Analyzing Joni's Case: Prioritizing Nursing Care Needs and Strategies

This presentation analyzes Joni's case study, focusing on the application of the Critical Reasoning Cycle (C.R.C.) to identify and prioritize nursing care needs. The presentation addresses the complexities of Joni's health, including type II diabetes, morbid obesity, depression, and smoking. The presentation highlights the importance of a holistic, person-centered approach to care, emphasizing the need for smoking cessation strategies and depression management. The analysis delves into the pathophysiology of Joni's complications, discussing their interconnections and impact on his daily life. The presentation proposes actionable goals, such as smoking cessation and depression management, and outlines interventions. The presentation also underscores the significance of collaboration with the multidisciplinary team to ensure the best possible outcomes for Joni's health and well-being, and references evidence-based literature to support the proposed care plan.

C.R.C.: Joni’s Case
Study

Introduction
• The purpose of this presentation is to use Critical Reasoning
Cycle to discuss the complications facing Joni and recommend
two health priorities to help solve Joni’s problems

Consider the patient, collect cues and
information
• The first stage in the clinical reasoning cycle (C.R.C.) is taking into account the situation of the
patient, which permits the Nurse to gain the first impression alongside the individual historicity.
• From the above scenario, Joni is likely to face difficulties with obesity because of his overweight.
• Ability to critically think is crucial in nursing practice because it makes sure that the individual
alongside clinical-care needs of a patient get achieved, and the care provision remains effective
and safe (Berman et al., 2015).
• Application of Levett-Jones (2013) C.R.C. shall help guide this essay in identifying, prioritizing,
clinically analyzing as well as justifying two complicated care preferences in the case of a 53-year-
old Joni who is currently living with an intricate a blend of chronic illness.
• It shall further adhere to the importance of collaborating alongside delivering holistic, family, and
person-centered care as a guide for care plans for Joni with chronic illness (Chang & Johnson, 2014).

Process information
• Analyzing the case of Joni, he has a complicated blend of acute
condition relating to type II diabetes mellitus alongside morbid
obesity, with various identified needs related to care, which includes
altered self-body-image, depression, altered-nutrition, social isolation,
smoking-status as well as rising difficulty performing daily living
activities (A.D.L.s).
• Reflecting as well as processing this info culminates in establishing
two complicated care priorities that need to be tackled by P.H.C. nurse.
Joni's smoking condition alongside depression.

Identify Issue (Patho)- Continued.
• The nurse will interview Joni regarding addiction to smoking, assess his
readiness to stop, and specific cessation efforts already employed in the
course of Joni's latest hospitalization.
• It might be presumed that Joni stood given particular nicotine patches or gum
(Metro South Health, 2018) concerning Tobacco and Other Smoking Products
Act 1998 ("Queensland Legislation-Queensland Government," 2018) that
prohibits people from smoking at every Queensland hospital and health facility.
• Joni's efforts as to what he could have attempted and the way it performed
remains crucial for his care-plan’s assessing and planning.

Establish Goals
• The goalmouth for Joni might be to entirely stop smoking, establish realistic alongside
achievable goals in the short-run.
• Firstly, educating Joni about the withdrawal symptoms he will experience, including cigarette
craving, depressed mood, surged appetite, frustration, irritability, anxiety, anger, restlessness,
and trouble sleeping will be imperative.
• Comprehending that such symptoms further affect Joni's depression negatively will be
necessary (Pan, Wang, Talaei, Hu & Wu, 2015).
• It remains more vital to fathom Joni’s unwillingness in cessation since smoking stoppage
remains linked to gaining weight.
• In cooperation with Joni, a nurse might effectively implement a Smoking Cessation Clinical
Pathway, with the Nicotine Replacement Therapy necessities (Metro South Health, 2018).

Take Actions
• To acquire additional info, the nurse might seek Joni's input, his G.P.'s as well as
multidisciplinary team which stood responsible for his care in the course of his
hospitalization.
• This will help clarify any current plans for treating his depression.
• Asking Joni regarding his medical as well as social history, his insight in the latest
depression diagnosis and comprehending his most recent hospitalization,
alongside any concerns he might be having about these, might assists in
prioritizing his care needs as well as permits Joni to feel engaged in his treatment
hence achieving desired relationship (therapeutic) (Berman et al., 2015).

Take Action- Continued.
• Upon the collection of such info, assumption alongside association is made between Joni's
complex blend of long-lasting conditions alongside the depression.
• Joni's sleep apnoea besides obesity ventilation syndrome might jointly influence patterns of
sleep featuring disturbance of sleep, disruption of mood alongside irritability, these all remain
contributory variables to depression of Joni (Yildiz et al., 2016, and Rezaeitalab et al., 2014).
• Joni's ineffectively managed diabetes remains a further contributory variable since Joni’s sleep
apnoea alongside obesity ventilation syndrome trigger disturbance of sleep, culminating in Joni's
fatigue feeling alongside the absence of concentration, leading Joni to poor eating as well as
maintaining Joni's medication administration. (Rezaeitalab et al., 2014; Yildiz et al., 2016).
• As such conditions are all inter-connected and aggravate each other, they culminated in Joni’s
hospitalization.

Take Actions-Continued
• Depression alongside obesity co-exist with each other which makes it vital to
comprehend that except Joni's depression is never managed effectively, Joni
shall never had the inspiration for a healthy lifestyle (Elder et al., 2013.
• Joni has since posited that he is feeling "uncomfortable" as well as
"embarrassed" with the weight and hence stays indoors. This is the indication of
Joni's depression barring his inspiration (Grima & Dixon, 2013).
• Allowing Joni sets individual goalmouths, with help from a nurse, which he
perceives as sustainable alongside achievable, shall assist Joni's sense of
empowerment via an understanding of control-regain over his health and life
(Luczynski, Glowinska-Olszewska & Bossowski, 2016).

Conclusion
• In summary, this essay has comprehensively analyzed as well as a proposed
plan for caring for Joni's two highlighted complex priorities for care; the
cigarette smoking cessation alongside Joni's depression management, via the
C.R.C. guidelines and the holistic, person-centric care and collaboration
principles.
• As Joni might be morbidly-obese that is a contributory variable to Joni’s
underlying depression, alternative treatment for John's depression remain
demanded as anti-depressants show side-effects of gaining weight (Battle et
al., 2010) which include cognitive-behavioral therapies alongside international
psychotherapy that further benefits Joni' social isolation.

References
• Battle, C., Uebelacker, L., Friedman, M., Cardemil, E., Beevers, C., & Miller, I. (2010). Treatment Goals of Depressed
Outpatients. Journal Of Psychiatric Practice, 16(6), 425-430. http://dx.doi.org/10.1097/01.pra.0000390763.57946.93
• Berman, A., Snyder, S., Levett-Jones, T., Dwyer, T., Hales, M., Harvey, N., Stanley, D. (2015). Kozier and erb's fundamentals of
nursing (3rd Australian edition). Melbourne, V.I.C.: Pearson, Australia.
• Carey, M., Small, H., Yoong, S., Boyes, A., Bisquera, A., & Sanson-Fisher, R. (2014). Prevalence of comorbid depression and obesity
in general practice: a cross-sectional survey. British Journal Of General Practice, 64(620), e122-e127.
http://dx.doi.org/10.3399/bjgp14x677482
• Carlson, N. (2014). Physiology of behavior (11th ed.). Harlow: Pearson.
• Chang, E., & Johnson, A. (2014). Chronic illness and disability: Principles for nursing practice. Sydney: Sydney: Elsevier Health
Sciences APAC.
• Chang, S. (2012). Smoking and Type 2 Diabetes Mellitus. Diabetes & Metabolism Journal, 36(6), 399.
http://dx.doi.org/10.4093/dmj.2012.36.6.399
• Courtney, R. (2015). The Health Consequences of Smoking-50 Years of Progress: A Report of the Surgeon General, 2014Us
Department of Health and Human Services Atlanta, GA: Department of Health and Human Services, Centers for Disease Control
and Prevention, National Center for. Drug And Alcohol Review, 34(6), 694-695. http://dx.doi.org/10.1111/dar.12309

References
• Ebneter, D., & Latner, J. (2013). Stigmatizing Attitudes Differ Across Mental Health Disorders. The Journal Of
Nervous And Mental Disease, 201(4), 281-285. http://dx.doi.org/10.1097/nmd.0b013e318288e23f
• Elder, R., Evans, K., & Nizette, D. (2013). Psychiatric and mental health nursing (3rd edition). Chatswood, N.S.W.:
Mosby/Elsevier, Australia.
• Grima, M., & Dixon, J. (2013). Recommendations for management in general practice and beyond. The Royal
Australian College Of General Practitioners, 42(8), 532-541.
• Jantaratnotai, N., Mosikanon, K., Lee, Y., & McIntyre, R. (2017). The interface of depression and obesity. Obesity
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• Levett-Jones, T. (2013). Clinical reasoning: Learning to think like a nurse. Melbourne, Victoria: Pearson, Australia.
• Yildiz, F., Argun Baris, S., Tuncel, D., Ozerdem, C., Kutlu, H., & Onyilmaz, T. et al. (2016). The effect of positive
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