This report presents a clinical reasoning assessment of Mr. Cyril Smith, a 72-year-old patient admitted for bowel cancer surgery. The assessment includes a review of his medical history, current observations, and an analysis of relevant cues and information. Key issues identified include dehydration, potential hyperglycaemia, and elevated respiratory and pulse rates, possibly exacerbated by stress and recent personal losses. The report also addresses critical thinking questions related to safe medication practices, the importance of therapeutic communication in person-centered care, and reflections on the learning experience, emphasizing the importance of family involvement and behavioural therapy in managing elderly patients' conditions. The student nurse outlines future actions to monitor vitals, administer fluid challenges, and notify the doctor of any concerns.