NRS163 Clinical Reasoning In Nursing 1
Answer:
Description of each stage of the clinical reasoning cycle
Tracy-Levett Jones promoted the concept of the clinical reasoning cycle and organized the overall clinical decision-making in different steps. Clinical reasoning focuses on diagnosis and prognosis determination and develops a therapeutic approach for a particular patient (Daly, 2018, p. 5). The heterogeneity of the tasks involved in the care planning possess is the foundation of the cycle. The clinical reasoning cycle has the following stages-
Consideration of the patient’s situation
At this stage, the healthcare professionals are presented with the clinical case. The current medical status of the individual is presented in this stage. Nurses’ assumptions, perceptions, and biases are considered within this stage (Theobald & Ramsbotham, 2019, p. 3).
Collection of cues for information
The cue collection stage focuses on collecting the patient’s medical history. Results of the tests and the navigation that have been performed on the patient. The nursing professionals consider the collection of relevant information and understand the concern of the patient and their families.
Process information
It is a critical stage while focusing on the core of the clinical reasoning cycle. The nursing personnel analyses the current information and aberration of the current standards of health of the patent. The anticipation of potential outcomes and complications is analysed considering the current plan of action and patient health status.
Identification of problems
The collected information is synthesized and analysed by the experienced health professionals in this stage. To consider the appropriate nursing diagnosis, the implementation of this stage is considered, and it further focuses on the possible course of action to be taken. The criticality of this stage lies in identifying the problems and developing appropriate care goals for the same as well (Pusztová et al., 2020, p. 2).
Goal establishment
As per the situation of the patent, the current goals and prioritized as per the requirement of the patient’s health; the goals within this stage should be SMART and consider the previous identification of the problem by the nursing diagnosis, without the specificity of the goals, the efficacy of the actions cannot be determined by the nursing professionals as well (Laleci Erturkmen et al., 2019, p. 1).
Actions taken
To achieve the goals of the care plan and the patients’ health, the nursing professionals focus on the activities considered within this stage. The interventions are considered within this stage, and the responsibilities are assigned to the multidisciplinary team of the care process. Other than nursing professionals, other healthcare professionals have been involved in this stage; the goals and the responsibilities should be effectively communicated with the whole team.
Evaluation of outcomes
The re-examination of the objectives and the course of actions is considered. The nursing interventions are evaluated, and the improvement of the patient’s condition is analyzed within this stage. Further examination of the analysis considers replanning the care procedure and implementing a more appropriate course of action.
Reflection on the process
Effective clinical reasoning considers developing cognitive and metacognitive skills development among individuals (Lusk Monagle et al., 2018, p. 202). The final stage of reflection allows the nurses to critically review their activities within the care process and further learn from the case. The deliberate, structured intellectual activity allows the nurses to process their experience and understand the care planning process of particular processes.
Analyzing the case study
Identifying the patient cues through the patient’s situation
Healthy aging has become an important issue considering the public healthcare burden within western countries. The maintenance and development of functional ability are declining due to the lower physical activity in old age (Freiberger et al., 2020, p. 1). Considering the case, it has been identified that Mrs Stewart is an 85 years old lady facing issues regarding mobility. The worsening condition of her mobility is reducing her quality of life. Due to her condition, the orthopaedic surgeon has recommended an elective left total hip replacement procedure. She has higher blood pressure than normal, and her heart rate is also higher. However, her respiratory rate and temperature of the body are normal. The patient is allergic to penicillin.
Along with that, the patient has a medical history of high blood pressure and irregular heartbeats. The patient used to smoke at a younger age, and the patient felt lightheaded on the morning of admission. The patient’s pain score is six, and after laying down, she does not feel dizzy anymore.
Analyzing the ways to decision making for treatment
The problem with the patient’s mobility is the main issue the patent is facing. Furthermore, her high blood pressure and irregular heartbeat are also a matter of concern for healthcare professionals. The care planning is mostly framed as per the patient’s requirement and the situation (Heyland, 2020, p. 2). Along with that, the resources available for the treatment process are also considered. Considering the case, the registered nursing professionals need to focus on the current problems and self-assessment of the patient regarding the issues. As per the case, the primary objectives of the nursing professionals are to focus on the mitigation of the blood pressure and prepare the patient for the pre-operative process. The main goal of the treatment process is to restore the functionality and mobility of the patient. To do that, the elective total left hip replacement has been recommended for the patient (Valenzuela et al., 2022, p. 1). As per the patient’s age and condition, the rehabilitation process could be initiated after 48 hours of the operation. The surgery outcomes are expected to provide the functionality and mobility of the patient. Considering the focus on the nursing professionals, patient education and patient-family education should be considered within the rehabilitation process.
Analyzing the process information for the decision making of a registered nurse
It has been identified that the implementation of pre-operative physical therapy can result in better outcomes in the postoperative period. The process information and the tasks to be performed during the surgery should be communicated to the multidisciplinary team of healthcare professionals. Furthermore, nursing professionals should be aware of the activities performed within the pre-operative procedure. The analysis of the patient’s vitals, drug resistance, and allergy is necessary for the further surgical procedure. Furthermore, it has to be identified whether the patient is suffering from any other abnormality to maintain the quality of the surgical procedure. After the surgery, the restoration of the patient’s habits and the changes within the lifestyle are to be incorporated. The monitoring of the pain reduction and the fluctuations of the vital signs are considered within the rehabilitation procedure. The pain management team should be assigned, and the medication should be followed as per the requirement. After the procedure, the consideration of the physiotherapy should be implemented. Furthermore, the proceedings and improvement of the patient’s condition should be monitored, and accordingly, the rehabilitation process could be changed. Along with that, the nursing professionals can identify the appropriate intervention methods considering the particular situation of different patients.
References
NRS163 Clinical Reasoning In Nursing 1
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