The Science of Nursing: Decision Making

The Science of Nursing
Decision Making

Contents
INTRODUCTION...........................................................................................................................1
MAIN BODY..................................................................................................................................1
Identify a patient’s need (health problem) and assess it holistically from the biological,
psychological and social aspects.................................................................................................2
Identify the recommendations that would be appropriate to introduce to the patient’s care plan
.....................................................................................................................................................5
CONCLUSION................................................................................................................................6
REFERENCES................................................................................................................................7
APPENDIX......................................................................................................................................8

INTRODUCTION
Mr Murphy is seen by the intermediate care team at home complaining of worsening
breathing difficulties over the last few days. Patient has a history of chronic obstructive
pulmonary disease and is suffering from upper respiratory infection from past two weeks. He has
not consulted any health care professional so far. Patient is married and he has 2 children.
The present Assessment will discuss as well as critique the decision making processes that are
required for delivering care to the chosen case of Mr. Murphy. Present report will lay focus on a
patient’s need (health problem) and the report will assess it holistically from the biological,
psychological and social aspect. Lastly, recommendations appropriate to the patient’s care plan
will be identified. Critiquing and evaluation of care is significant for care delivery as both these
processes lead to improvement in the quality of care being delivered to the patient. Further,
critique of care delivery is essential for informing the decision making process. Moreover,
evaluation of care is important as with it there can be development of a deeper understanding
regarding improvement in care plan (Oliver, and et.al., 2018). According to Fitzsimmons and et.
al., (2016) evaluation of care can directly help healthcare professionals in gaining understanding
of health problems from which patient is suffering and it helps them in understanding type of
care that they should provide to patient and develop an effective plan of care for patient. Health
problem chosen for the patient is worsening breathing difficulties after suffering from upper
respiratory infection from past two weeks.
MAIN BODY
The Biopsychosocial model assists in understanding interactions among biological and
psychosocial components of illnesses that can further help professionals in bringing
improvement between dyadic relationship of patient, clinicians, and other multidisciplinary team
members involved in patient care which is eventually helpful in gaining proper understanding of
a person’s medical condition (Kusnanto, Agustian and Hilmanto, 2018). This model explains that
there are various physical, social and biological factors that can affect an individual health
condition. All these factors needs to be taken into consideration when taking care of patient.
Biological factors are associated with physiological pathology. Further, psycho factors include
the emotions, thought and behaviours that can be used for understanding the medical condition
of the patient (Wade and Halligan, 2017). Moreover, social factors consist of cultural, socio-
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economical and socio- environmental factors. In this, family circumstances and work issues can
be considered for understanding a patient’s condition.
Identify a patient’s need (health problem) and assess it holistically from the biological,
psychological and social aspects.
From the case study it has been identified the Mr. Murphy is facing health problem of
breathing difficulty. He has a long-standing history of emphysema which is popularly known as
COPD. Patient has been involved in smoking cigars sometimes, even after suffering from the
respiratory disease. Mr. Murphy weighs 76 kg. Patient’s mother was suffering from COPD
which means he has family history of COPD. Service user was consuming
Glycopyronium/indacaterol inhaler, 1 puff daily. Pathophysiology refers to process which is
associated with particular disease. it helps to understand how organ function and disease related
to it (Thabet, and et.al., 2017). For this health care professionals and nurse needs to be involved
in analysing patients’ needs so that health and well being of patient can be improved (Melin‐
Johansson, Palmqvist and Rönnberg, 2017). The initial observation of patient was Respiratory
rate (RR) 36 breaths per unit. Respiratory rate of a normal adult is between 12 to 20 breaths per
minutes (Oliver, and et.al., 2018). This clearly helps in understanding that his respiratory rate
high if it is compared to normal respiratory rate rate. But this does not help in explaining that Mr
Murphy is suffering from respiratory disease but this high RR rate is due to the respiratory
infection. The heart rate of patient has been measured at 100 BPM, and the blood pressure
measured is 100/64 mmHG. An adult has an ideal blood pressure between 90/60 mmHg and
120/80 mmHg and heart rate between 60 and 100 bpm while at rest (Wade and Halligan, 2017).
This shows that heart rate and blood pressure of Mr Murphy are normal. Patient’s Cardiac rate is
faster than usual heart rhythm. This faster rhythm is known as sinus tachycardia. It is an alert and
healthcare professional need to focus upon it. They should find out what disease Murphy is
suffering from by doing various tests. Pupils equal and reacting to light, Temp 37.5 C. There are
various screening and test done for patient such as CT scan, X ray, etc. Patient has been
transferred to acute trust and he has been admitted to respiratory ward. He had sputum sent for
microscopy and culture, blood taken for full blood count, urea and electrolytes. Patient now has
on a venti-mask 2L (24%).
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