental Stage Related to pt. & Cite References (1)
o A.R. requires a proper diet that
hospitalized. At this time, A.R. is currently A.R.’s current age is 30 years old which places her in the sixth category of Erik Erikson’s stage theory
will meet her nutritional need
unemployed. She disclosed that she has of psychosocial development known as Intimacy vs. Isolation. This particular stage is indicated for
and aid her in managing her
finished high school and has completed one individuals who are in their young adulthood from the ages of 18 to 40 years old. In this stage, the
elevated blood pressure levels.
year of community college. Her husband major issue stems from forming intimate, loving relationships with other people (Santrock, 2017). In
A therapist
makes a living from being a pizza delivery Intimacy vs. Isolation, individuals begin to share themselves more intimately with others and explore
o A.R. may benefit and improve
driver. As previously mentioned, A.R. is different relationships with someone other than their own family member (Santrock, 2017).
her pregnancy experience by Successfully completing this stage of Erik Erikson’s psychosocial developmental stages will result in
Caucasian with no religious preference.
possibly speaking with a happy and healthy relationships that foster a sense of commitment, safety and care within the
relationship whereas a failed result of this stage will resemble something that looks like avoiding
intimacy, fearing commitment and relationships (Santrock, 2017). This can ultimately lead to isolation,
loneliness, and possible depression (Santrock, 2017).
After collecting all information needed for A.R.’s concept map, I believe that A.R. finds herself on the
Diagnostic Test/ Lab Results with dates successful end of the Intimacy vs. Isolation psychosocial development stage. I have learned that she is
and Normal Ranges (3) happily married to someone at the age of thirty which means that she has been able to form an
intimate, loving relationship with someone other than a family member. From this, they also have a 4-
year old daughter they are raising together and another one on the way. A.R. also has stated throughout
*** On another page the duration of her hospital stay that she very much misses her daughter. It seems that A.R. has
successfully been able to create and experience a sense of commitment, safety and care within her
relationships and at home.
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