Nursing Assignment: Clinical Reasoning Cycle and Nursing Priorities

This nursing assignment discusses the implication of the clinical reasoning cycle in the case of a patient suffering from a critical health condition. It highlights the identification of nursing priorities and the interventions applied to improve the patient's health condition.

Running head: NURSING ASSIGNMENT
NURSING ASSIGNMENT
Name of the Student:
Name of the University:
Author note:

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Introduction:
The implication of clinical reasoning cycle in the case of patient’s suffering from a
critical health condition assists the healthcare provider to understand the complexity of
patient’s health condition and their concern thus highlighting the priority of treatment in the
care plan (Welbourn et al., 2016). In order to provide complete care to the patient, the
association of multidisciplinary team is must. This paper highlights a case study of Marcel,
70 year old man who was suffering from hypoglycaemia and obesity. The two major nursing
priority is identified and accordingly intervention will be applied.
Identification of nursing priority:
The nursing priority was identified from the case study of a 70 year old man named
Marcel Lever, who is suffering from obesity as Marcel weighs 116 kg with a height of 180.5
cm. According to the case study Marcel was at high risk of uncontrollable diabetes due to an
amplified risk factor associated with obesity. He also had a past family history of diabetes
type 1 and type 2 and hypertension. He feels week and fatigue and according to American
Diabetes Association (2016) the above symptoms were due to extreme obesity and abnormal
diabetic condition because of which the patient might suffer from serious health conditions.
According to Levett- Jones clinical reasoning cycle, the identification of the above symptoms
was required as detailed assessment and observation of the patient will help the doctor and
nursing professionals to recognize the health condition and effectively provide treatment and
diagnosis to treat the patient as early as possible (American Diabetes Management, 2017).
Hence, the two nursing priority was identified to improve the health condition of Marcel.
Detail health analysis was conducted for Marcel to identify the first nursing priority.
After analysis the nursing priority identified was his diabetic (Hypoglycaemic condition) and
obesity. From the case study it was evident that Marcel was suffering from hypoglycaemic

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condition that resulted in higher blood glucose level in the patient. It was also distinguished
that his increased diabetic condition was rising due to obesity and according to American
Diabetes Association (2016), it was clearly stated that the diabetic patient are connected with
an inappropriate diet system that result in increased blood glucose level in such patients.
From the case study analysis it was noted that Marcel was a retired man who was leading a
normal inactive lifestyle that lacked any sort of physical activity required to effectively
prevent or maintain the incidence of diabetes (Little et al., 2016). Marcel’s bad health
condition was majorly due to his inactive lifestyle, increased blood glucose level and his
incapability of maintaining a healthy diet. These factors were responsible for increasing
health complications in Marcel, hence blood glucose management is the first identified
nursing priority for Marcel to maintain his blood glucose level according to the clinical
reasoning cycle.
It was noted from the case study that Marcel could understand his health urgency but
he was not educated to understand his health literacy and hence was not able to implement
any effective strategy to maintain his blood glucose level and obesity. From his critical health
condition it was evident that he required extensive knowledge of weight management and
diabetes management (Care 2018). In order to improve his health condition different types of
drugs were delivered to him that was poorly managed by Marcel due to his lack of literacy.
Lack of literacy is considered as one of the most important healthcare complication because
of which the patient is unable to lead a healthy lifestyle with medication strategy by the
health care professionals. Hence it was a major complication faced by Marcel in the provided
case study with a target to help marcel with effective medication and life style strategy that
will assist him to understand and recognize the importance of medicines so that he can easily
implement provided medication strategy to overcome for his bad health condition (Dietz et
al., 2015).

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Intervention and Evaluation:
According to clinical reasoning cycle, the primary or first nursing intervention applied
in the healthcare management for marcel will be nutrition and diet management strategy
accompanied with improved physical activity that will help marcel to increase and improve
his blood glucose level and also decrease his obesity condition (Mogre et al., 2015). The
patient suffering from chronic diabetes and obesity are at higher risk of health complication
hence, effective nutritional diet devoid of sugar and carbohydrates will help Marcel to
improve his blood glucose level accompanied by adequate physical activity and exercise to
maintain the health complication. The above intervention will be applied by the
physiotherapist, nutritionist and dieticians for a particular time period. The second
intervention applied for the patient is medication management that will involve educational
sessions to teach the patient on blood glucose monitoring and how he can test his BGL before
and after meal and further explaining him the necessity to continuously self-monitor his
blood glucose level. This intervention strategies will help the patient to understand the
significance of medicines and motivating him to consume his medicine on time to reduce his
health complication (Puhl et al., 2016). The addition of insulin was very much required for
marcel like Lantus 10 to maintain his BGL level accompanied with metformin as prescribed
by the healthcare professional. Hence, the professional must educate him with the advantages
of the above medicine for controlling his diabetic level. The evaluation of Marcel health
condition will be assessed on the basis of his improvement by monitoring his blood glucose
level, reduction in weight and enhanced ability to administer his medication before and after
the intervention application.
Conclusion:

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It can be concluded that the study effectively used clinical reasoning cycle in order to
identify the symptoms of Marcel’s health condition and use them to further determine the
nursing priorities that would help the healthcare professionals to develop an effective nursing
intervention to improve the health condition based on his nursing priorities.

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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: 10.2337/diaclin.34.1.3
American Diabetes Association. (2017). 4. Lifestyle management. Diabetes Care,
40(Supplement 1), S33-S43. https://doi.org/10.2337/dc17-S007
CARE, I. (2018). Standards of Medical Care in Diabetes—2018 Abridged for Primary Care
Providers. https://doi.org/10.2337/cd17-0119
Dietz, W. H., Baur, L. A., Hall, K., Puhl, R. M., Taveras, E. M., Uauy, R., & Kopelman, P.
(2015). Management of obesity: improvement of health-care training and systems for
prevention and care. The Lancet, 385(9986), 2521-2533.
https://doi.org/10.1016/S0140-6736(14)61748-7
Little, P., Stuart, B., Hobbs, F. R., Kelly, J., Smith, E. R., Bradbury, K. J., ... & Margetts, B.
M. (2016). An internet-based intervention with brief nurse support to manage obesity
in primary care (POWeR+): a pragmatic, parallel-group, randomised controlled trial.
The Lancet Diabetes & Endocrinology, 4(10), 821-828.
https://doi.org/10.1016/S2213-8587(16)30099-7
Mogre, V., Ansah, G. A., Marfo, D. N., & Garti, H. A. (2015). Assessing nurses’ knowledge
levels in the nutritional management of diabetes. International Journal of Africa
Nursing Sciences, 3, 40-43. https://doi.org/10.1016/j.ijans.2015.07.003
Puhl, R. M., Phelan, S. M., Nadglowski, J., & Kyle, T. K. (2016). Overcoming weight bias in
the management of patients with diabetes and obesity. Clinical Diabetes, 34(1), 44-
50. https://doi.org/10.2337/diaclin.34.1.44
Welbourn, R., Dixon, J., Barth, J. H., Finer, N., Hughes, C. A., Le Roux, C. W., & Wass, J.
(2016). NICE-accredited commissioning guidance for weight assessment and

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management clinics: a model for a specialist multidisciplinary team approach for
people with severe obesity. Obesity surgery, 26(3), 649-659. DOI:
https://doi.org/10.1007/s11695-015-2041-8