Clinical Reasoning Cycle | Report

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Case Study- Clinical Reasoning Cycle
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Author Note

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1
Part One
Introduction
The patient is an aged woman who is suffering from sepsis and got
admitted in the hospital. The nursing assessment of vital signs confirmed
the disease. The patient also had a history of diabetes, which might also
be the reason for developing sepsis indeed. The condition of the patient
got deteriorated due to a urinary tract infection after a few days of
admission. The nurse assess the condition and according treatment is
planed following the guideline of clinical reasoning cycle (Leoni-Scheiber,
Mayer & Müller-Staub, 2019). The primary purpose of the below paper was
to provide correct intervention to the admitted patient and also helps in
recovering the patient by providing person-centred care.
Consider the patient
The patient is an aged woman of 56year had symptoms of sepsis
and was admitted in the hospital. She has a history of diabetes and
hypertension. The vital signs that were found observed by the nurse
during admission are blood pressure- 150/85mm Hg, the respiratory rate-
24bpm, spo2- 99%, body temperature- 101F, heart rate 100bpm. The
glucose level was found to be160mg/dl. The patient takes metformin
20mg for controlling diabetes (Nasri & Rafieian-Kopaei, 2014). The patient
lives alone and has a sedentary lifestyle. The cause for this sepsis can be
the previous infection of pneumonia, along with high diabetes and
hypertension, which made the condition worsen (Frydrych et al., 2017).
During the initial assessment, there was no such sign of urinary tract
infection in the patient. The patient was catheterized as she was suffering
from high fever and was unable to move along with urinary retention
symptoms (Feneley, Hopley & Wells, 2015). The patient developed urinary
tract infection due to weak immune system and can be because of sepsis.

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2
Collect Cues
The patient was admitted due to a condition for sepsis that might
have developed due to previous history of pneumonia. In the morning, the
handover report after administering the Ampicillin, Meropenem, and
paracetamol were Fever- 90F, blood pressure- 140/80mmHg, spo2- 96%,
heart rate- 80bpm, respiratory rate- 22bpm. The blood glucose level was
still high with 150mg/dl. The patient’s condition suddenly got deteriorated,
and the vital signs increased, such as blood pressure- 160/90mmHg, spo2-
100%, lower abdominal pain, heart rate- 110bpm, body temperature-
100F, the blood sugar level was found to be 170mg/dl. The patient was
also having anxiety symptoms due to pain, along with restlessness. The
urine culture proved that she is grasped by urinary tract infection as many
colonies of Escherichia coli, was found from the agar plate as well as from
gram staining (Maheux et al., 2014). The patient was also having a
symptoms of severe abdominal pain and problem in urination which was
reported by the previous shift. All these made the patient restless.
Process the information
The patient was admitted in the hospital due to sepsis that was
developed due to previously acquired pneumonia. The immune system
gets weakened in an older age, which makes the body more prone to
infection. Here, in this case, the patient already suffered from pneumonia,
which might be an indication of this sepsis state (Gyawali, Ramakrishna &
Dhamoon, 2019). The patient was given Ampicillin and Meropenem, which
controlled the situation of sepsis to some extent. The condition of the
patient suddenly got detoriated with a symptom of severe stomach aching
and burn sensation during urination. It is observed after deterioration that
the vital signs are increased in terms of heart rate, blood pressure,
respiratory rate. The body temperature was also high along with
restlessness. The observations were blood pressure- 160/90mmHg, spo2-
100%, lower abdominal pain, heart rate- 110bpm, body temperature-
100F, the blood sugar level was found to be 170mg/dl. The condition