Concept Map for Hans’ Patient Journey: Managing a Complex Health Condition

QUESTION

Case scenario:

A disheveled man is found unconscious under a bridge with a necrotic right foot that is gangrenous and bleeding profusely. He is brought to the emergency room by paramedics and a full assessment including diagnostics is completed. It is determined that he needs immediate surgery to amputate his right leg above the knee and a differential diagnosis of sepsis is included in the client’s plan of care. Since the man, later known as Hans, is unconscious and has no family, preoperative care includes documenting inability to obtain consent and storing the client’s valuables.

Hans is brought back to the surgical floor from the PACU. The nurse responds to his reports of limb pain and intervenes in response to the presence of bright red drainage on the dressing. Bleeding continues and the nurse manages his bleeding accordingly. The nurse administers packed red blood cells (RBC’s) and continues to monitor Hans laboratory reports and response to the transfusion. The nurse plans care based on the priority nursing diagnosis “Ineffective peripheral tissue perfusion” of the remaining foot.

Hans is transferred to a rehab unit, where his residual limb is prepared for an above the knee prosthesis. The nurse responds therapeutically when conversing with Hans about his amputation and his homeless lifestyle and assists the social worker with discharge preparation to an assisted living facility. Discharge teaching regarding foot care and crutch walking is completed.

Later, Hans comes to the clinic with signs of a stump wound infection, a cut on his left foot, and intermittent claudication pain. Teaching about a prescribed antibiotic is provided and a home health consult is initiated. Hans returns home under the care of a home health nurse.

Question: please help me to identify the main points to consider for the concept map?

Thank you!

ANSWER

Concept Map for Hans’ Patient Journey: Managing a Complex Health Condition

Introduction

In this concept map, we will outline the main points to consider while depicting the patient journey of Hans, a disheveled man with a necrotic foot that led to an above-the-knee amputation. The concept map will highlight critical aspects of his care, including the initial emergency response, surgical interventions, postoperative care, rehabilitation, and discharge planning. The goal is to provide a comprehensive overview of the key points to consider in managing Hans’ complex health condition.

Main Points for the Concept Map

Emergency Response and Assessment

Discovery of Hans under the bridge with a necrotic and gangrenous right foot
Paramedics bringing Hans to the emergency room
Full assessment and diagnostic workup, including differential diagnosis of sepsis
Need for immediate above-the-knee amputation due to limb necrosis

Preoperative Care and Informed Consent

Hans’ unconscious state and lack of family support
Documentation of inability to obtain consent
Storage of Hans’ valuables during the preoperative phase

Postoperative Care and Complications

Hans’ return from the PACU to the surgical floor
Nurse’s response to limb pain and bright red drainage on the dressing
Management of bleeding and administration of packed red blood cells (RBC’s)
Monitoring of laboratory reports and response to transfusion
Priority nursing diagnosis: “Ineffective peripheral tissue perfusion” for the remaining foot

Rehabilitation and Prosthesis Preparation

Transfer of Hans to the rehab unit
Preparation of the residual limb for an above-the-knee prosthesis
Therapeutic communication with Hans about his amputation and homeless lifestyle
Discharge preparation with the social worker for an assisted living facility

Post-Discharge Care and Home Health

Hans’ return to the clinic with signs of a stump wound infection and left foot cut
Teaching on prescribed antibiotic administration
Initiation of a home health consult for continued monitoring and care

Conclusion

The concept map provides an organized visual representation of Hans’ patient journey, encompassing various stages of care from the emergency room to post-discharge. It highlights the critical interventions, complications, and collaborations between healthcare professionals in managing Hans’ complex health condition. The concept map serves as a valuable tool to facilitate communication, streamline care coordination, and ensure a comprehensive approach to address the unique challenges faced by patients like Hans in the healthcare system.