Clinical Reasoning Cycle for Nursing Care: A Case Study

Running head: BACHELOR OF NURSING
BACHELOR OF NURSING
Name of the student:
Name of the University:
Author note:

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Introduction:
In most cases, the nurses have to take critical and immediate clinical decisions pertaining
to the health and wellbeing of patients (). Clinical reasoning cycle serves as one of the most
significant tools or frameworks that allows the nursing professionals to be able to able to engage
in practice taking the assistance of the skills of clinical reasoning, decision making and critical
analytical thinking all the while adhering to the evidence based practice and other relevant
clinical guidelines. As mentioned by Dalton, Gee and Levett-Jones (2015), the clinical reasoning
cycle provides the nurse with the opportunity to follow a systematic step by step guiding
framework that they can follow and be able to provide safe, effective and person centred care in
any care emergencies. This essay will attempt to outline the care decision making, care planning
and implementation procedure of a patient named Denise Palmer taking the assistance of a case
study.
Considering patient situation:
The clinical reasoning cycle outlines the very first step of care planning to be preliminary
consideration of the situation that the patient is in. In this case scenario, the patient is Mrs.
Denise Palmer, a 47 year old patient who presented in the facility with the symptoms of
shortness of breath and middle of the night gasping for breath.
Collecting cues or information:
Collecting care cues and information involves reviewing current information such as
handover reports, patient history, patient charts, results of investigations and nursing/medical
assessments previously undertaken (Dalton, Gee & Levett-Jones, 2015). The past medical history
of the patient includes a myocardial infarction (STEMI) 18 months ago for which she had been

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hospitalized for 5 days and although she had been referred a cardiac rehabilitation program, she
did not attend. Along with that, she mentioned she ran out of medication and was waiting on a
refill hence her medication regimen was also disrupted prior to the deterioration. The vital signs
of the patient includes Temp 37.2, BP 162/90, HR 108 bpm, RR 32,SaO2 95% on 2LO2 via
nasal prongs. This section also requires the nurse to implement further investigation and
assessment to gather as much data as possible which will help in identifying care problems and
care priorities. Hence, in this case as a shift nurse I would also have to carry out repeat ECG,
pain assessment, cardiac and respiratory assessment as well (Gerhard-Herman et al., 2017).
Processing information:
The processing of information is a step that encompasses interpreting, discriminating,
relating, inferring, matching, predicting and synthesizing the collected information to arrive at a
possible diagnosis and identifying care needs. In this case, it has to be mentioned that the patient
had been a MI patient with considerable lifestyle restrictions as well as instructions to follow,
which she had been ignoring (Lloyd-Jones et al., 2016). Denise had discontinued the cardiac
rehabilitation program completely which had been attributed to cause significant detrimental
impact on the cardiac health and optimal functionality of a patient. Along with that she had
negligible physical activity, had not been following the instructed dietary modification, and had
recently also run out of her medication as well which indicates that not only she had not been
engaging in the necessary lifestyle modifications, her conditions were not medically managed
which aggravated the hyperlipidaemia and hypertension which accelerated the progress of
another MI event (Shacham et al., 2015). His vital signs indicated extremely high BP at 162/90
and heart rate at 108 bpm which reduced from 118 bpm due to her ill maintained cardiac health
which may have further aggravated the coronary blockages judging from her lifestyle and