Question:

Describe facts and content.

This is the initial stage of the clinical reasoning circle. Here, the nurse starts to get an impression of the client’s situation.

Answer to Question: NRSG259 Promoting Health In Extended Care

An important part of nursing’s service is to recognize and manage an alining person.

Nurses need to be able to evaluate critically the patient’s medical condition in order to do this.

Critical reasoning cycles aid nurses in making clinical judgments, problem solving and decision-making.

It is an important tool that helps nurses observe patient symptoms, to collect cues, then process the information. (Nighingale 2015.

The nurse should have a clear understanding of the patient’s situation and plan for intervention.

She isn’t only responsible for the execution of interventions.

She must also assess the effects of her interventions to determine if they are improving patient health.

Nursing nurses also get the chance to reflect on their own practice during the entire patient management with clinical reasoning cycle.

Reflection on the nursing experience helps nurses to improve their skills as they gain new experiences with each patient.

This essay will cover the entire process of clinical reasoning.

It will aid the nurse to plan and execute the case, as well as provide the correct interventions for her patients.

The clinical reasoning cycle’s first step focuses on the patient situation. This helps the nurse to explain the list of facts.

Barbara was found to have dry macular disease and hypothyroidism.

She also suffers with rheumatoidarthritis.

She has limited mobility and impaired mobility.

These conditions had made her feel isolated from her friends. She lost the confidence to leave her home, and she suffers from depression.

Tracy, her daughter, and her family feel she is a burden.

She has constipation and dizziness.

Recently her weight has dropped and this has become a problem.

The second phase of the clinical reasoning circle consists of reviewing any current information found in the medical history or general physician’s reports.

A nurse would then analyze the person to gather the information and verify whether there are any new clinical signs.

The nurse will then have to recall what she learned in her education and from her work experience regarding the physiology.

Barbara had received a report that was compiled by the doctor.

Barbara is a firm believer in the Catholic Church, and she wants to be associated with it.

Her macular degeneration is due to damage to the central portion of the retina.

This is found in the inside black of the eye. It is responsible for the recording of images before being sent to the brain.

In addition, her cartilage has been degenerated over time.

The cartilage becomes irritated, and then eventually breaks down.

Also, she had a history hypothyroidism. This occurs when antibodies within the body attack your own tissues or organs.

Scientists aren’t certain whether it is due to microorganisms attacking the body or a genetic flaw.

Rheumatoid is a form of an autoimmune disorder similar to autoimmune disease that attacks healthy tissue.

This is the third step. It involves the collection of valuable information that will help to identify the problem.

This includes interpretation and understanding the causes.

This is followed with identifying important and less important information, relating symptoms and signs, and inferring opinions after an analytical logical analysis (Liaou.

Then, it is followed by matching current circumstances and predicting future outcomes.

Barbara is an example of someone who has hypothyroidism.

This could explain her symptoms of constipation.

Her symptoms include rheumatoid, osteoarthritis, and others.

These are the contributing factors to her limited movement and impaired mobility.

The degeneration of cartilage and severe pain in her muscular section had caused problems with the smooth movement of the joints.

Additionally, the macular primarily helps in focusing the central visual system of the eye. This allows the macular to see detail, read, and drive cars.

Because of degeneration in this section, she is unable to drive a car.

Her vision has been impaired, and she sometimes experiences dizziness.

A result of her impairments, she felt like she was being socially excluded. This has caused her depression.

It is possible that her weight loss may be a contributing factor to depression.

Fourth step is mainly about synthesising the facts with analysis of the inferences from the previous steps.

This would enable the nurse to identify the problem and give goals for the patient’s life (Koivisto (2016)).

Barbara’s case is an example of how a nurse can diagnose her problem. She has severe pain in her joints and immobility.

She also tries and manages her severe pain from weakness in her hip, knee, and fingers.

So that her stiffness and pain can be reduced, she needs intervention.

For her, interventions could include increasing the movement of her joints and addressing her vision issues.

You should ensure she does not have to fall and that her medications are taken on time.

She should address her constipation concerns (Rovner&Fontenot, 2016).

The fifth and final step involves the setting of goals. These goals would set a time limit for patient outcomes.

This would enable patients to understand the nature of the interventions required and the timeframe during which they would see them.

Barbara’s main goals are to help her husband regain his mobility and to reduce her joint pain.

Her vision deficit should not cause her to fall, or she could be injured. She also needs to take precautions so she doesn’t get in accidents.

She should also be monitored for constipation and hypothyroidism.

Within one month, she should be able and able to feel better.

The sixth step concerns taking appropriate actions to improve patient’s health.

This step examines the specific intervention and the reasoning behind them.

Ibuprofen, a non-steroidal, anti-inflammatory drug, would be applied to the patient’s pain.

It functions by controlling hormones that cause inflammation and pain. This is especially helpful for arthritis patients (Ndosi, et. al., 2014.

It is also important to give her supplemental thyroid hormone as her thyroid gland is not functioning properly. Thyroxin medication should be included in her medication plan.

Hydroxychloroquine can be used to treat rheumatoid.

It is effective in reducing the pain and swelling associated with arthritis.

It helps to prevent joint damage, which in turn reduces the likelihood of long-term disability. (Nevitt 2015.

Paracetamol slow-release is also a great option for treating osteoarthritis.

The patients feel relief from their chronic pain.

The medication is likely to increase compliance and thereby help in relieving pain (Zhang & Sons, 2015).

The nurse’s nursing interventions should also include education about the patient’s eyesight, providing enough lighting to allow her to do her daily activities, providing night light to her room so that she can see her, providing large print objects and visual aids for her activities (Kang and Tsai, 2015).

A nurse will provide assistance devices for her osteoarthritis symptoms, including canes, ambulatory and other devices (Kao & Tsai (2014).

She should ensure that Barbara begins exercises slowly, and gradually increases her intensity.

Barbara will be relieved of her pain by the physical therapy she may arrange.

Comfort measures such as heat or cold, massage and relaxation techniques would be used for rheumatoid.

A qualified occupational therapist can help with fatigue reduction and mobility. She will encourage independence and promote self-care for Barbara.

Her constipation issues can be overcome by a balanced diet that is high in fiber.

Encourage her to socialize with friends and relatives to help overcome depression.

The seventh step involves evaluating the effectiveness or non-effectiveness of the interventions used by the nurse (Dalton, et al. (2015)).

This can be done by thoroughly analysing Barbara’s situation.

Barbara’s mobility, her comfort level, her vision problems, and her mobility development will all help the nurse determine whether her interventions have positive results.

These data will allow her to make adjustments to her interventions.

For the nurse to assess if she is still depressed, it is crucial that she interacts with her.

Critical reflection by the nurse would be the last step. It will help her understand the effectiveness of her interventions for patients.

Her episode would include information about all aspects of the interventions and how they have helped patients (Nightingale 2015.

This would help her to improve her expertise.

She will be more confident when handling her next case.

The clinical reasoning process is a very useful tool. It helps nurses to approach each case sequentially.

It allows nurses to take a step by step analysis of each case.

After thorough analysis, it assists the nurse in setting a goal and implementing appropriate interventions.

An accurate evaluation of the intervention results helps nurses reflect on their own practice.

This will help the nurse feel more confident and allow her to learn from her mistakes.

The positive experiences she has will enable her to grow and the negative ones will teach her how to avoid unnecessary interventions.

A nurse who is committed to providing the best possible care for patients should use the cycle.

It allows nurses to be very careful and not make mistakes.

Clinical reasoning cycle was found to be extremely beneficial in the case Barbara.

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