Case Study Analysis of John Wells for Nursing Assignment

This nursing assignment discusses the case study analysis of John Wells, a dairy farmer who developed critical health complications after a mild accident. The paper uses the Clinical Reasoning Cycle to prioritize his care process and develop interventions. It also emphasizes the importance of priority-based nursing care in healthcare processes.

Running head: NURSING ASSIGNMENT
CASE STUDY ANALYSIS OF JOHN WELLS
Name of the student
Name of the university
Author note

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Introduction
Priority based nursing care is an effective approach that helps nursing professionals to
understand the critical health complication of the patients and arrange their complications
depending upon priority of care to include quality and effectiveness in the care process (Shi
and Jiang 2018). This requires the nursing professionals to be skilled to understand the
priority of care for patients so that they could implement effective care for the patients to help
them to overcome their health complications (da Costa, da Costa Linch and Nogueira de
Souza 2016). One such approach that helps them in this priority based nursing practice is
Clinical Reasoning Cycle, developed by Levett-Jones, which includes six steps
implementation of which, helps to analyse the priorities for care (Dalton, Gee and Levett-
Jones 2015).
This paper would also use the Clinical Reasoning Cycle (CRC) to analyse the case
study of John Wells (82) so that his care process could be prioritised and using the steps of
CRC, his interventions could be developed.
Considering patient condition
This case study is of John Wells (82), who is a dairy farmer and has been brought in
the healthcare facility’s emergency department. His son brought him in the healthcare
facility, after he received a call from his mother Mavis. It was mentioned in the case study by
John that while returning home from his farm, he fell from his motor bike. He mentioned that
he fell from his motorbike because of instability and after that he fell on his left side, due to
which his head strike the ground. Exactly after this incidence, the patient developed critical
health condition with complications like nausea, dizziness and headache. His wife Mavis
noticed that John is unable to remember things that he performed since morning and he also
developed lack of appetite and these were the conditions that his wife noticed as a drastic

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change after his accident. His son also mentioned that his father did not have any head injury
in the past and no other of his past healthcare complications could be used to justify his
recent health complications associated with headache, nausea and dizziness. Concussion
could be one risk factor that the patient may develop after the left side of his head hit the
ground after accident and due to this concussive damage, he might felt dizzy, or persistent
lack of appetite (Max 2016). Besides this, there are other conditions, due to which the patient
develop dizziness or headache, such as sudden drop in blood pressure or blood glucose level
due to which the patient felt nauseated and weak. Therefore, after considering patient
condition, one aspect that was found to be effective for the health complication of Mr. Wells
was associated with his risk of concussion cue to which he developed health complications of
nausea, dizziness and headache. Hence, in such condition, it is important to collect cues of his
health condition through vital assessment or some important physiological analysis so that the
actual complication could be effectively analysed.
Collection of cues and patient information
After admitting John Wells in emergency ward and understanding the complications
after which the patient was brought to the healthcare facility, it was important to collect the
cues of the patient condition and then analyse them to develop specific interventions. The
vital signs of John, included his body temperature, his blood pressure, pulse and respiratory
rate and oxygen saturation levels. He had optimum body temperature, with slightly increased
blood pressure (148/84 mmHg) and his pulse rate and respiratory rate was also found to be
optimum. Therefore, from vital signs it was difficult to collect cues for his health
complications associated with headache, nausea, dizziness and his lack of appetite. Hence, to
analyse the patient condition and to analyse the reason of his health complications and lack of
appetite, presence of any internal brain injury in the patient’s body should be analysed.

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For understanding his consciousness level and to analyse his ability to remember
things, Glasgow Coma Scale or the GCS process should be implemented so that the level of
consciousness of the patient could be understood. As per Zhang et al. (2017), GCS is an
effective patient assessment scale that helps the healthcare professionals to understand the
consciousness level of patient by analyzing their eye opening, their motor responses towards
situations as well as verbal responses. The assessment includes the scores given upon all
these aspects and if the patient is unable to score above 8 or within 9 to 12, then the patient is
considered to be severely and moderately injured respectively (Belchev et al. 2017). On the
other hand scoring more than 12 up to 15 considered to be optimum consciousness. Further,
to understand the brain injury and other aspects associated with this health complication, the
patient should undergo CT scan of his left side of head, as well as MRI should be conducted
to understand the internal injury related chances after he met the accident. These would be the
means to collect cues from the patient condition and patient assessment so that the patient
could overcome the critical risk of concussion.
Processing the information
One of the primary risk that could be identified from the patient’s health condition, is
the increased risk of concussion due to which the patient developed the risk of critical health
condition (Selci et al. 2015). As per McLeod, Frase and Johnson (2017) concussion is the
health complication that includes several post traumatic complication such as headache, post
traumatic vertigo, accumulation of multiple brain injuries, and others. Further, due to
increased risk of post traumatic injury the patient develops complications in mobility, speech
and balance and all of these were observed in the case of Mr. Wells (Rague 2017). The
patient also developed dizziness which is one of the primary signs of post traumatic condition
after concussion. It was seen that the patient developed dizziness and light headedness due to
which they developed aspects associated with increased blood pressure or complications in

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their vision (McLeod, Frase and Johnson 2017). Further, other than slightly increased blood
pressure and a pain score of 4/10, the patient did not develop any critical condition, that
should be used to determine the complications of his health condition. Therefore, application
of GCS becomes the most important aspect to understand the presence of any complication
that he developed due to his moderate accident. If the GCS score of the patient remains less
than 8 then multiple brain damage diagnostic aspects such as CT scan and MRI assessment
would be conducted so that the presence of any severe brain injury could be effectively
identified (Zhang et al. 2017). Hence, as per Reith et al. (2016), these are the assessment and
diagnosis methods that would be used for the analysis of the health complication associated
complication of the patient.
Conclusion
While concluding this paper, the discussion should be refocused upon the priority
based nursing and its importance in the healthcare processes. Priority based nursing helps the
professionals to arrange the health complication of the patients effectively so that they could
understand the effectiveness of it. This paper discusses about the case study of John Wells
and his health complications that arises after his mild accident on a particular day. Further,
through the application of critical reasoning cycle, the health complication of patients were
assessed, cues were collected and depending upon those cues, the patient were provided with
diagnostic processes so that the patent could be provided with accurate interventions for his
health complications.

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References
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