SAMPLE: Scenario:

Rio Birdie 35 year-old, female lives on the mountain top for 5 years now when he married Mr.
Birdie at age of 30. She went to the down town clinic with complains of blotchy red appearance
on the skin. Upon physical assessment, Rio Birdie appeared red all over with reddish spots in
many areas of the body. Her skin appeared tight and shiny, BP – 150/90, P- 100, RR- 32, T- 37.2.
She mentioned that ever since she lived on the mountain top, she noticed an increase in her
weight, she seemed to be grasping for breath most of the time, her heartbeat is racing,
lethargic, and frequent headache.

Simple steps in Making a Concept Map ( based on the above scenario):

1. Identify the Medical Diagnosis as basis in tracing pathophysiologic conditions

e.g. Secondary Polycythemia

2. Identify and research on the different factors that could lead to the occurrence
or development of these conditions e.g. living on the mountain top for 5 years

3. Trace the series of events leading to the development of the medical conditions
starting from each causative factors. Also indicate the legend.
 Demographic location: living on the mountain top for 5 years now

Consist of
Low environmental Oxygen level

Leads to
Decreased level of inspired Oxygen

Results to

Tissue Hypoxia
Triggers

Compensatory Mechanisms

Heart Bone Marrow

Pumps rapidly to deliver enough Increased production of RBCs to

supply of Oxygen to the whole body increased blood’s O2 carrying capacity

Increased Circulating RBCs

Increase in blood volume with more

Legend: RBCs while plasma volume remains

Etiologic factor -
Increased blood viscosity
Pathophysiology --

Organ involved --
 4. Along the pathophysiologic tracing, identify if there are signs and symptoms manifested
due to the pathophysiologic changes.

Demographic location: living on the mountain top for 5 years now

Consist of

Low environmental Oxygen level

Leads to

Decreased level of Inspired Oxygen

Results to

Tissue Hypoxia -lethargy

Triggers
-frequent
Compensatory headaches
Mechanisms

Lungs Heart Bone Marrow

Tend to tends to compensates to
Increased Pumps rapidly to deliver Increased production of RBCs
respiration enough Oxygen to the whole to increase blood’s O2 carrying
body capacity

-Increased RR- 32bpm Causes

-increased Respiratory -Increased HR-100bpm Increase Circulating RBCs

effort
-Increased BP 150/90 Results to

-vein distention Increase in blood volume with more

RBCs while plasma volume remains

causes

Legend: Increased blood viscosity

Etiologic factor -

Pathophysiology -
-blanched skin (red spots on skin)
Organ involved -
-skin appeared tight and shiny
Signs and Symptoms -
-ecchymosis
 5. With each signs and symptoms, identify the nursing diagnosis applicable.

Demographic location: living on the mountain top for 5 years now

Consist of

Low environmental Oxygen level

Leads to Risk for injury r/t
Decreased level of inspired periods of lethargy
Oxygen
Results to

Tissue Hypoxia
-lethargy
Triggers -frequent
headaches
Compensatory Mechanisms

Lungs Heart Bone Marrow

Tend to tends to compensates to

Increased Pumps rapidly to deliver Increased production of RBCs
respiration enough Oxygen to the whole to increase blood’s O2 carrying
body capacity

-Increased RR- 32bpm Causes

-increased Respiratory -Increased HR-100bpm Increase Circulating RBCs

effort
-Increased BP 150/90 Results to

-vein distention Increase in blood volume with more

Ineffective RBCs while plasma volume remains
breathing pattern
Risk for decreased causes
r/t increased lung
compensation cardiac output r/t Increased blood viscosity
impending cardiac
exhaustion

-Body image disturbance r/t changing of -blanched skin (red spots on skin)
skin color
-skin appeared tight and shiny
-Fluid volume deficit r/t over production
-ecchymosis
of RBCs
 Legend:

Etiologic factor -

Pathophysiology -

Organ involved -

Signs and symptoms -

Nursing diagnosis -

6. Identify deviations of lab results and diagnostic tests that may occur as the disease
progresses and determine their normal results as well.

Demographic location: living on the mountain top for 5 years now

Consist of

Low environmental Oxygen level

Leads to Risk for injury r/t
Decreased level of inspired periods of lethargy
Oxygen
Results to

ABG result: Tissue Hypoxia

Respiratory acidosis -lethargy

Normal: pH 7.35-7.45 Triggers -frequent

headaches
PO2 : 80- 100 Compensatory Mechanisms
 Lungs Heart Bone Marrow

Tend to tends to compensates to

Increased Pumps rapidly to deliver Increased production of RBCs
respiration enough Oxygen to the whole to increase blood’s O2 carrying
body capacity

-Increased RR- 32bpm Causes

-increased Respiratory -Increased HR-100bpm Increase Circulating RBCs

effort
-Increased BP 150/90 Results to

-vein distention Increase in blood volume with more

RBCs while plasma volume remains
CXR: Cardiomegaly

Normal: No heart causes

Elevated RBS count
enlargement Increased blood viscosity
Normal:

Women 4.2-5.4 mil/ul

Men 4.7- 6.1 mil/ul

Ineffective -blanched skin (red spots on skin)
breathing pattern Children 4.6- 4.8 mil/ul
-skin appeared tight and shiny
r/t increased lung
compensation -ecchymosis

Risk for decreased

cardiac output r/t
impending cardiac -Body image disturbance r/t
exhaustion changing of skin color

-Fluid volume deficit r/t over

Legend:
production of RBCs
Etiologic factor--

Pathophysiology--

Organ involved--

Signs and symptoms--

Nursing diagnosis--

Diagnostic tests--