Clinical reasoning cycle Assessment 2022

Assessment task 3

Table of Contents
Introduction......................................................................................................................................3
Clinical reasoning cycle...................................................................................................................3
Consider the person’s situation....................................................................................................3
Collect the cues............................................................................................................................3
Process the related health information.........................................................................................4
Identification and prioritization of three nursing problems/issues...............................................4
Establishment of goals for priority of nursing care......................................................................5
Discussion of the nursing care of Mrs. Zata................................................................................5
Evaluation of nursing care strategies...........................................................................................7
Reflection on the Mrs. Zata’s outcomes and my learning...........................................................8
Conclusion.......................................................................................................................................8
References........................................................................................................................................9

Introduction
Nurses who have good clinical reasoning skills tend to impact patient’s outcomes in a positive
way, however, nurses who lack efficient clinical reasoning skills are not able to recognize
potential patient deterioration which at times may cause failure in rescuing the patients. Clinical
reasoning cycle signifies the clinical judgements and clinical decision-making that are put
forward as a logical process and has eight different and significant stages (Levett-Jones T. ,
2013). This assignment will use Clinical Reasoning Cycle to plan and assess care for a 46 year
old female, Mrs. Zata Zata.
Clinical reasoning cycle
Consider the person’s situation
Mrs Zata complained of passing dark blood stained stools for 2 months and her GP made a
referral to the hospital when she complained of intense cramping and blood in diarrhea. A
colonoscopy was performed which revealed an obstructive lesion in her sigmoid colon. It was
followed by a laparoscopic sigmoid colectomy. The biopsy investigation revealed that Mrs. Zata
had infiltrating and poorly differentiated adenocarcinoma. Her history reported of mild
hypertension and hyperlipidemia. An appendectomy was also performed at the age of 25. Her
father also died of cancer with unknown origin at 66 years. She has been separated from her
husband and has 2 children of ages 23 and 20.
Collect the cues
On investigating the vital signs, her temperature was recorded to be 37.8, pulse 72, RR 22 and
blood pressure 166/85 mmHg. Blood result revealed CEA> 25 ng/ml, CA- 19 -9 > 120 U/ml, Hb

88 and Neutrophils <500/mcl. Currently she has been prescribed Rosuvastatin, Metoprolol,
Pantoprazole, Coloxyl and Senna, Targin and Endone. PRN medications included Panadol and
metoclopramide. She complained of intense pain with pain score of 8-10 at night. She also
experienced sleeplessness and constipation for four days. A weight reduction of 5kgs was also
observed in 14 days. Her hospital stay is extended by doctors for improvement of her
neutropenic state. Recently, Mrs Zata refused to get out of bed and eat.
Process the related health information
The pathological report along with blood results of Mrs. Zata confirmed that she has been
suffering from Sigmoid Adenocarcinoma Stage IV. Doctor ordered treatment of Mrs. Zata with
six cycles of chemotherapy to be followed by radiotherapy. Most of the colorectal polyps and
tumors are slow-growing which may have led to the delay by Mrs. Zata and the GP as they spent
time in determining whether their symptoms are of cancer. During this time the cancer cells grew
and invaded and destroyed the nearby normal tissue (Jensen, Hvidberg, Pedersen, &
Vedsted, 2015).
Identification and prioritization of three nursing problems/issues
1. Acute pain- Mrs. Zata is suffering from intense pain which ranged between 8 and 10
particularly at night so, it becomes the priority of the nurse to minimise her pain so that
her suffering is reduced and she could sleep at night. The cause of the acute pain could be
her ongoing chemotherapy and radiotherapy as majority number of patients experience
pain in advance stage which is Mrs. Zata’s stage (Lu & Rosenthal, 2013)