Clinical Reasoning Cycle – Health Promotion Template Presentation 2022

Clinical Reasoning Cycle – Health Promotion Template (Workshop 1).
(Modified from Levett-Jones, 2013)
ASSESSMENT
Stage
Response.
Determinants of Health
Initial.
Mrs Ruby Pascal has been presented to a medical ward due to her poorly managed
Type 2 diabetes and general anxiety disorder. She has been admitted in the ED with
Nausea, chest pain and vomiting, which is probably due to the panic attack that has taken place.
Interview,
documentation,
observation.
Medical history includes Metformin for managing diabetes. For her general anxiety disorder, she
had been receiving professional treatment. She has been vising psychologists and had been
under short term treatment by her GP. Ruby’s BMI>35.
Ruby’s anxiety have augmented highly after her husband’s diagnosis with cancer 3 months age,
and her three children are being looked after by her mother in Gin Gin.
Ruby also stated that she self-meditated valium 10 mgs at both day and night and sometimes
even three times a day. She stated that she knows about the dosages and does not takes much.
Ruby does not eat healthy food, as there is nobody to help her with cooking. She is not much in
to physical exercises and usually utilizes the taxi vouchers to get in to the hospital.
SW
our
text
her

Identify health
concerns.
Identify patterns or
connections.
1. Uncontrolled diabetes
2. Generalized anxiety disorder
3. Overweight and obesity
People with mental health problems like depression or anxiety disorder are likely to develop
anxiety disorders. Diagnosis of Ruby’s husband with bowel cancer and her children living
under the care of Ruby’s mother away from Ruby also troubles can be the possible reasons
for her anxiety. Biological changes induced by diabetes along with the life style limitations
and feelings associated with chronic illness can be linked with poor mental health.
Ruby is not a healthy eater as she has no domestic help to assist her in cooking and hence
have to manage in take away meals from nearby shops.