Clinical Reasoning Cycle for Mr Cyril Smith's Case

This document provides a complete Clinical Reasoning Cycle for Mr Cyril Smith's case, including a description of the patient situation, collection of cues and information, processing of information, relating and inferring, and identification of problems and nursing diagnosis. The importance of effective therapeutic communication and safe medication practices are also discussed.

ATHC 1 Assessment Three (3) template
Student Name:
Student Number:
Tutor Name:
Patient Name:
Complete the following table using information from Mr Cyril Smith’s story
Clinical Reasoning Cycle
Consider the patient situation
In this section, providea
relevant and concise
description of your
observation of the context
and patient situation.
 The patient has been admitted in the care facility after being
diagnosed with bowel cancer.
 Upon patient assessment, he mentioned of improper therapeutic
communication.
 His blood pressure is low (99/50), temperature is normal,
respiratory and pulse rate is also normal.
 Further, it was seen that his oxygen saturation level is moderate
 His upper limb is stronger and has equal power but lower limb has
unequal strength due to injury in the right ankle.
 Patient was not emptied his bowel and last urinated at 9 AM.
 Blood glucose level and osteoarthritis related pain is also under
control.
Collect cues and/or information
Review / Gather / Recall
Record current information,
new information, knowledge
 It was mentioned in patient history that he suffered from diabetes,
chronic obstructive pulmonary disease and osteoarthritis and due to
these he suffered from critical health complications.
 He was admitted to the healthcare facility after being affected with
bowel cancer and as his surgery of bowel resection is tomorrow, he
was not provided with any food of liquid diet so that his bowel could
be emptied and cleaned before operation.
 Patient has 3/10 pain and all of these is due to his arthritis
condition.
 Patient has controlled blood glucose, fever, and pain of arthritis due
to the application of proper medications.
 However, he has a right ankle injury and he is feeling dizzy due to
which he is highly affected with risk of fall.
 Further, he is unable to drink on his own and hence he does not
have urge to drink water on his own.
Process Information
Interpret
Analyse data and come to
understanding of
signs/symptoms
after collecting the cues, it could be said that patients weakness and
dizziness was due to the healthcare application s the patient has a surgery
the next day and hence as per Huntington, Royall and Schmidt (2014), he
was not provided with any food or liquid as it could hinder the healthcare
process effectively.
Discriminate
Distinguish relevant from
Patients smoking history, and his mental health complication were irrelevant
in this condition as it does not affected any of his critical healthcare
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irrelevant information complications.
Relate &Infer
Cluster cues, make
deductions or form opinions
Due to the upcoming surgery, the patient was asked to keep away from
food and water and hence, he started feeling thirsty and the effect of this
condition could be observed in his lowered blood pressure and his
dizziness. Further due to his ankle injury, it is possible that he would
develop high risk of fall and hence, it should be treated. Further, it was seen
that he does not have urge for water and hence, this o=should also be
prevented for the healthcare of the patient.
Match
Match current situation to
past situations
The current condition of less pain and controlled osteoarthritis condition is
the applications of arthritis medications. Further, it was seen that the patient
consumed metformin that controlled his current diabetes, paracetamol that
controlled his current fever and applied Salbutamol due to which his airway
was clear and he was able to breathe freely.
Predict
Predict an outcome
If the patient is not provided with effective intervention for his risk of fall and
risk of dehydration, then it could affect his ability to overcome health
complications.
Identify problems / issues
Synthesise facts and
interferences and make a
definitive nursing diagnosis
After analysing the complete healthcare condition, synthesis of facts, and
developing interferences of healthcare complications, it was observed that
the high risk of dehydration was one of the critical health condition.
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Critical thinking questions
Identify and discuss two factors that can contribute to safe medication practices (provide
references) 100 words
1 The first factor that could contribute to effective and safe medication practice could be
application of therapeutic interventions. As per Hammer, Fox and Hampton (2014), with the
application of therapeutic intervention, the patient would be able to provide effective
intervention to the patient and the patient would also be able to develop trust and belief on
the care system.
2 The second intervention would be application of medication documentation and reporting so
that effective and safe medication practice could be applied. As per Lee et al. (2015), with
application of effective documentation, the rate of medication error would decrease and
hence, eventually effective and safe medication would be achieved.
Outline the importance of effective therapeutic communication and how it relates to person centred
care (provide references) (200 words)
Therapeutic communication could be termed as the process in which with effective nurse to nurse,
or nurse to patient communication, accurate and appropriate care process could be implemented.
As per Gyoneva and Ransohoff (2015), there are several factors due to which effective
interventions become unable to provide benefit to the patient and as per Hammer, Fox and
Hampton (2014), lack of therapeutic intervention is one of them due to which patients become
unable to take benefit of their care process and then with these, they become unable to revert to
their health and wellbeing. As per Martin and Chanda (2014), effective communication in
therapeutic scenario is helpful in determining that the patients are understanding the care process
and they would be able to maintain the preventive measures on their own so that patient centred
holistic care could be achieved. In this case study, it was seen that Mr. Smith was unable to
understand the conversation conducted by RN Cameron and hence, he provided all the wrong
answers about his health condition (Ruesch et al. 2017). Therefore, from this scenario, it is
evident that with the application of effective communication, the patients would be able to maintain
care process and would be able to understand about their illness and increase their health
literacy. Hence, this is an effective aspect that helps to revolve the entire care process around
patients.
What have you learned from this assessment? What actions will you take into clinical practice as a
result of what you have learned?(provide references) (200 words)
There are two aspects that I have learned about the care process and healthcare assessment.
The first thing I have learned about the health assessment from this case study assessment is
application of priority based care process (Toode et al. 2014). As per Lee et al. (2015), with
application of priority based care process, it is possible to implement effective intervention to the
patients so that they could overcome their critical health condition, depending upon its severity
level. The second aspect that I have learned from this aspect is the application of therapeutic
communication related intervention so that with proper application of this, patients could be
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connected to the care process and then with their involvement effective and accurate care could
be implemented in the care process (Weller, Boyd and Cumin 2015).
If such critical condition arises in my future healthcare condition, then I would be implementing
therapeutic communication so that I could develop a rapport with the patient so that they could
understand the application of interventions for their health improvement. Further, I would also use
priority based care for the critically ill patients that are unable to make decision for their own
healthcare process (Shantz, Alfes and Arevshatian 2016).
References
Gyoneva, S. and Ransohoff, R.M., 2015. Inflammatory reaction after traumatic brain injury:
therapeutic potential of targeting cell–cell communication by chemokines. Trends in
pharmacological sciences, 36(7), pp.471-480.
Hammer, M., Fox, S. and Hampton, M.D., 2014. Use of a therapeutic communication simulation
model in pre-licensure psychiatric mental health nursing: Enhancing strengths and transforming
challenges. Nursing and Health, 2(1), pp.1-8.
Huntington, J.T., Royall, N.A. and Schmidt, C.R., 2014. Minimizing blood loss during hepatectomy: a
literature review. Journal of surgical oncology, 109(2), pp.81-88.
Lee, Y.C., Wu, H.H., Hsieh, W.L., Weng, S.J., Hsieh, L.P. and Huang, C.H., 2015. Applying importance-
performance analysis to patient safety culture. International journal of health care quality
assurance, 28(8), pp.826-840.
Martin, C.T. and Chanda, N., 2016. Mental health clinical simulation: therapeutic
communication. Clinical Simulation in Nursing, 12(6), pp.209-214.
Ruesch, J., Bateson, G., Pinsker, E.C. and Combs, G., 2017. Communication: The social matrix of
psychiatry. Routledge.
Shantz, A., Alfes, K. and Arevshatian, L., 2016. HRM in healthcare: the role of work
engagement. Personnel Review, 45(2), pp.274-295.
Toode, K., Routasalo, P., Helminen, M. and Suominen, T., 2014. Hospital nurses' individual priorities,
internal psychological states and work motivation. International nursing review, 61(3), pp.361-370.
Weller, J., Boyd, M. and Cumin, D., 2014. Teams, tribes and patient safety: overcoming barriers to
effective teamwork in healthcare. Postgraduate medical journal, 90(1061), pp.149-154.
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