Please see attached file for the concept map assignment guidelines and rubric. One page can be used for this. I have attached a document that includes a list of nursing theorists you may choose from to do the concept map on.

The second page is a discussion forum. Please answer the question below.
"Discuss briefly the theorist that has intrigued you most, or that you have agreed with the most. What did you enjoy about that particular theory/theorist? How do you plan to implement that theory in your future nursing practice?"


 

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Rheumatoid Arthritis: Explaining the Concept Map

An extremely common autoimmune disease, Rheumatoid Arthritis is usually activated by an unknown trigger. While the exact cause of Rheumatoid Arthritis is unclear, it is believed that a number of factors contribute to it. One factor is that it is a genetic trait and that certain genes are associated with the disease, however, it is not known why some individuals have the genes and yet the disease never develops. Environmental factors such as infections and chemicals may also play a role in the onset of Rheumatoid Arthritis but the exact role is unknown.

What is clear is that an unknown trigger affects the immune system so that it begins attacking itself, and specifically, the joints of the body. This begins with an increased number of white blood cells congregating in the blood vessels surrounding the synovial fluid. The white blood cells are exchanged for T-cells and B-cells. The T-cells release cytokines which increase inflammation and stimulate the B-cells to produce more antibodies. These antibodies then destroy what it recognizes as a foreign body, in this case the joints.

As the process continues the inflammatory process begins in the synovial fluid. Eventually the synovium begins to leak excessive amounts of synovial fluid which contributes to more inflammation within the joint. This continued inflammation causes thickening of the synovial fluid which ultimately leads to the formation of pannus. The cytokines released by the T-cells stimulate the pannus to then produce destructive enzymes that destroy cartilage. This further irritates the area leading to more accumulation of white blood cells and continues to contribute to the inflammatory process.

A diagnosis of Rheumatoid Arthritis can sometimes be difficult as the symptoms of this disease are similar to other conditions. Tests that can assist in diagnosis are a Complete Blood Count to measure the amount of each blood cell. Erythrocyte Sedimentation Rate, which indicates how much inflammation there is in the body. Rheumatoid Factor, which tests for specific antibodies in the synovium that can indicate the likelihood of Rheumatoid Arthritis, and X-Rays, which can assist in determining if any joint damage has occurred.

The inflammation causes symptoms of tender, red, warm, swollen joints, fatigue, fever, and general malaise. Complications of this disease are infections, usually due to the effects of immunosupressing medications, heart disease caused by inflammation in the body, periodontal disease, also due to inflammation, cancer, linked to some Rheumatoid Arthritis treatments, and osteoporosis. While not fatal, Rheumatoid Arthritis can sometimes shorten one’s life-span.

References

Find All the Information You Need to Understand Rheumatoid Arthritis. (2009, April 1). Healthcentral.com – Trusted, Reliable and Up To Date Health Information. Retrieved November 21, 2009, from http://www.healthcentral.com/rheumatoid-arthritis/understanding-rheumatoid-arthritis.html?ic=4018

Ignatavicius, D. D., & Workman, M. L. (2009). Medical-Surgical Nursing: Patient-Centered Collaborative Care, 2-Volume Set (6 ed.). St. Louis: Saunders.

Institute of Arthritis and Musculoskeletal and Skin Diseases. (n.d.). Handout on Health: Rheumatoid Arthritis. Arthritis, Musculoskeletal and Skin Diseases Home Page. Retrieved November 21, 2009, from http://www.niams.nih.gov/Health_ Info/Rheumatic_Disease/default.asp

Rheumatoid Arthritis Pathology. (2009, March 31). HAVING JOINT PAIN? Simplified approach from an expert. Retrieved November 21, 2009, from http://www.joint-pain-expert.net/rheumatoid-arthritis-pathology.html

Ruderman, E., & Tambar, S. (n.d.). Patient Education – Rheumatoid Arthritis. American College of Rheumatology. Retrieved November 21, 2009, from http://www.rheumatology.org/public/factsheets/diseases_and_conditions/ra.asp?aud=pat


 

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Attachments

Concept map template

Nursing 110

Name:

Class:

Due Date:

Patient’s Initials:

Step 1: Complete the chart using the patient assigned to you. You may want to refer to the Physical Assessment Chapter in the Tres & Wilkinson text for assistance. Do not leave any box blank, use “Not Applicable” if there is absolutely nothing that you can identify for the box.

Body Systems Subjective Data Objective Data
Neurologic
HEENT (Head, Eyes, Ears, Nose, Throat)
Integument
Musculoskeletal
Cardiovascular
Respiratory
GI
GU
Emotional/Social/Spiritual
Reproductive

*

Step 2: Group the subjective and objective data that belong together in the same data cluster. Identify the correct Gordon’s Pattern. Note: Findings may repeat in multiple boxes this is the process of forming “data clusters”. Not every box will have data – type not applicable under the data cluster, but give a definition. Expand and rearrange the boxes as needed.

Clustered Data (all relevant)

Relevant Gordon Pattern: Health Perception/Health Management

Definition:

Clustered Data (all relevant)

Relevant Gordon Pattern:

Sleep/Rest

Definition:

Clustered Data (all relevant)

Relevant Gordon Pattern: Sexuality/Reproductive

Definition:

Clustered Data (all relevant)

Relevant Gordon Pattern: Value/Belief

Definition:

Clustered Data (all relevant)

Relevant Gordon Pattern: Cognitive/Perception

Definition:

Clustered Data (all relevant)

Relevant Gordon Pattern: Elimination

Definition:

Clustered Data (all relevant)

Relevant Gordon Pattern: Nutrition/Metabolic

Definition:

Clustered Data (all relevant)

Relevant Gordon Pattern: Activity/Exercise

Definition:

Clustered Data (all relevant)

Relevant Gordon Pattern: Coping/Stress

Definition:

Clustered Data (all relevant)

Relevant Gordon Pattern:

Self-Perception/Self-Concept

Definition:

Clustered Data (all relevant)

Relevant Gordon Pattern:

Role/Relationship

Definition:

Patient Name:

Age:

Gender:

Chief Complaint:

Clustered Data (all relevant)

Relevant Gordon Pattern (name, functional or dysfunctional):

Associated Nursing diagnostic label:

Patient Name:

Age:

Gender:

Situation:

Priority Nursing Diagnostic Statement:

Diagnostic Label

Related to

Evidence

Goal:

2-3 SMART outcomes:

1.

2.

3,

In your own words, based on the data cues, what is the most important (priority) problem?

List and prioritize all Nursing Diagnostic Statements (3 part or 2 part) based on data clusters above (at least 3):

1.

Step 3: Type in the Data Clusters. Identify the Gordon’s Pattern and functionality; Analyze the data cluster to determine the problem. Identify the appropriate Nursing Diagnostic Label (nursing diagnosis). Complete the remaining sections. Include arrows showing how each data cluster/problem influences others on the care map. . Add, Expand, or Rearrange the boxes as needed.

Clustered Data (all relevant)

Relevant Gordon Pattern (name, functional or dysfunctional):

Associated Nursing diagnostic label:

Clustered Data (all relevant)

Relevant Gordon Pattern (name, functional or dysfunctional):

Associated Nursing diagnostic label:

Clustered Data (all relevant)

Relevant Gordon Pattern (name, functional or dysfunctional):

Associated Nursing diagnostic label:

Clustered Data (all relevant)

Relevant Gordon Pattern (name, functional or dysfunctional):

Associated Nursing diagnostic label:

References


 

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