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Identify the three nursing care priorities using the first four steps of the Clinical Reasoning Cycle
Consideree Functional Consequences Theory (embedded in discussion):
1.Consider the patient describe factsand contents. This is the first stage ofthe clinical reasoning cycle, the nursebegins to gain an initial impression ofthe client situation.
For example: This is an 89 old client Giuseppe Guinta. He feels breathless on exertion, with wheezing and chest tightness. A 5 x 6x 0.2 cm ulcer is found at his right ankle, with a fair amount of exudate and an offensive smell. Giuseppe lives with his wife, Regina who experiences an intermittent memory loss, in a two- storey house
Age-related changes (notmodifiable) such as the decreasedrespiratory muscle tone andefficiency; decreased number ofcilia cells; diminishedchemoreceptor sensitivity tohypoxaemia; increased chest-wallcompliance (Hunter, 2012, p.434).
Risk factors (modifiable) such assmoking, occupational exposureto respiratory toxins, living in a 2-storey house, with COPD, etc.(Hunter, 2012, p. 434).
Negative FunctionalConsequences difficulty
2. Collect cues/information review the
information, gather new information and
recall knowledge;
Giuseppe had a history of smoking for
20 years, COPD for 10 years,
hypertension and cardiac failure for 6
years
Giuseppe feels tired easily and has
difficulty climbing stairs and managing
garden recently. His leg ulcer shows no
sign of improvement. He also feels
embarrassed about the smell and
exudate from his leg ulcer
performing ADLs; a risk of being
socially isolated and depression.
3. Process information to interpret,
discriminate, relate, infer, match the
data and predict an outcome.
COPD related to smoking
Shortness of breath related to
COPD and cardiac failure
Leg ulcer related to immobility,
smoking, cardiac failure and
COPD
(You should expand each point with support
of the literature evidence.)
4. Identify problems/issues synthesise
all the information that has been
collected and processed in order to
identify the most significant patient
problems or issues. You only need to
identify three (3) issues for this
assignment.
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