Running Head: CONCEPT MAP

Concept Map Jan Michael Ruiz Nurs 466 March ! "#$4

Concept Map

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T% is a &4 'ear old (ale )ith a histor' o* h'pertension and asth(a+ Client arri,ed at the )al-.in clinic )ith co(plaints o* headache *or t)o da's+ He recentl' lost his /o0 o* "# 'ears as a sales(an at a large phar(aceutical co(pan'+ He states that he has not 0een sleeping )ell *or se,eral )ee-s and he has 0een *rustrated )ith his ina0ilit' to get an inter,ie) *or a ne) /o0+ 12 36+3! 44! "#! $3#56#! O"2AT 647+ He states that his headache pain as a 45$#+

Legend: Main Idea Priority Clinical Manifestation Nursing Interventions

Concept Map

Jo0 loss )as identi*ied as the (ain idea *or T%8s case 0ecause o* se,eral reasons+ 9irst! dealing )ith ps'chosocial stressors can i(pact one8s health :%asl ; Jones! "###<+ T% reported that he recentl' lost the /o0 that he had *or "# 'ears+ Jo0 loss is di**icult! as it in,ol,es not onl' a loss o* an inco(e source! 0ut also conse=uent changes in a person>s )a' o* li,ing! sel*.estee(! social status! and social connections :2trull'! "##6<+ ?t has also 0een *ound that in,oluntar' /o0 loss )as signi*icantl' related to a decline in sel*.reported health status and (ore depressi,e s'(pto(s :@urgrand! @rand! ; House! "## A Ballo et al+! "###<+ More speci*icall'! those )ho lose their /o0 as the' are nearing their retire(ent! as (a' 0e the case *or T%! ha,e increased ris*or negati,e health conse=uences :Ballo et al+! "###<+ These conse=uences (ani*est in T% as headaches *or the past t)o da's and ina0ilit' to sleep )ell *or se,eral )ee-s+ 2econd! not onl' is in,oluntar' /o0 loss related to negati,e health conse=uences! su0se=uent di**iculties )ith 0eing une(plo'ed or *inding e(plo'(ent can *urther i(pact a person8s health :@urgrand et al+! "## <+ T% has not had success )ith getting an inter,ie) and has reported *eeling *rustrated a0out it+ Third! it has 0een )ell docu(ented that stress pla's a signi*icant role in the de,elop(ent o* cardio,ascular diseases :%u0zans-' ; %a)achi! "###<+ 2peci*icall'! une(plo'(ent is signi*icantl' related to increased ris- o* h'pertension! stro-e! and coronar' heart diseases :@rac-0ill et al+! $66&A Janlert! $66"A Ballo et al+! "##4A Ce0er ; Dehnert! $66 <+ T% has a histor' o* h'pertension+ His 0lood pressure )as $3#56# at the ti(e o* his ,isit )hich *alls under the high nor(al range+ ?t is plausi0le that along )ith a histor' o* h'pertension! the stress o* losing a /o0 puts T% at increased ris- o* ele,ated 0lood pressure! cardio,ascular diseases! and cere0ro,ascular diseases+ The a0o,e sho)s that losing a /o0 is a ps'chosocial stressor that is i(pacting T%8s health ad,ersel'+

Concept Map T% reported that he is ha,ing di**iculties )ith sleeping )ell *or se,eral )ee-s+ He also presented )ith co(plaints o* headache *or t)o da's+ His inso(nia appears to 0e o* greater

concern than his headaches *or se,eral reasons+ One! he rated his headache pain as (ild intensit' :45$#< and reported ha,ing eEperienced it (ore recentl' than his inso(nia )hich ha,e 0een going on *or se,eral )ee-s alread'+ 2econd! it is li-el' that poor sleep =ualit' and reduced sleep ti(e are causing his headaches+ 2leep and headache are closel' related to one another! such that headaches (a' 0e induced 0' sleep distur0ances in duration and =ualit' as in the case o* T% :Jennu( ; Jensen! "##"<+ Bi,en this! it is ai(ed that through the i(ple(entation o* inter,entions *or inso(nia! his headaches )ill also dissipate+ Third! inso(nia is a clinical (ani*estation reported a(ong people dealing )ith /o0 loss :Ballo et al+! "###<+ ?t is li-el' that T%8s *rustration )ith his ina0ilit' to get an inter,ie) is i(pacting the =ualit' o* his sleep+ Along )ith *eelings o* *rustration! )orries a0out his *inances! *uture! and health (a' 0e getting in the )a' o* getting a rest*ul sleep and sta'ing asleep+ Moreo,er! not getting enough! good =ualit' sleep can cause di**iculties )ith da'ti(e *unctioning :Jennu( ; Jensen! "##"<+ This i(plies that as T% 0eco(es (ore sleep depri,ed! his challenges )ith getting a /o0 inter,ie) and doing other /o0 search acti,ities could )orsen+ The longer he re(ains une(plo'ed! the (ore he 0eco(es *rustrated )hich could then (a-e it (ore di**icult *or hi( to sleep )ell+ The interrelationship a(ong his sleep distur0ance! *eelings o* *rustration! and challenges )ith 0eing re.e(plo'ed i(pl' that addressing the inso(nia can ha,e 0ene*icial e**ects on his /o0 search outco(es and e(otional )ell0eing+ Dastl'! it is i(portant to address sleep pattern distur0ance 0ecause o* its association )ith ris- o* de,eloping coronar' heart disease :Partinen! $664<+ Thus! treating T%8s inso(nia (a' also 0e (eans o* pre,enting cardiac diseases :Partinen! $664<+ There are se,eral nursing inter,entions *or dealing )ith ina0ilit' to sleep :Carpenito.

Concept Map Mo'et! "##4A Partinen! $664A Bulanic- ; M'ers! "#$3<+ T% can 0ene*it *ro( 0eing reassured that his di**icult' )ith sleeping is a natural response o* the 0od' to the stress caused 0' the /o0 loss :Partinen! $664<+ Teaching the ph'siological di(ensions o* sleep! causes *or sleep pattern

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distur0ance! and *actors a**ecting sleep =ualit' can also 0e discussed+ Fiscussing the role o* sleep in )ellness and da'ti(e *unctioning can help T% understand the possi0le connection o* his inso(nia )ith his headache and challenges )ith /o0 search+ These in*or(ation can help alle,iate so(e o* the anEiet' T% (a' ha,e a0out his ph'sical health and 0ring greater a)areness to )hat he is eEperiencing+ Teaching T% to do en,iron(ental (odi*ications li-e setting up a dar-! =uiet roo( )ith co(*orta0le te(perature )ill 0e conduci,e to his sleep :Carpenito.Mo'et! "##4A Bulanic- ; M'ers! "#$3<+ T% (a' also 0ene*it *ro( learning relaEation techni=ues :e+g+! deep 0reathing! ha,ing a )ar( 0ath! and listening to cal(ing (usic< to help hi( relaE 0e*ore 0edti(e :Carpenito.Mo'et! "##4A Bulanic- ; M'ers! "#$3<+ EEercising can also help )ith sleep as it pro,ides relaEation 0ene*its! pro(otes increased stress tolerance :Carpenito.Mo'et! "##4< and pre,ents heart diseases+ As sho)n in the concept (ap! the a0o,e inter,entions can also help )ith T%8s headaches+ 2leep.pro(oting strategies li-e eating high protein snac-s :e+g+! (il- and cheese< and a,oiding ca**eine 0e*ore 0edti(e can also 0e suggested :Carpenito.Mo'et! "##4A Bulanic- ; M'ers! "#$3<+ @ecause T% (a' ha,e concerns related to his /o0 loss! it is necessar' to pro,ide hi( e(otional support and eEplain to hi( ho) )orries can inter*ere )ith sleep :Bulanic- ; M'ers! "#$3<+ T% and the nurse can (a-e a plan to allot ti(e during the da' to address these )orries+ Journal )riting can also 0e suggested :Bulanic- ; M'ers! "#$3<+ Dastl'! 0ecause his inso(nia is closel' tied to the /o0 loss! a re*erral to a counsellor or social )or-er that is trained to gi,e support around /o0 search! *inancial assistance! and (ental health can 0e (ade i* T% desires+

Concept Map References @rac-0ill! R+M+! 2iegel! P+ G+! Ac-er(ann! 2+P+ :$66&<+ 2el* reported h'pertension a(ong une(plo'ed people in the Hnited 2tates+ British Medical Journal, 310, &64+ @urgard! 2+ A+! @rand! J+ E+! ; House! J+ 2+ :"## <+ To)ard a 0etter esti(ation o* the e**ect o* /o0 loss on health+ Journal of Health and Social Behavior, 48, 366I344+ Carpenito.Mo'et! D+ J+ :"##4<+ Nursing care lans and docu!entation+ Philadelphia: Dippincott Cillia(s ; Cil-ins+ Ballo! C+ T+! @radle'! E+ H+! 2iegel! M+! %asl! 2+ 1+ :"###<+ Health e**ects o* in,oluntar' /o0 loss a(ong older )or-ers: 9indings *ro( the health and retire(ent sur,e'+ Journals of "erontolog#, $$:3<! $3$.$4#+ Ballo! C+ T+! @radle'! E+ H+! 9al0a! T+ A+! Fu0in! J+ A+! Cra(er! D+ F+! @ogardus! 2+ T+! ; %asl! 2+ :"##4<+ ?n,oluntar' /o0 loss as a ris- *actor *or su0se=uent ('ocardial in*arction and stro-e: 9indings *ro( the Health and Retire(ent 2ur,e'+ %!erican Journal of &ndustrial Medicine, 4$:&<! 4#4.4$6+ Bulanic-! M+ ; M'ers! J+ D+ :"#$3<+ Nursing care lans :4th ed+< Philadelphia: Else,ier+ Janlert! H+ $66"+ Hne(plo'(ent and 0lood pressure in 2)edish 0uilding la0ourers+ Journal of &nternal Medicine, '31, "4$I"46+ Jennu(! P+ ; Jensen! R+ :"##"<+ 2leep and headache+ Slee Medicine (evie)s, *:6<! 4 $.4 6+ %u0zans-'! D+ F+ ; %a)achi! ?+ :"###<+ Boing to the heart o* the (atter: Fo negati,e e(otions cause coronor' heart diseaseJ Journal of +s#choso!atic (esearch, 48, 3"3.3" + Partinen! M+ :$664<+ 2leep disorders and stress+ Journal of +s#choso!atic (esearch, 38, 46.6$+ 2trull'! %+ C+ :"##6<+ Jo0 loss and health in the H+2+ la0or (ar-et+ ,e!ogra h#, 4*:"<! ""$. "46+

Concept Map Ce0er! A+ ; Dehnert! B+ :$66 <+ Hne(plo'(ent and cardio,ascular diseases: A causal relationshipJ &nternational %rchives for -ccu ational and .nviron!ental Health, /0, $&3I$6#+