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Nursing Priorities using Clinical Reasoning Model

   

Added on  2020-03-07

11 Pages2961 Words98 Views
Nursing priorities using clinical reasoning model 1Nursing priorities using clinical reasoning modelStudent's Name:Instructor's Name:Date:

Nursing priorities using clinical reasoning model 2Nursing priorities using clinical reasoning modelIntroduction:Nursing is a profession that involves a considerable amount of responsibility and proactiveprovision of care. Nurses play a vital role in the intervention and training provided to patientsand their families (Hunter, 2016). Nurses provide the necessary information about the case,the diagnosis, and the ongoing treatment procedure to the patients and their carers (Hunter,2016). They play the role of bridging the gap between the physicians and the patients(Levett-Jones, 2013). In cases of patients with terminal illnesses that limit the activities ofdaily life of the patient, the nurse plays a major role in the establishment of the specificproblems of the patient and identifying the priorities that need to be addressed whilst caringfor that patient (Levett-Jones, 2013). The current essay primarily aims to identify thepriorities in nursing care with respect to a specific case study of a patient with Parkinson’sdisease (Levett-Jones, 2013). The essay follows the pattern of logical reasoning in nursing toidentify the specific problems and considerations of the patient and proceeds to identify thepriorities of nursing care (Hunter, 2016). The current essay establishes the need for thepatient to be aware of his treatment protocol and the role the nurse plays in enabling thepatient to perform their activities of daily life and work around the problems and limitationscaused by the disease (DeMaagd & Philip, 2015).The following essay uses the approach suggested by the Miller’s theory of functionalconsequences (Hunter, 2016). It essentially provides a framework for the appropriate methodfor the promotion of wellness in older adults in nursing methods (McMahon & Fleury, 2012).It is important for caring nurses to identify the potential of an individual to overcome thedisease limitations and to utilize various diagnoses in nursing care (Levett-Jones, 2013). Thishelps to provide the dignity of the elderly patient (Hunter, 2016). Dignity and integrity are

Nursing priorities using clinical reasoning model 3critical considerations for patients with limiting chronic illnesses such as Parkinson’s,Alzheimer’s, or dementia (Hunter, 2016). Miller’s theory urges nurses working with geriatricpatients to adapt a holistic approach in treatment. They need to functionwith inter-relatedfunctionality of spirit, thoughts, and mind whilst handling older adults (Levett-Jones, 2013).The current essay follows the critical thinking model of reasoning in nursing education(Levett-Jones, 2013).Part A1.Considerations for the patient:The present essay discusses the case of Mr. Ratin Bhai, an 87-year-old immigrantfrom India, diagnosed with Parkinson’s disease. He has a history of hypothyroidismthat has been controlled by continuous medication. Ratin Bhai is a widower and hashis brother’s family for support when required. However, Ratin expresses a strongdesire to be independent and refrain from involving his brother’s family and burdenthem with the care procedure. Therefore, the primary considerations for Ratin are hisindependence and treatment for his motor and non-motor functions (Levett-Jones,2013). In the case of Ratin, the Miller’s theory becomes functional whilst protectinghis dignity in terms of providing him basic support for overcoming the limitationscaused by Parkinsonism (Levett-Jones, 2013). Since he is particular that he must notbe a burden to others, it is crucial for the nurse to enable him to perform his activitiesof daily life. Mr. Ratin reports difficulty in making coffee or cooking due to tremorscaused by Parkinson’s disease. 2.Collection of information and cues from patient history and presentations:Mr. Ratin has slight tremors in both his hands. The primary reason for this is theeffects of Parkinson’s disease on the motor functionality of the central nervous system

Nursing priorities using clinical reasoning model 4(DeMaagd & Philip, 2015). Parkinson’s disease has been initially described as“shaking palsy” by Dr. James Parkinson (Levett-Jones, 2013). It is characterised as achronic condition with progressive degeneration of neurological functionality(DeMaagd & Philip, 2015). Mr. Ratin experiences difficulties in making coffee,cooking, and doing up his buttons. He has a history of hypothyroidism and has beentaking constant medication and had been controlled (Amore, James, & Mitchell,2012). His history of medication includes thyroxine for hypothyroidism (100 mg perday). He also takes levodopa/carbidopa/entacapone formulation as medication forParkinson’s disease. The patient needs to be supervised for the timely intake ofmedication due to slight fatigue and forgetfulness common in Parkinsonism. 3.Analysis and processing of the obtained information:The patient has been on a constant medication of thyroxine at 100 mg per day forseveral years as part of the treatment for hypothyroidism. However, levothyroxine forhypothyroidism has several implications and side-effects in health of the elderly (El-Gilany & Abusaad, 2013). Levothyroxine has a half-life of approximately 7 dayswhen the dosage is taken on an everyday basis (Mann, 2012). In older adults,especially with chronic ailments such as dementia or Parkinson’s, the requirements ofdaily dosage of levothyroxine decreases heavily (El-Gilany & Abusaad, 2013). Thedegradation of the drug levothyroxine is reduced in the elderly, due to which thedosage needs to reduce with the progress of age. In the elderly, high dosages oflevothyroxine may result in the occurrence of myocardial infarction and may evencause angina or cardiovascular complications (El-Gilany & Abusaad, 2013).Levothyroxine has negative interactions with several factors such as dietarysupplements of iron, cholestyramine, calcium, and aluminium (Mahmoud, 2012).

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