Application of Clinical Reasoning Cycle

Application of clinical reasoning cycle 1
APPLICATION OF CLINICAL REASONING CYCLE
Student’s Name
Institutional Affiliation

Application of clinical reasoning cycle 2
Introduction
Osteoarthritis is a medical condition that affects joints in the body. The most common
forms of osteoarthritis affect the knees, elbows and wrists. In osteoarthritis, the cartilage that
forms the link between two bones within a joint is normally broken down and the bones in the
joint rub against one another in any movement (Fransen et al, 2015). This causes pain and
stiffness within the joints which form the classical symptoms of osteoarthritis. The consequences
of the condition are limited movement and inability to hold things. Mary is an example of a
patient suffering from osteoarthritis. The condition has affected both of her knees leading to total
knee replacement by surgical means in order to manage her condition. There is need to develop
an effective nursing care plan for the patient in order to achieve the best outcome possible as she
recuperates. The aim of this discussion is to critically analyze Mary’s case study, identify
moments of deterioration in her health care plan and provide appropriate nursing interventions
that can aid in her recovery.
Patient analysis using the clinical reasoning cycle
The clinical reasoning cycle as described by Levett-Jones enables nurses and health care
providers to clearly understand a clinical situation of a patient in depth and offer the appropriate
care plan that best suits them. The first phase of the cycle is consideration of facts from the
patient and the clinical situation at hand (Bartels et al, 2016). Mary in this case study for example
has just had a total knee replacement surgery to aid in combating her long-term osteoarthritis. In
the clinical setting the patient is still admitted for clinical monitoring after the surgery. The facts
revolving around her state include the fact that she is now fully alert and conscious after the
surgery. The wound dressing is dry without any oozing. She is experiencing pain in her knees
and feels a bit lightheaded. The fact that she feels nauseated is also an important current state

Application of clinical reasoning cycle 3
consideration that needs to be incorporated in the nursing care plan. Mary is 82 years of age and
therefore quite old. This is an important consideration as osteoarthritis worsens with old age.
This can be explained by the fact that as the body ages, the cartilages in the joints wear out and
become less effective in their functioning leading to increased friction with minimal movement.
The second phase of this clinical cycle involves collection of information about the
patient. Mary has a past medical history of osteoarthritis of both knees. She is a known type 2
diabetic patient over the past 3 years, a history of essential hypertension and fatty liver disease.
This information is of necessity to analyze the patient’s possible risk factors related to her
condition and also in the development of a proper diagnosis and treatment plan. There is a
considerable association of osteoarthritis and diabetes. The association can best be described by
the fact that diabetes exacerbates some of the symptoms of osteoarthritis (Courties, Sellam &
Berenbaum, 2017). Pain for example in the joints due to osteoarthritis can be exacerbated by
diabetic condition. This is associated with the fact that diabetes causes poor healing of wounds.
Since Mary had just undergone through a knee surgery, the wound had not yet completely healed
and the fact that she was diabetic could lead to worsening of the wound and poor wound healing.
In order to effectively manage the patient’s current condition, there is need to include treatment
of the diabetic condition in the treatment plan. Processing of the information collected and
linking it to the pathophysiology behind the state is an important phase of the clinical reasoning
cycle that all nurses and medical professionals must engage in (Wajon et al, 2015).
Mary’s medical history is of importance in identifying the pathophysiology behind her
condition. She has a history of essential hypertension. Despite being idiopathic, this is an
increase in blood pressure associated with old age and that could be linked to various factors
including the fact that she was diabetic and poor health lifestyles. Health lifestyles and diet are