Nursing Assignment: Clinical Reasoning, Patient Assessment, and Values

This nursing assignment delves into the core concepts of clinical reasoning, encompassing the process of data collection, processing, and the formulation of patient diagnoses. The assignment addresses clinical reasoning as an art, highlighting the continuous nature of the process from data collection to intervention and reflection. It differentiates between focused case analysis and complete analysis, emphasizing their roles in gathering information for differential diagnosis. The role of patient history, particularly the use of OLDCARTS, is discussed for effective patient interviews. Furthermore, the assignment explores the impact of patients' inherent values on their perceptions and the potential for value clashes during data collection, impacting data validity. The author reflects on their personal act of caring, emphasizing the importance of ethical considerations in nursing practice. The assignment concludes with a comprehensive list of references to support the discussed concepts.

Running Head: NURSING ASSIGNMENT
Nursing Assignment
Name
Institution

NURSING ASSIGNMENT 2
Nursing Assignment
Question 1
Clinical Reasoning
Clinical reasoning (CR) is a process in which nurses (plus other clinicians) collect cues,
process the data collected, come to understanding of a patient or client problem or condition,
plan and implement the appropriate interventions, assess outcomes, as well as reflect on plus
learn from the reasoning process (Yazdani, Hosseinzadeh & Hosseini, 2017).
Art of Clinical Reasoning
Clinical reasoning is an art of a constant process, which does not end when the diagnosis
has been performed on the patient. The process begins with the collection of data from the
patient and reviewing the chart. The next stage will be for the clinicians to use their skills to
distill the data collected into pertinent positive and negative findings followed by the creation of
problem presentation regarding the relevant features of the positive and negative findings
translated to appropriate medical terminology. The next process will be adopting a differential
diagnosis framework, like the anatomic model, or physiologic model. The final process of CR is
to apply the relevant positive and negative findings to a framework on the findings selected to
generate the differential diagnosis (Yazdani et al., 2017).
Question 2a
Focused case analysis is a general process of analysis through a diagnosis of a patient
based on a specific case as presented at the clinical setting while complete analysis will entail the

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actual examination of both the history of the patient and physical examination. Both the focused
case analysis and complete analysis is geared at collecting information from the patient for
differential diagnosis.
Question 2b
The history of the present illness offers the original data to generate differential
diagnosis towards identifying the medical problem of the patient. The effective interviewing
process needs the clinician to avoid medical terminology and utilized a descriptive language,
which is familiar to the patient. For those clinicians that favor mnemonics, the eight dimensions
of a medical problem may easily be recalled utilizing OLDCARTS (Onset, Location, Duration,
Character, Aggravating elements, Relieving elements, Timing, and Severity). This will entail the
use of OLDCARTS during an interview to get an accurate history concerning the current illness
of the patient. The content of the subsequent questions would rely both on what the clinician
discovers and the knowledge base/understanding of the patient and the present disease that will
dictate the success of the interview in promoting effective differential diagnosis (Alshenqeeti,
2014).
Question 3a
Patients’ inherent values make them believe that they are not worth living because of
their current illness that affects their actions and perceptions regarding their value in life. These
patients will feel that the illness make them be worthless and they consider being a burden to the
society and their families. In many instances, their illness makes them to lose confidence and
meaning of life (Kimmelman, 2012).

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Question 3 b
My personal system is my act of caring where I just find myself assisting patients even
not in my department. The act of caring just comes out voluntary and I find myself caring for
people without my conscience (Kimmelman, 2012).
Question 3c
The potential value clash during the collection of data on the patient will affect the
validity of the data collected. The clash will create an environment that will result in bias that
will affect the accuracy and validity of the data collected. The patient may provide inaccurate
information because of the class of the values during the interview session (Alshenqeeti, 2014).

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References
Alshenqeeti, H. (2014). Interviewing as a Data Collection Method: A Critical Review. English `
Linguistics Research. 3(1):39-45.
Kimmelman, J. (2012). Ethics, ambiguity aversion, and the review of complex translational
clinical trials. Bioethics. 26(2):242–250.
Yazdani, S., Hosseinzadeh, M., & Hosseini, F. (2017). Models of clinical reasoning with a focus
on general practice: A critical review. Journal of advances in medical education &
professionalism, 5(4):177–184.