McAllister - David MSN FP6021 Assessment 1 Attempt 2
McAllister - David MSN FP6021 Assessment 1 Attempt 2
McAllister - David MSN FP6021 Assessment 1 Attempt 2
Capella University
MSN-FP6021
June 2018
MSN-FP6021 Concept Map
Outcomes:
Pt will establish a healthy
diet and maintain glucose
Outcomes: levels <150.
Treatment:
Pt will adhere to Education:
-Menstrual and
nutrition and physical -How to track
ovulation
activity plans. Pt will menstruation and
tracking
be able to state risks ovulation
of being overweight. -Birth control
-Proper birth control
usage
Outcomes:
Pt will learn how to
properly take birth control
and track ovulation and
menstruation each month.
Running head: CONCEPT MAP 3
Carrie Alves is a 31-year-old female who presents to St. Anthony’s Medical Center with
complaints of irregular menstrual cycles over the last six months. Carrie notes having only three
periods in the past six months with a negative pregnancy test. She also notes weight gain of 12
pounds, difficulty falling asleep and staying asleep, and an increase in facial hair growth. Carrie
is seeking medical advice because she is “freaked out”. Carrie also states these occurrences
began after quitting birth control. Carrie’s symptoms align closely with Polycystic Ovarian
Syndrome (PCOS) – the most common endocrine disorder in women of reproductive age (Kim,
et al., 2016).
During her interview, Carrie exhibited risk for overweight as evidence by gaining 12
pounds and feeling that her pants are getting tighter. Carrie stated she was scared to weigh
herself at first, but noted her weight gain when she finally did. Carrie is at risk for overweight
and obesity, but her scenario does not offer her current height and weight so it is difficult to
determine her risk. It would be ideal to offer Carrie nutritional and weight loss coaching to
mitigate her weight gain issues. It would also help to provide physical activity recommendations
so that she may lose the weight she has gained. It is also appropriate to initiate a discussion on
health risks related to being overweight or obese. Weight gain is a common symptom of PCOS,
so a well-planned nutrition and exercise plan may help Carrie to lose and maintain her weight
In addition to weight gain, Carrie also noted difficulty sleeping. Carrie stated she
sometimes jolts awake during her sleep and then finds it difficult to fall back to sleep. She also
notes having vivid dreams. These symptoms align with a disturbed sleep pattern. It would be
CONCEPT MAP 4
helpful to teach Carrie about adequate nutrition, exercise, and sleep hygiene. “The sleep-wake
cycle plays a critical role in balancing the body’s immune function” (Wilson & Brooks, 2018, p.
7). Sleep hygiene helps promote healthy sleep habits that affect the body’s function. Sleep
hygiene habits to teach are: (a) avoid naps more than 30 minutes; (b) keep the same wake
schedule; (c) avoid nicotine and caffeine a few hours before sleep; (d) practice meditation,
reading, or aromatherapy prior to sleep; and (e) do not use computers, TVs, or cell phones 90
Lastly, Carrie is at risk for ineffective childbearing related to irregular menstrual cycles
and negative pregnancy tests. These could be related to a PCOS diagnosis. Women with PCOS
may have irregular menstrual cycles (less than eight per year). Women with PCOS may also
experience an increase in facial hair growth, which Carrie noted. While PCOS is a type of
infertility, women with PCOS can still get pregnant. However, successful pregnancies typically
require assistance, such as weight loss, medication, in vitro fertilization (IVF), or surgery (Office
and ovulation, and appropriate usage of birth controls. Carrie will experience less menstrual
cycle irregularity with improvements to her nutrition and exercise routine (Marzouk, Nabil, &
Senna, 2015).
Carrie’s main concern is her risk for overweight and obesity. To implement nutrition and
exercise education, nurses, doctors, and dieticians will need to work together. These
interprofessional collaborations will ensure that all of Carrie’s needs are being met and covers
“the big picture” for her plan of care (DeBate, Daley, Vamos, Kline, Marsh, & Smith 2014).
Since Carrie potentially has PCOS, she is at an increased risk for diabetes, increased blood
CONCEPT MAP 5
pressure, unhealthy cholesterol levels, sleep apnea, depression, and anxiety (Office on Women's
Health, 2016).
achieve the desired outcomes. Nutritional experts, such as registered dieticians, should be
utilized in the teaching of proper nutritional intake. In addition, physical therapists or personal
trainers should be involved in the education pertaining to proper exercise techniques for weight
loss. Weight gain or difficulty losing weight is very common in women who have PCOS (Office
on Women's Health, 2016). Furthermore, the primary care physician and a gynecologist should
collaborate to educate Carrie on how to properly track menstruation and ovulation to help
determine the frequency and length of menstrual cycles, and proper birth control usage to help
Each of these collaborations will aid in achieving the desired outcomes for Carrie. Carrie
will learn to manage her diet and exercise routine, discover methods of weight loss, and gain
knowledge of menstruation and ovulation tracking. By working together, each discipline will be
References
DeBate, R., Daley, E. M., Vamos, C. A., Kline, N., Marsh, L., & Smith, S. (2014).
Kim, J., Mersereau, J., Khankari, N., Bradshaw, P., McCullough, L., Cleveland, R., & ...
Marzouk, T., Nabil, H., & Senna, M. (2015). Impact of a Lifestyle Modification Program on
doi:10.4069/kjwhn.2015.21.3.161
https://www.womenshealth.gov/publications/our-publications/fact-sheet/polycystic-
ovary-syndrome.html
Wilson, D. R., & Brooks, E. J. (2018). Sleep & Immune Function: Nurse Self-Care & Teaching