Clinical Reasoning Cycle: Analysis And Nursing Interventions For A Patient Essay.

Clinical Reasoning Cycle refers to the procedure through which nursing staff, as well as other healthcare professionals, accumulate cues, process data, reach an understanding of such a client issue or circumstance, schedule and incorporate treatments, analyse the outcome measures, and demonstrate on as well as gain knowledge from the procedure (Gummesson, Sundén, & Fex, 2018). It guides every healthcare practitioner, particularly doctors and nursing staff, through some kind of series of reasonable processes. Medical thinking is separated into major five phases, and it is important to highlight that such a procedure, while separated into sections, is a continuation. In actuality, it may not necessarily advance through one stage or cycle to some other, however instead backward and forward unless an appropriate evaluation of a sufferer's medical state is established. The main aim of this study is to analyse all of the issues John Lee using the Clinical Reasoning Cycle and find the best possible nursing intervention to cure his issues. 

In this study, the first step which will be taken from the Clinical Reasoning Cycle is Processing information. It is the first stage at which authorized nurses are initially given a medical assessment. Here, nurse practitioners obtain the sufferer's presentation data as well as the patient's existing healthcare state (McMillan et al., 2019). This case study is mainly based on an 83 years old patient named John Lee who has been admitted to an emergency department from an aged care facility for having a non-productive cough. He has been also feeling nauseated and hot. He has a history of dysphagia, and hypertension after he had a cerebral vascular accident 1 year ago. He is also having a very high temperature of 39.4 C and slightly less than normal intake of oxygen which is 92% oxygen saturation lower than normal but not a very severe condition. He is also having slight wheeze and COVID test results show negative. In the very old age like 83 years old, the immunity systems become very weak, and old people get affected by various types of germs. In this case, the patient may have any other disease like influenza or Pneumonia, so further tests are needed to be done to find out further information to identify the disease and based on that to do the next steps of the Clinical Reasoning Cycle properly (Van Cauwenberg et al., 2019).

It is the second and most important phase of the Clinical Reasoning Cycle. Registered nurses would become capable to ascertain the cause of the sufferer's present condition during this stage, which includes a thorough data analysis step (Willand, Maller & Ridley, 2019). The main importance of this phase is based on proper identification of the future treatment and care plans being made. So, if the health professional could not able to identify the proper issues and based on that if they failed to diagnose the right disease then the nursing team could not be able to give the proper treatment by creating the best possible goals for the future. Collecting and processing all of the information above it can be concluded that the patient John Lee is mainly suffering from the common cold. As he does not have any kinds of special serve symptoms of influenza or Pneumonia so analysing his condition can confirm that he currently has a common cold. So, at current times the treatment procedure for common cold should be started and based on the further test results the next treatment plan must be taken. If the physician feels that John Lee is suffering from a pathogenic bacterium or another ailment, he might request a chest X-ray or even other investigations to clear out alternative possible explanations for his problems. From all of the analysis the main two issues which are identified are John Lee has low oxygen saturation and has Swallowing problem.

Process information

Registered nurses need to determine which steps to undertake as well as how quickly they would like the target result (Zajac et al., 2020). Here the SMART goals to treat John Lee's current issues are to identify the main cause of the issues John Lee and based on that give the best possible treatment to cure his problems provide a medication that can help John Lee to control his hypertension.

The nursing staff have to take the following four steps in the given sequency to solve his initial issues. At first the nurse needs to keep his airways open to help him breathing if he stuck any food for difficult swallowing problem. After that the nurse must provide him breathing to maintain his oxygen level 95% (Homer, 2019). After that in the third step the nurse should give him circulation to keep his temperature down. And in the final step the nurse needs to do Glasgow comma scale (GCS) to assess the alert and orientation. After that nurse need to re-orientate him on time and also assess neurovascular observation (Leong et al., 2019). Following that the nurse needs to check the strength of both arms and legs and eye reaction to check his condition as he has history of stroke. And finally, they also need to maintain falls risk. Following the establishment of objectives, registered nurses carry out the activities required to achieve the client's therapeutic objectives. This would, naturally, include various personnel of the medical staff, so everybody must be kept up to speed on the client's therapeutic interventions (Fogg et al., 2018). The ordinary cold does not have a cure. Most instances of the ordinary cold clear up on their own within a week to ten days. Coughing, on the other hand, might remain for another several days. John Lee's best option is to take proper care of him- until his health recovers. In this case, John Lee is 83 years old and lived in an old-age care facility. So here he cannot take care of themselves so the registered nurse must take care of him and give him proper medication to help him to cure his issues as soon as possible. Antimicrobials are useless versus cold germs and therefore only be administered if a bacteria disease is present. Over-the-counter (OTC) medicine may be used to lessen his temperature, body pains, discomfort, and coughing. Some solutions may be helpful to alleviate his problems as well as prevent him from getting so down. However, over-the-counter painkiller medications, decongestants, nose sprays, and coughing syrups all have advantages and disadvantages. Individuals frequently resort to over-the-counter paracetamol such as Tylenol or similar moderate pain medicines including aspirin including Advil, Motrin IB, plus much more comparable to those for temperature, dry mouth, and headaches (Johnston et al., 2020). The most needed nursing intervention for John Lee is as follows. Reduce Body Heat Generation by Advising the client to relax completely to avoid excessive energetic expenditure that might raise body heating. Following that, heat measurements should be taken every four to six hours to check as well as sustain physiological systems. In cases of high temperature, heartbeat, respiratory rate, and hypertension must all be checked because such vital indicators might suggest difficulties. Lastly, increasing pleasure may be accomplished by often shifting positions and using linens to alleviate pain. If the patient does have terrible pain in the head, use a strong painkiller including Paracetamol. Regardless of the increasing perspiration, it is sometimes important to change the clothing. Also, if the individual is chilly or trembling, a lighter cover should be used (Khan et al., 2020). In this case, based on the past medical record, present results of tests, age and health condition the physical has to choose the suitable medication. With that, a good quality nursing care to help him in doing all of his daily work as well as in taking medication must be provided.

Identify Issues

During this stage, registered nurses assess the efficacy of the plan of treatment they have chosen. This would allow professionals to decide how to modify the existing strategy or remain on the current path (Daniel et al., 2021). In this case study, the evaluation will be mainly done on the outcome of the condition of John Lee. In this case study, the patient is an 83-year-old patient whose current condition has been described above. Based on the SMART objective the nurses have taken the above nursing intervention to cure a cold and identify any other issues (Alteri et al., 2019). After giving the above-mentioned medication and nursing intervention the condition of John Lee must be evaluated by doing the blood tests and Chest x-ray and based on that the next step must be taken. Finally, to increase the oxygen saturation oxygen therapy in semi-fowler position needed to be prescribed. As the client is very old and cannot being able to sit straight with his cough and is having oxygen therapy, so the Semi Fowler's Position is being employed here. And as the patient is having Swallowing problem so liquid diet plan from occupational therapists and nutritionist is given to the patient to give him proper nutrition.

Conclusion

From the above study, it can be concluded that following the Clinical Reasoning Cycle in giving any kind of nursing care is very important to take all of the steps properly and get the best possible outcome. Implementing this process helps the thought behind the sufferer's treatment plan, enabling the medical practitioner to proceed throughout a number of methodical steps, eventually resulting in a definitive choice that analyses whatever is appropriate for that client in a specific circumstance. The advantages of effective medical thinking include establishing early evaluations, initiating existing therapy programs, eliminating superfluous examinations, which saves the client money, and eventually enhancing the patient's condition. Therefore, in this study, the above-mentioned benefits are being analysed based on the case of John Lee to give him the best possible medical care to cure his current described situation.

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