Clinical Reasoning: Acute Care Nursing Case Study Analysis

This case study provides an analysis of acute care nursing through the application of the clinical reasoning cycle, focusing on an 83-year-old male patient, John Lee, with a history of hypertension and dysphagia following a cerebral vascular accident. The report details the eight phases of the clinical reasoning cycle, including consideration of patient facts, information collection, processing gathered information, problem identification, goal establishment, action implementation, evaluation, and reflection. It outlines specific interventions and medications used to manage John Lee's conditions, such as Botulinum toxin type A for dysphagia and various drugs for hypertension, and emphasizes the importance of continuous evaluation and reflection in improving patient outcomes. The study concludes that the clinical reasoning cycle is essential for investigating health issues, symptoms, and medical history, ultimately supporting patient care in complex health situations. Desklib is a platform where students can find similar resources and study tools.

ACUTE CARE
NURSING

Table of Contents
INTRODUCTION...........................................................................................................................1
MAIN BODY...................................................................................................................................1
CONCLUSION................................................................................................................................4
REFERENCES................................................................................................................................5

INTRODUCTION
Acute care nursing is defined as the highly skilled and trained nurses which help to provide the
care which is critically focus on the ill patient within an acute care or the hospital setting. The
acute care usually involves with the context of patient who is usually experience the severe
illness or the trauma which is require for the pre and post-operative care that is based on the
urgent medical condition (Choi, Jeffers, and Logsdon, 2020). The acute care is level that health
care in which is based on the term of patient which is related with the brief but the severe episode
that is related with the illness for condition that are used to focus on the disease and trauma and
during the aspect of surgery. In addition, the report usually configures the case study which is
essential for the providing nursing care and support with the help of clinical reasoning cycle
which help to generate the aspect which provide proper for the nursing case when they are
associated with the case study (Cole and et. al., 2019).
MAIN BODY
The clinical reasoning cycle is defined as the process which is used by nurses and other
healthcare professional in order to collect the cues, process the information, arrive at the level of
understanding which is related with the patient or the situation and plan and implement that
associated with the intervention that evaluate the outcome and reflect on and learn from the
process which is measurable with the approach of John Lee who require nursing care for their
health issue. The case study is usually focus on the John Lee who is 83-year-old male which is
showing the emergency need from the department from the aged care facility. The John is
usually retired horticulturist with the extreme history of hypertension, dysphagia which is may be
follow to the cerebral vascular accident 12 months ago. These all factor are usually taking under
the consideration of case study that is related with the John Lee. In addition, the clinical
reasoning cycle play vital role in order to develop the quality of health with term of care and
support. The clinical reasoning cycle is usually divided into the various phases which is may be
associated with the different process which is conducted in order to retain the information of
client or patient and plan the effective therapeutic approach which may contributed for the
improvement of health condition (Donesky, Sprague, and Joseph, 2020).
The eight phase of the clinical reasoning are well structure and they provide proper aspect to
plan effective intervention with term of care and support. The various phases of clinical
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reasoning cycle are including with the connection of John Lee issue are presented (Tebbett-Mock
and et. al., 2020). Such as,
Consideration of fact from the patient or situation: In the context to the case study which is
related with the John Lee are focus on the chronic condition which is happen with the
unconditional aspect which is ageing. In such ages, the number of people are used to face the
issue of various complex disease. With context to case study, the analysis and evaluation well-
presented that the John Lee has issue with the blood pressure from the previous of years which
may lead to cause the issue of hypertension and also facing the risk of dysphagia. The issue of
dysphagia is related with the difficulties in swallowing of the food and taking more time and
efforts in order to move the food or liquid into the stomach. Therefore, the dysphagia that is very
painful. In addition, there are some of the cases which help to swallow is impossible. The major
symptoms of the dysphagia are usually arising with the aging or sometime they are associated
with the various condition such as some condition which affect the nervous system, head injury
which is analysed with the respect to John Lee who face the accident 2 month ago with the
cerebral vascular. These are the condition which may associated with the John Lee as the first
approach of clinical reasoning cycle (Grossman and et. al., 2018).
Collection of information: With the help of this phase, the past medical history of the
patient is introducing and done proper investigation with the help of pathophysiology and clinical
feature which impact the John Lee in the wider ways. The analysis of the case study with aspect
to case study, John is alert with the lethargy that slight audible and show the wheeze heard at the
bedside and an anterior chest auscultation of the right lung which is taken under the analysis
which may play vital sign for the chronic condition. The past history of the John is usually
related with the hypertension which is showing the gradually increase in the blood pressure
which may impact the anatomy of the John regards with the complication which may prior for
the understanding of past medical condition (Klancnik Gruden, Turk, McCormack, and Stiglic,
2021).
Processing gathered information: This is defined as the critical stage and the core aspect of
clinical reasoning which is related with the impact of the hypertension and dysphagia which
enhance the factor or approach which may affect the health of John Lee. Therefore, enhance
blood pressure with context to the pathological condition, where the wall of mouth become
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swallow and show the behaviour of inflammation that impact the health of John in taking food
and liquid.
Identification of problem: The patient current state is usually focus on the context of case
study of John Lee where he used to face the issue of hypertension and dysphagia which
interrupted the health. Therefore, as per the collected information or cues the entry of the air in
the right lung are reduced which may arise the symptoms of respiratory distress that show the
sign of shortness of breath within the John that create consequence on the presented state of
condition (McKinnell and et. al., 2019).
Establish goals: In addition, John Lee face issue with the shortness of breath and also suffer
from the condition of dysphagia. The major goals which is analysed with the situation of John is
provide proper support and care with the term and condition that is productive in order to provide
relief to the patient. The goals are to provide liquid supplement with the help of tube which is
directly inserted within the mouth which provide proper liquid intake and reduce the effect of
dysphagia on John. Therefore, the medication and their regimen are used to provide for the
patient that is helpful and reduce the complexity of John Lee (Sloane, Zimmerman, and Nace,
2020).
Take actions: The major action which is taken for the situation of John Lee is to provide
primary drug and medication that improve the health condition. The recommended and suggested
drug which is prescribed by the healthcare professional in order to reduce the complication and
consequences. The proper action has been taken in order to analyse the in depth analysis which is
provide proper support to cure the disease. The medication which is recommended for the
dysphagia are Botulinum toxin type A which is also called as BoNT-A that injected
endoscopically into the gastroesophageal sphincter and upper oesophagus in order to minimise
the tone which can be useful for the cricopharyngeal spasm which are usually cause the issue of
dysphagia. In addition, the other medication which is prescribed for the dysphagia are
corticosteroid, antacid and proton pump inhibitor. For the condition of hypertension, the diuretic,
calcium channel blocker, angiotensin inhibitor and many more drug are well prescribed with the
compatibility of other drug that does not show any type of drug-drug interaction (Nibbelink, and
Reed, 2019).
Evaluation: The evaluation is usually focus on the course of action which is suggested in
order to provide the proper outcome by initiating the medication process that is providing proper
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drug and medication and analyse the effect on the John. With contrast to the above listed drug
show proper action potential that help to develop the therapeutic. The John condition usually
taken a step and make the factor which is about under control for the complexities and
complication that is probably focus on John comfortability. In addition, the proper health
outcome is achieved when the proper medication is used to prescribed for the complication that
render the health of John (Rushton, and Edvardsson, 2018).
Reflection: While providing proper health to the John seek to provide the knowledge regard
with the clinical aspect and feature which is related with the pathophysiology. It helps to
generate supportive aspect which is related with condition that analyse within the case study
(Sitammagari and et. al., 2021).
CONCLUSION
As per the above discussion, it is well analysed that the clinical reasoning cycle is helpful in
order to investigate the information which is related with the case study regard with the health
issue, sign and symptoms, causes and risk factor, past medical history and implement objective
for the proper action plan that support the patient in health complexities.
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REFERENCES
Books and Journals
Choi, K.R., Jeffers, K.S. and Logsdon, M.C., 2020. Nursing and the novel coronavirus: Risks
and responsibilities in a global outbreak. Journal of advanced nursing.
Cole, D.A., Bersick, E., Skarbek, A., Cummins, K., Dugan, K. and Grantoza, R., 2019. The
courage to speak out: A study describing nurses' attitudes to report unsafe practices in
patient care. Journal of nursing management, 27(6), pp.1176-1181.
Donesky, D., Sprague, E. and Joseph, D., 2020. A new perspective on spiritual care:
Collaborative chaplaincy and nursing practice. Advances in Nursing Science, 43(2),
pp.147-158.
Grossman, L.V., Choi, S.W., Collins, S., Dykes, P.C., O’Leary, K.J., Rizer, M., Strong, P., Yen,
P.Y. and Vawdrey, D.K., 2018. Implementation of acute care patient portals:
recommendations on utility and use from six early adopters. Journal of the American
Medical Informatics Association, 25(4), pp.370-379.
Klancnik Gruden, M., Turk, E., McCormack, B. and Stiglic, G., 2021. Impact of person-centered
interventions on patient outcomes in acute care settings: a systematic review. Journal of
Nursing Care Quality, 36(1), pp.E14-E21.
McKinnell, J.A., Singh, R.D., Miller, L.G., Kleinman, K., Gussin, G., He, J., Saavedra, R.,
Dutciuc, T.D., Estevez, M., Chang, J. and Heim, L., 2019. The SHIELD Orange County
Project: multidrug-resistant organism prevalence in 21 nursing homes and long-term
acute care facilities in southern California. Clinical Infectious Diseases, 69(9), pp.1566-
1573.
Nibbelink, C.W. and Reed, P.G., 2019. Deriving the Practice-Primed Decision Model from a
naturalistic decision-making perspective for acute care nursing research. Applied Nursing
Research, 46, pp.20-23.
Rushton, C. and Edvardsson, D., 2018. Reconciling conceptualizations of ethical conduct and
person‐centred care of older people with cognitive impairment in acute care
settings. Nursing Philosophy, 19(2), p.e12190.
Sitammagari, K., Murphy, S., Kowalkowski, M., Chou, S.H., Sullivan, M., Taylor, S., Kearns, J.,
Batchelor, T., Rivet, C., Hole, C. and Hinson, T., 2021. Insights from rapid deployment
of a “virtual hospital” as standard care during the COVID-19 pandemic. Annals of
internal medicine, 174(2), pp.192-199.
Sloane, P.D., Zimmerman, S. and Nace, D.A., 2020. Progress and challenges in the management
of nursing home infections. Journal of the American Medical Directors
Association, 21(1), pp.1-4.
Tebbett-Mock, A.A., Saito, E., McGee, M., Woloszyn, P. and Venuti, M., 2020. Efficacy of
dialectical behavior therapy versus treatment as usual for acute-care inpatient
adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 59(1),
pp.149-156.
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