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This case study is designed to demonstrate the integration of various principles of managing care of patients with chronic conditions. Students will be expected to analyse the case scenario, identify the care needs and from the list of identified needs discuss two COMPLEX care priorities. Please refer to the subject outline and marking rubric when answering this question. 

Critical Reflection for Clinicians

Critical reflection needs that the scholar look at the hidden suppositions and drastically question or uncertainty the legitimacy of contentions, affirmations, and even realities of the case. Basic intelligent abilities are fundamental for clinicians; be that as it may, these aptitudes are not adequate for the clinician who must choose the proper behaviour specifically circumstances and maintain a strategic distance from patient harm ("MS Australia | The National Voice for People with MS", 2017). Accessible research is based upon various, underestimated beginning stages about the general way of the circulatory framework. All things considered, basic reflection may not give what is expected to a clinician to act in a circumstance. This thought can be viewed as sensible since basic intelligent intuition is not adequate for good clinical thinking and judgment. The clinician's advancement of handy basic reflection relies on being instructed what to focus on, and in this way picking up a feeling of remarkable quality that advises the forces of perceptual handle ("Diabetes Australia", 2017). The forces of seeing or perceptual handle rely on seeing what is notable and the ability to react to the circumstance.

Parkinson's disease, or loss of motion agitans, is an advancing neurologic development issue that in the long run prompts handicap. It happens after the age of 50 and increments in occurrence with age. The illness influences a larger number of men than ladies and it's the fourth most regular neurodegenerative ailment. Parkinson's disease is related with diminished levels of dopamine coming about because of obliteration of pigmented neuronal cells in the substantia nigra in the basal ganglia area of the cerebrum (Bryant & Knights, 2015). Neural pathways extend from the substantia nigra to the corpus striatum, where neurotransmitters are critical to the control of complex body developments. The loss of dopamine stores in territories of the mind brings about more excitatory neurotransmitters than inhibitory neurotransmitters, prompting an awkwardness that influences intentional development.

One of the care priorities can be of disturbance of the thought process. The Assessing on the depressed behavior with the causative events leads to the reality. It is considered as one of the common cause among the people suffering from depression as this is an abnormality of the biochemical ("Home — Stroke Foundation - Australia", 2017). Orientation towards the reality helps the patient to be more aware towards her surroundings and the self. The other reason for this can lead to suicide and the ideas of the suicide.

Parkinson's Disease and its Causes

The other care priority can deal with the impairment of the physical mobility. In the given scenario, the patient already started developing tremor, shaking of the limbs. She need to be attending the therapies for learning a special walking technique. The relaxation of the muscles relieves the patient that accompanies the rigidity.

The clinical reasoning cycle consist of the following cycles:

Firstly we have to take into consideration of the situation of the patient, collecting the information about the patient, processing the information of the patient, identifying the issues of the patient, establishment of the goals, taking the actions on the basis of the goals, evaluating the outcomes and then reflecting the process.

The situation of the patient includes the description and the objects of the patient. The collecting of the information includes reviewing the information like patient history, charts, investigation of the results and lastly the previous medical assessment. The process information includes analyzing the data for understanding the signs and symptoms and comparing it with the normal values. The steps of identifying the problems include diagnosis of problem occurring to the patient. The step of establishing the goals includes the establishment of the goal within the time frame. The action taking plan helps in selecting the appropriate course plan from the different alternatives that are available. Evaluating the outcomes helps in assessing whether the situation is been improved. The reflection on a particular process as well as new learning helps in assessing what is been learnt from this process.



Considering the situation

Patient is 64 years old female. She is suffering from Parkinson disease. She was a science teacher and semi retired. She was having 3 children.

Collecting Information

The fatigue was increasing and she was facing fatigue for 12/12. She felt that her hands are becoming stiff and Bradykinesia was around 6/12. She is feeling tremor in her left hand and was suffering from emotional depression. There are no Tripping as well as stumbling. She is having high cholesterol (Brown, 2010). She is also having a surgical history. She gave birth to a caesarean baby in 1980. She also had a surgery in her childhood. The tonsils are been removed by surgery. She has been admitted in the hospital on 14/01/2016 as Parkinson’s disease had been found after the diagnosis.

Process the information

Hindrance of the personal satisfaction of Diana. The physical and enthusiastic effect on the family ought not to be thought less as the patient turns out to be progressively reliant on their support.

Treatment advances are progressively viable in lightening manifestations and notwithstanding abating movement of the infection (Hunter, 2016).

Changes in chemicals in the mind that influence the state of it and prosperity.

The inconveniences of its manifestations profoundly affect every day life that can be candidly obliterating without help and support.

Identifying the issues

Parkinson's disease occurs because of the passing of neuro-cells called substantia nigra, which are in charge of the era of dopamine, straightforwardly impacting the motoric capacity of the body.

Absence of control over development, muscles, and subjective capacity, taking part in every day exercises turns out to be progressively challenging for Diana.

Establishing the Goals

· Maintaining overall quality of life

· Improving the mobility and function

· Reducing the rigidity

· Reduction of tremor

· Reversing the slow movements

· Improving the posture, speech, gait, balance and writing skills

· Maintaining the mental sharpness

Action Taken

There is no cure for Parkinson's disease, yet solutions, surgery, and multidisciplinary administration can give help from the manifestations. The fundamental groups of medications helpful for treating engine side effects are levodopa (normally consolidated with a dopa decarboxylase inhibitor or COMT inhibitor that does not cross the blood–brain boundary), dopamine agonists and MAO-B inhibitors.The phase of the illness figures out which gathering is generally valuable. Two phases are normally recognized: an underlying stage in which the person with PD has officially built up some inability for which he needs pharmacological treatment, then a moment arrange in which an individual creates engine difficulties identified with levodopa utilization. Treatment in the underlying stage goes for an ideal tradeoff between great indication control and symptoms coming about because of change of dopaminergic capacity (Forrester & Griffiths, 2014).

At the point when drugs are insufficient to control indications, surgery, and profound cerebrum incitement can be useful. In the last phases of the illness, palliative care is given to enhance nature of the life of Diana.

Evaluation of the outcome

A differential conclusion of PD is principally in light of a clinical analysis. A clinical conclusion of PD requires the nearness of the cardinal indications of distal resting tremor of 3–6 Hz (Bullock & Manias, 2014), unbending nature, bradykinesia, and topsy-turvy onset. Patients determined to have PD must react to a sufficient helpful levodopa or a dopamine agonist challenge. The clinical analysis of PD is further upheld by dynamic useful and engine weakness.  

Reflection on the process

Individuals commonly have the infection for quite a long time before they begin to have symptoms. There are some minor manifestations before individuals begin having issues with engine abilities yet should individuals never acknowledge they have PD. There is right now no cure for Parkinson's and all specialists can do is treating the symptoms as they emerge (Chang & Johnson, 2014).

Parkinson's is not lethal however the issues causing the disease can be.

Reference list:

Australia Institute of Health and Welfare (AIHW). (2011). The health and welfare of Australia's Aboriginal and Torres Strait Islander people: an overview 2011. Cat. no. IHW 42. Canberra: AIHW. 

Brown, P. (Ed.) (2010). Health care of the older adult: An Australian and New Zealand perspective. 

Bryant, B., & Knights, K. (2015). Pharmacology for Health Professionals ( 4th ed.). Chatswood: Elsevier Australia. 

Bullock, S., & Manias, E. (2014). Fundamentals of Pharmacology (7thed.). Sydney: Pearson Education. 

Forrester, K., & Griffiths, D. (2014). Essentials of Law for Health Professionals (4th ed). Sydney: Elsevier Australia. 

Chang, E., & Johnson, A. (Eds.) (2014). Chronic illness and disability. Principles for nursing practice (2nd ed.) Sydney: Elsevier Australia. 

Hunter, S. (Ed.) (2016). Miller’s Nursing for wellness in older adults. (2nd Aust. & NZ ed.) Sydney: Wolters Kluwer. 

Diabetes Australia. (2017). Retrieved 23 March 2017, from

Home — Stroke Foundation - Australia. (2017). Retrieved 23 March 2017, from

MS Australia | The National Voice for People with MS. (2017). Retrieved 23 March 2017, from

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