Clinical Reasoning Cycle Case Study for Healthcare - myassignmenthelp

Question: Discuss about theClinical Reasoning Cycle Case Study for Healthcare. Answer: Clinical reasoning cycle is one of the best frameworks that enable healthcare professionals to identify various symptoms that are presented by the clients. This model has steps which when by followed by professionals in a sequential manner, helps them to relate the symptoms with the disorders understand their pathophysiology, identify the biological and social determinants of health and thereby recognize the care priorities (Vlayeyen et al., 2015). Following this, the professionals will set goals and plan their interventions that will e sure safety and quality care of the patients. However, professionals should always focus on providing care that is culturally and ethically justified so that the patient can be satisfied with the care they get. This assignment will mainly portray the ways by which clinical reason cycle helps professionals to handle a critical nursing case and help patents to get the best service. The first step is considering the patient situation. Mrs. McKay is a 86 year old widow who has been transferred to residential aged care named Sunset. She has faced a fall previously that had made her undergo hip replacement in acute care hospital. She had also faced a skin tear after bumping on her wheelie walker. She already has Alzheimers diseases and vascular dementia in the early stage. She is intermittently incontinent as she fails to reach the toilet on time. The second step is called the collecting cues or information through the three steps of reviewing, gathering and recalling information. Mrs.Mckay is currently under medication of Paracetamol, aspirin and desmopressin. She is not compliant with the professionals in her activities of daily life. She used to be a strong-minded person and had strong opinions. Although she needs to walk with wheelie walker, she often forgets it. She is suffering from Alzheimers diseases and vascular dementia that needs to be cared by the professionals. The third step is called the processing of information. It is seen that the patient Mrs. McKay is suffering from early stages of Alzheimers disease and dementia. Researchers are of the opinion that this disorder occurs due to two important abnormalities. Plaques are formed when clumps of proteins called beta-amyloid causes damage and destruction of the brain cells in different ways that mainly participate in cell-to-cell communication. Besides, tangles are also formed when threads of tau protein that mainly helps in carrying nutrients through brain are seen to form tangles (Alvarez et al., 2016). This results in failure of the transport system. These factors both result in destruction of brain cells and result in shrinkage of brain. This affects brain functions like memory and cognitive abilities. Moreover, patient Mrs. McKay had undergone hip replacements following fall, which had compromised her mobility and had made her restricted in her movements. She had always been independent and therefore taking support due to her impaired mobility or inability to conduct ADL have made her agitated and affects her self-respect. Therefore, she might be non-compliant with the professionals as taking helps affects her dignity and self-respect. Another important aspect of care is to take care of her wound that might affect her quality life by providing her with pain. Therefore, this should be taken care of in the nursing care plan. The fourth step is called the identification of the problems by synthesizing of facts. From the above discussion, it becomes quite clear that the patient Mrs. McKay is suffering from a number of issues that should be taken care of. She has developed restricted mobility and often forgot to take up her wheelie walker. Therefore, the first care priority would be to develop intervention for fall prevention so that the patient does not suffer from any falls (Santamaria et al., 2015). The second issue is that she is suffering from early stage of dementia and Alzheimers and therefore, she may be seen to suffer from memory loss, social withdrawal, mood swings, distrust in others, irritability, wandering activities, delusions and many others. Already some form of symptoms are visible in her from now only. Therefore, nursing professionals should try their best to care for her in ways by which she can develop her quality life (Breimaier et al., 2015). Moreover, she has faced a skin tear that ma y be painful to her and may make her suffer during healing of the wound, as she has grown old. Therefore, take these three-care priorities should in consideration. The fifth step is called the setting of goal. The first goal would be to conduct a risk assessment of fall for the patient and thereby taking initiatives by which the environment may be made safe for the patient from fall. Second goal would be to take care of her in way that would help to ensure that her symptoms of Alzheimers and dementia are actively controlled and maintained. The third goal would be her proper wound management so that her skin tear in her knee can be managed effectively. The sixth step is called the action taking stage where the nursing individuals need to take interventions for the care priorities chosen. As she is at a risk of fall in the residential care, a wristband should be first provided to patient Mrs. McKay to help so that the healthcare professionals are aware of her risk for fall. Mrs. McKay should be then transferred near the nurse station so that nurses can attend her immediately when called. As she is intermittently incontinent, this would also help her to prevent her from wetting her bed (Gustavvson et al., 2015). Items should be moved near her bed so that she can easily access them without the need for covering a certain distance. This would reduce the fall hazards. The nursing professionals should also position the beds at the lowest possible position. They should make the sleeping position adjacent to the floor that reduces chances of falls. Moreover, the professionals should allow use of bed rails as well as hand rails in the washr ooms and other places possible so that the Mrs. McKay can seek support to when locomotion (Anderson et al., 2015). Moreover, proper arrangement of bright room lighting should also be done. Mrs. McKay should be also encouraged to take on slippers or soles that are non-skid. The patient should be familiarized with the layout of the room and clutters should be removed from her pathways. No light furniture should be which increases the risk of the patient tumbling down (Dowsett Dowsett, 2015). Too much loose clothes should be avoided as it may increase the chance of fall. The professionals should also collaborate with physiotherapist and occupational therapists that would be having physiotherapy sessions to develop her gait, provide her proper assistive service, and teach het to do light free exercises (Boltz et al., 2016). The second priority would be maintenance of her Alzheimer and dementia disorders. The nursing professionals should assess her though process by evaluating her cogni tive, disorientation, issues with communication or changes in thinking patterns. Mrs. McKay is in her early stages, so these issues are not yet pronounced. However, she gets irritated and does not allow anyone to help her in her activities of daily life. Therefore, it is very important for the nurse to develop a therapeutic relationship with the patient where the patient learns to trust and rely on the professionals. Effective communication in a compassionate and empathetic manner may help in developing bond with the patient. Mainly Mrs. McKay is frustrated and agitated as she used to be independent and strong opinionated woman. As she has to depend on the professionals now, her self-esteem is affected (Farina, Rusted Tabet, 2014). Therefore, the nursing professionals should always respect her dignity and autonomy and should always take her informed consent before undertaking her for any activities of her daily life. The better the bond developed between them, the patient will lear n to rely the nurses and would accept help from her. However, the nurse should never connect any activities that would overpower her presence over the client. The client should be treated in a way where she always feels respected and her consent is prioritized. The better the emotional connection with the patient, Mrs. McKay will have better health outcomes. For her skin tear, the nurse should first monitor the sights around the wound once daily for identifying any color changes, redness, swelling, pain, warmth and others. Depending on the status of the wound, care should be taken about the kind of dressing that it needs like whether the wound is dry or wet. Accordingly, wet or dry dressing, lubricants, hydrocolloid dressings would be provided. A sterile dressing technique would be adopted for preventing infection (Cabrera et al., 2015). Care should be taken so that lessened exposure of the skin tear to moisture takes place from incontinence, wound drainage and perspiration. Proper antibiotics should be given and the patients should be advised to prevent rubbing or scratching. A nutritional diet should be encouraged. The last two stages are effective evaluation followed by reflection of the nursing professionals after application of the intervention. The nurses should evaluate the walking posture and the ability of the patient. The patient should be able to walk properly with a steady gait and should be free from any risks of fall. Secondly, the patient would successfully participate in her ADL activities conducted by the nurses after effective therapeutic relationship development. The nurses should also evaluate the conditions of the wound and the ways it is healing (Muller et al., 2017). After evaluation, the nurse should reflect on the interventions and the ways the patient has responded to all the interventions. From these interventions, the nurses should reflect on the experiences gathered and find out ways by which better quality care can be ensured (Farlow et al., 2016). From the above discussion, it becomes clear about how clinical reasoning cycle has helped nurses to develop proper care plans for the patient named Mrs.Mckay. Moreover, it is also helpful in understanding the pathophysiology and determining the symptoms that need to be treated. Therefore, every nursing professional should know the ways about how to conduct each step properly. This would ensure developing of a care plan that would address all the symptoms of the person and help her to develop better quality life. References: lvarez Barbosa, F., Pozo?Cruz, B., Pozo?Cruz, J., Alfonso?Rosa, R. M., Sanudo Corrales, B., Rogers, M. E. (2016). Factors associated with the risk of falls of nursing home residents aged 80 or older.Rehabilitation nursing,41(1), 16-25. Anderson, C., Dolansky, M., Damato, E. G., Jones, K. R. (2015). Predictors of serious fall injury in hospitalized patients.Clinical nursing research,24(3), 269-283. Boltz, M., Capezuti, E., Fulmer, T. T., Zwicker, D. (Eds.). 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