Clinical Reasoning for Mrs. Roseanne Chivers' Patient Situation

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Name of the student
University Name
Author’s note

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Consider the patient situation
The case study is about Mrs Roseanne Chivers who has visited a sea side swimming pool
for the first time and it was her first even ocean swim pool. The temperature is 35degree C, pule
rate is 102 beats per minute, respiratory rate (RR) – 24 breaths per minute and blood pressure
150/84 mm Hg. According to her past medical records, her blood pressure is found to be 124/80
and 128/82 on consecutive days. This paper will draw a clinical reasoning over the assessment
data of Roseanne’s situation and will analyze and interpret the cues, explaining the assessment
fundings in relation to this case.
Collect cues
Objective data
Temperature (tympanic) 35.0 C, Pulse rate 102 beats/min, Respiratory rate (RR) 24 breaths/min
Blood pressure (BP) 150/84 mmHg
- Subjective data
Mrs. Roseanne Chivers was shivering at times and her hands are very cold red and cold.
Process information
The pulse rate has been found to be a bit higher. This might have been caused as the
patient has come off the swimming pool. The heart rate generally increases after exercise. The
respiratory rate of the patients is 102 beats minutes, whereas the normal respiratory rate ranges
under 12-25 breaths in a minute. Often cold hands are the part of the body’s natural responses for
regulating the body temperature.. It is the known that it was Mrs. Chivers’ first time to an ocean

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pool, and her body might have not been able to acclimatize so quickly with the cold water. A
clinical symptoms called Raynaud’s attacks can be the cause of cold hands. This clinical
condition is usually triggered by the cod causing the lack of blood flow to the extremities. Some
people might have over sensitive blood vessels at the tip of the fingers and Raynaud’s attacks can
sometimes be painful. Women are more likely to get this disease. It is mainly caused by the
sympathetic activation of the autonomy nervous system, on exposure to cold but often emotions
causing the arteries to constrict and thus Primary Raynaud’s symptoms. Constriction of the small
arteries in the toes or the fingers is displayed in patches. The toes or the fingers might not hurt,
but numb and tingling sensation is common.
Prete et al., (2014) have related stress and smoking to be one of the important factors of
Reynaud’s disease. It is evident from the case study that the patient had lost her husband just six
months back, which might have been traumatic or stressful for the patient. According to the
studies Prete et al., (2014), about one-third of the vasospastic attack has been found to be
associated with tachycardia and increases stress. In contrast to this cold alone can provoke most
of the attacks of the Raynaud’s phenomenon. Again Raynaud’s disease can also be due to several
reasons like certain blood pressure, chemical s, migraine, medications, over the counter pain
medications (Hughes and Herrick 2016). Again, the vital signs few days back states that the
patient had been feverish, which might be the sudden exposure to cold water. High respiratory
rate can be linked with the fact that the heart has to work spontaneously in order to reach blood
in to the region of the body that has been suffering from hypoxemia (Wigley et al. 2014). The
pathogenesis of the Raynaud’s disease is yet to be discovered. Recent advancements are still to
be made to understand the therapeutics of the children.