Nursing Assignment: Application of Clinical Reasoning Cycle

This nursing assignment discusses the application of the clinical reasoning cycle in the critical health condition of a patient. It identifies nursing priorities and interventions for the patient's health improvement.

Running head: NURSING ASSIGNMENT
NURSING ASSIGNMENT (APPLICATION OF CLINICAL REASONING CYCLE)
Name of the student
Name of the university
Author note

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Introduction
Application of clinical reasoning cycle in the critical health condition of patients helps
the nursing professionals to understand the priority of patient’s concerns that should be treated in
the care process (Dalton, Gee & Levett-Jones, 2015). In this aspect collaboration with
multidisciplinary teams helps to provide a holistic aspect to the care process. This paper
discusses about one such clinical scenario of Marcel Lever, a 70 year old farmer suffering from
obesity and hypoglycemic condition. Hence, by identifying two nursing priorities, interventions
would be applied.
Identification of nursing priorities
In the provided case study of Marcel Lever (70) is suffering from extreme obesity as he
weighs 116 kg with 180.5 cm height. As peer the case study the patient is at higher risk of
diabetes as with increased risk factors supported with obesity and past healthcare history of
hypertension, his family history includes both type 1 and type 2 disorder. He feels fatigue and
weak and as per American Diabetes Association (2016) these are the signs of extreme obesity
and associated higher risk of diabetes condition, due to which the patient may suffer from critical
health conditions. Identification of these was important because as per Levett- Jones clinical
reasoning cycle, detailed observation and assessment of their health condition helps the nursing
professionals to understand the healthcare cues addressing which could provide the patient with
effective relief. Therefore, in this case, Marcel’s detailed observation would lead to identification
of two nursing priorities for his health improvement.
The first priority that could be identified after detailed analysis of the patient’s health
condition would be his obesity and associated diabetes condition and increased hypoglycemic

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condition. As per the case scenario of Marcel, he suffers from hypoglycemic condition due to
which his blood glucose level is higher. Further, it was also noted that his overweight condition
increased his body’s ability to acquire diabetes. In this condition it should be mentioned that as
per American Diabetes Association (2016), patients who are suffering from diabetes are
generally associated with improper diet and hence, their blood glucose levels are found high.
Further, as per the case study, Marcel was retired from his job and was leading sedentary
lifestyle due to which he lacked the physical activity level which should be maintained to prevent
the occurrence of diabetes as per Eaton and Eaton (2017). Hence, his less active lifestyle, his
inability to control his diet and blood glucose level was one of the crucial healthcare
complications due to which his health condition affected (Geiss et al., 2017). Therefore, this high
blood glucose management would be the first priority as per the Levett- Jones clinical reasoning
cycle for Mr. Marcel.
It was seen that the patient was able to understand the urgency of his health condition, but
due to the lack of health literacy, he was unable to implement strategies provided for his weight
management and blood glucose levels (Heijmans et al., 2015). Further, the numerous types of
drugs provided to him for his health improvement was poorly managed by the patient and hence,
it required complete detailed assessment. As per Palumbo (2016), lack of healthcare literacy is
one of the crucial healthcare complication due to which patients are unable to stick to their
lifestyle and medication strategy provided by the healthcare professionals and hence, it should be
targeted in the health condition of Mr. Marcel as well. This would help him to understand the
importance of his medications and he would be able to implement strategies so that medication
could be precisely administered (Nouri & Rudd, 2015).

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Intervention and evaluation
As per the Levett- Jones clinical reasoning cycle, the first intervention that should be
applied in the healthcare for Mr. Marcel would be application of diet and nutrition management
strategy with increased physical activity so that patient could be provided with all the aspects to
decrease his weight and increased blood glucose of level. As per American Diabetes Association
(2016), in the patients affected with obesity and increased blood sugar, could lead to severe
health complication. Therefore, application of diet restrictions by omitting the carbohydrate and
sugar from the diet as well as physical activity with low to moderate physical exercise would
help the patient by decreasing blood glucose level (Mariam et al., 2017). The intervention would
be applied by dieticians, nutritionists, and physiotherapists for 4 weeks. The second intervention
for second intervention would be educational sessions for medication administration and detailed
medication schedule and the intervention would be provided for 4 weeks so that patient could
understand the importance of these and apply them in the care process (American Diabetes
Association, 2016). The evaluation would be done by assessing the health improvement of
patient by assessing the blood glucose level, reduction of weight and increased ability to
administer medication prior and after the application of intervention.
Conclusion
In the conclusion, it could be said that the paper effectively used Levett- Jones clinical
reasoning cycle for the identification of healthcare cues, connect them and determine nursing
priorities so that effective interventions could be applied and healthcare improvement for the
patient could be observed. Similar situation could be observed in this above-mentioned

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discussion where application of Levett- Jones clinical reasoning cycle was done for Mr. Marcel
for his health improvement.

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References
American Diabetes Association. (2016). Standards of medical care in diabetes—2016 abridged
for primary care providers. Clinical diabetes: a publication of the American Diabetes
Association, 34(1), 3. DOI: https://dx.doi.org/10.2337%2Fdiaclin.34.1.3
Dalton, L., Gee, T., & Levett-Jones, T. (2015). Using clinical reasoning and simulation-based
education to'flip'the Enrolled Nurse curriculum. Australian Journal of Advanced Nursing,
The, 33(2), 29. Retrieved from:
https://search.informit.com.au/documentSummary;dn=018184224173600;res=IELHEA
Eaton, S. B., & Eaton, S. B. (2017). Physical inactivity, obesity, and type 2 diabetes: an
evolutionary perspective. Research quarterly for exercise and sport, 88(1), 1-8. DOI:
https://doi.org/10.1080/02701367.2016.1268519
Geiss, L. S., Kirtland, K., Lin, J., Shrestha, S., Thompson, T., Albright, A., & Gregg, E. W.
(2017). Changes in diagnosed diabetes, obesity, and physical inactivity prevalence in US
counties, 2004-2012. PloS one, 12(3), e0173428. DOI:
https://doi.org/10.1371/journal.pone.0173428
Heijmans, M., Waverijn, G., Rademakers, J., van der Vaart, R., & Rijken, M. (2015). Functional,
communicative and critical health literacy of chronic disease patients and their
importance for self-management. Patient Education and Counseling, 98(1), 41-48. DOI:
https://doi.org/10.1016/j.pec.2014.10.006
Mariam, T. G., Alemayehu, A., Tesfaye, E., Mequannt, W., Temesgen, K., Yetwale, F., &
Limenih, M. A. (2017). Prevalence of diabetic foot ulcer and associated factors among

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adult diabetic patients who attend the diabetic follow-up clinic at the university of gondar
referral hospital, North West Ethiopia, 2016: Institutional-based cross-sectional
study. Journal of diabetes research, 2017. DOI: https://doi.org/10.1155/2017/2879249
Nouri, S. S., & Rudd, R. E. (2015). Health literacy in the “oral exchange”: An important element
of patient–provider communication. Patient education and counseling, 98(5), 565-571.
DOI: https://doi.org/10.1016/j.pec.2014.12.002
Palumbo, R. (2016). Designing health-literate health care organization: A literature
review. Health Services Management Research, 29(3), 79-87. DOI:
https://doi.org/10.1177%2F0951484816639741