Clinical Reasoning Essay: Applying the Clinical Reasoning Cycle

Running head: CLINICAL REASONING ESSAY
Clinical reasoning essay
Name of the student:
Name of the university:
Author note:

1CLINICAL REASONING ESSAY
Clinical reasoning cycle has been coined by Tracy Levett Jones as a model or framework
for the nurses to implement into practice in order to amplify the level of clinical decision making
and reasoning skills of the nurse (Levett-Jones, 2013). Clinical reasoning skills are imperative
for the nurses as they have also been reported to be having positive impact upon the patient
outcomes and recovery potential (Levett-Jones et al., 2010). This essay will attempt to apply the
first seven stages of the clinical reasoning cycle with respect to clinical decision making for the
patient in the case study.
Considering the patient situation:
The patient under consideration for this assignment had been an elderly lady whose
personal details were not revealed in the case study. She had ordered the student nurse to record
her BP which showed excessively high systolic pressure (200/90 mmHg). The patient had not
been diagnosed for hypertension before and claimed never taking any mediction for hypertension
before. However, as the blood pressure of the patient is higher than 180, the patient is at high risk
of going through hypertensive crisis.
Collection of cues:
The second step of the clinical reasoning cycle is the collection of cues, where the nurse
is expected to collect all the relevant information and care cues available about the patients. The
student nurse collected cues from handover reports patient history, patient charts, results of
investigations and nursing or medical assessments previously undertaken (Marcum, 2012). In
this case, the patient had been stating that she did not have any issues with hypertension before
and had been very thin; hence the pressure cuff had been very loose on the patient and the
reading had been taken over the light jumper that the patient had been wearing. Hence, the nurse
performed the reading again which revealed the similar results again which led the nurse to be

2CLINICAL REASONING ESSAY
taking the assistance of an automatic monitoring system which led to similar results again. Along
with that, the patient had also been suffering from severe headache, severe anxiety and an
instance of nosebleed as well. The readings that the nurse had been successful in discovering
revealed the fact that the patient can be having cardiac complications and inexplicable weight
loss as well (Wang et al., 2013).
Processing of information:
The third stage of the clinical reasoning cycle is where the nurses interpret, discriminate,
relate, infer and match the care cues identified and the possible health conditions that the patient
might be suffering from and then predict the most applicable care outcome for the patient (Hur &
Roh, 2013). In this case study, despite the patient suggesting that she did not have a problem of
hypertension, the sphygmomanometer reading and the automated monitoring system reading
indicated extremely high systolic pressure for which the patient required immediate
pharmacological attention in order to avoid the chances of a cerebrovascular accident (Wang et
al., 2013). Hence, depending on the risks of the patient and according to the evidence based
practice, the decision of the nurse to recommend the patient to a general physician had been
absolutely correct. Furthermore, the collected cues by the nursing professional reveals the fact
that the patient had also been suffering from nosebleed, severe headache and severe anxiety from
the past couple of weeks. Hence, the nursing professional in the case study took the assistance of
evidence based practice and discovered that systolic pressure going over 200 mmHg is very
severely linked with the possibility of acute hypertension crisis and it was very likely for her to
go through a cerebrovascular accident if therapeutic interventions are not carried out to lower her
blood pressure (Wang et al., 2013). Overall, from the processed information it can be clearly
mentioned that the patient had unnaturally high blood pressure and she had been in need for a