Posted: July 24th, 2021

CNA250 | Nursing Practice | A Case Study on Clinical Reasoning Cycle

Introduction:

The medical reasoning cycle serves as an important instrument in serving to the nursing professionals to design appropriate interventions by enhancing their decision making capability (Levett-Jones et al., 2015). This essay would think about utilizing medical cycle reasoning to guage the patron inside the case analysis and would progress with the steps to design an appropriate intervention.

Assortment and Analysis of actuality:

Jennie Pickett who's in her first being pregnant is visiting the clinic for her third antenatal go to. She is at her 26th week of gestation. The detailed observations from the first antenatal go to disclose that she was at her 12 weeks of gestation. The recorded peak was 178 cm with corresponding weight of 64 Kg. The recorded blood stress was common 120/80 mm Hg. The uterine measurement was moreover common and was felt barely above the symphysis pubis. The fetal coronary coronary heart beat was recorded to be common, beating at 120 beats per minute. The urinalysis was moreover recorded to be common and no totally different irregular functioning was recorded. On the third antenatal go to, a few modifications had been seen inside the affected particular person. The physique weight was recorded to be 66 Kgs. The recorded blood stress was considerably extreme at 140/92 mm Hg. Urinalysis was recorded to be common with no indicators of glycosuria or proteinuria. Uterus might very properly be evidently felt on the diploma of the affected particular person’s umbilicus. Fetal coronary coronary heart payment was recorded to be 140 beat per minute and delicate swelling was seen in arms and ft.

Processing the precise truth:

The recorded observations to this point revealed the healthful scenario of the affected particular person and as per the proceedings of the being pregnant it could be summarised that the being pregnant had been uneventful with no essential implications.

Identification of points:

Three factors that could be outlined simply in regards to the issues based totally on the properly being analysis data as collected by the nursing expert would significantly embody controlling the blood stress of the affected particular person. That's so on account of it is significantly evident that all through the third antenatal go to the recorded blood stress of the affected particular person revealed (140/92) which depicted an elevated blood stress that have to be immediately checked. Further, the documentation report moreover reveals presence of delicate swelling in arms and ft which can be thought-about as a sign of elevated retention of water inside the physique. Moreover, irritation in legs and arms might end in discomfort and points with mobilisation if not immediately addressed. The affected particular person is in her first being pregnant and in accordance with the statistical evidences it is revealed that better than 87% of the women actually really feel terribly anxious and nervous on the time of their first being pregnant (Alderice et al., 2013). Scientific literatures moreover reveal that at this stage of time, counselling have to be compulsorily administered to the affected particular person as a way to assist the affected particular person successfully with the being pregnant journey and on the equivalent time steer clear of event of an eventful being pregnant on account of manhandling of the affected particular person due to concerns of hysteria and stress (Ambrosius et al., 2014).

Establishing targets:

The targets developed to efficiently help the affected particular person with increased service provide will be based totally on future targets along with temporary time interval targets (Dalton et al., 2015). The long term targets would primarily make sure that the prospect associated to an eventful being pregnant is averted and the temporary time interval targets will be based totally on providing quick discount to being pregnant associated stress and melancholy (Dicenso et al., 2014). The temporary time interval targets would moreover comprise in designing drugs to normalise the elevated blood stress and provide discount from the contaminated legs and arms (Frederiksen et al., 2015).  Administration of Thiazide diuretics will assist in controlling the blood stress of the affected particular person (Daskalopoulou et al., 2015). This drugs environment friendly regulates the kidney to eliminate excessive sodium and water from the physique (Hill et al., 2013). Together with this, a strict weight-reduction plan with restricted consumption of salt will assist in normalising the blood stress. Together with this, the puffiness or the fragile swelling inside the legs and arms could also be prevented by administering minimal practice to the affected particular person. This is ready to be accomplished under the guidance of the physiotherapist. Evidences have moreover revealed that administration of therapeutic therapeutic massage will assist in bettering the blood circulation that will considerably help ion decreasing the puffiness of the legs and arms. Being pregnant requires the affected particular person to be in a optimistic surroundings with an optimistic surrounding. Any type of nervousness, melancholy or negativity can affect the properly being of the mother along with the creating little one. To have the ability to help the affected particular person handle the nervousness and nervousness associated to the occasion of her first little one, counselling will be provided to the affected particular person on a obligatory basis. Counselling intervals will be organised the place the psychologist would primarily counsel the affected particular person and help in sustaining positivity. 

Movement Plan:

The nursing care that will very properly be adopted with the intention to manage appropriate care of the affected particular person has been enlisted inside the desk given beneath with the anticipated timeframe requirement. An surroundings pleasant nursing plan is considered the hallmark of a worthwhile midwifery intervention program (Hunter & Arthur, 2016). As per my perspective, the nursing care plan would comprise the subsequent factors,

Movement

Rationale

The nursing observations will be documented with appropriate precision

This is ready to help in designing increased intervention with respect to the care given by the nursing professionals and would moreover help in set up the problems of the affected particular person in a better methodology.

A stringent observe over the dietary consumption of the affected particular person will be maintained

It would help in analysing the dietary components and the interval at which the meals is consumed by the affected particular person

A physiotherapist will be appointed to handle minimal practice and wellness care

It would help the affected particular person in mobilising and would moreover assist the affected particular person with muscular cramps and abdomen ache

A psychologist will be appointed to handle counselling intervals

It would help in boosting up the mood of the affected particular person and on the equivalent time efficiently help within the low cost of stress and nervousness that may in the long run help in gaining calm and composure which is essential all through the course of being pregnant

Affected particular person will be administered drugs and elevated water consumption

Therapy will be assisted as a way to regulate the elevated blood stress and elevated fluid consumption would efficiently help in decreasing the presence of swelling in legs and arms

 

The timeframe thought-about for the worthwhile implementation of the nursing plan would stretch over the entire gestation interval and detailed assertion will be recorded every week as a way to clearly set up the persevering with issues if any and efficiently hold the essential indicators of the affected particular person so that any complication could also be averted (Ricci, 2013).

Evaluation:

The diploma of effectiveness of the designed care plan will be relying on the strategies of the affected particular person. Together with this, the effectiveness would considerably depend upon the timeframe allotted for the completion of each purpose talked about inside the care plan. In case certain targets of the care plan are normally not seen to ship environment friendly outcomes, makes an try will be taken to intently set up the reason behind the failure of the plan and efficiently one different new plan will be designed with the intention to enhance the effectiveness (Levett-Jones et al., 2015). Moreover a lot of evaluative parts will be thought-about with the intention to analyse the effectiveness of the interventions used. As an illustration, frequent blood stress check-up to entry the feasibility of the drugs used with the intention to lower the blood stress. Further, utilizing ache score would possibly help in intently monitoring whether or not or not or not the affected particular person has developed any probability of trauma or infestation of ache (Mather et al., 2015). The mood and the behaviour of the affected particular person will assist in determining the affected particular person’s capability to handle up with the progress of being pregnant and with the flexibility to adapt with the continuous physiological modifications inside the physique (Nishikawa & Sakakibara, 2013).

Reflection:

On fully complying with the designed movement plan for the affected particular person, it could be anticipated that the affected particular person would yield optimistic outcomes. It might presumably extra be acknowledged that the affected particular person on acquire intervals with the psychologist would successfully be able to relieve herself of the nervousness, worry and mood swings based totally on her first experience of being pregnant. Moreover, it have to be well-known that the affected particular person would actually really feel further cozy and can be able to conveniently undertake the course of interventions designed. Moreover, the proper administration of elevated fluid consumption and proportional weight-reduction plan would help the affected particular person in following a healthful regime in the course of her journey of being pregnant. Together with this, the elevation inside the mood would help in conserving her happy with a ideas free from stress and worries that may finally end result within the occasion of a healthful and a cheerful little one.

Conclusion:

  Subsequently, it could be concluded that the devised intervention would effectively help in providing a cheerful being pregnant to the affected particular person and on the equivalent time would moreover reduce the hazards involved with the chance of an eventful being pregnant.

References:

Alderdice, F., McNeill, J., & Lynn, F. (2013). A scientific analysis of systematic opinions of interventions to boost maternal psychological properly being and well-being. Midwifery, 29(4), 389-399.

Ambrosius, W. T., Sink, Okay. M., Foy, C. G., Berlowitz, D. R., Cheung, A. Okay., Cushman, W. C., ... & Lewis, C. E. (2014). The design and rationale of a multicenter medical trial evaluating two strategies for administration of systolic blood stress: the Systolic Blood Pressure Intervention Trial (SPRINT). Medical Trials, 11(5), 532-546.

Dalton, L., Gee, T., & Levett-Jones, T. (2015). Using medical reasoning and simulation-based education to'flip'the Enrolled Nurse curriculum. Australian Journal of Superior Nursing, The, 33(2), 29.

Daskalopoulou, S. S., Rabi, D. M., Zarnke, Okay. B., Dasgupta, Okay., Nerenberg, Okay., Cloutier, L., ... & McKay, D. W. (2015). The 2015 Canadian Hypertension Coaching Program strategies for blood stress measurement, prognosis, analysis of menace, prevention, and remedy of hypertension. Canadian Journal of Cardiology, 31(5), 549-568.

DiCenso, A., Guyatt, G., & Ciliska, D. (2014). Proof-Based totally Nursing-E-E-book: A Data to Medical Observe. Elsevier Effectively being Sciences.

Frederiksen, Y., Farver-Vestergaard, I., Skovgård, N. G., Ingerslev, H. J., & Zachariae, R. (2015). Efficacy of psychosocial interventions for psychological and being pregnant outcomes in infertile men and women: a scientific analysis and meta-analysis. BMJ open, 5(1), e006592.

Hill, B., Skouteris, H., & Fuller?Tyszkiewicz, M. (2013). Interventions designed to limit gestational weight obtain: a scientific analysis of precept and meta?analysis of intervention components. Weight issues Evaluations, 14(6), 435-450.

Hunter, S., & Arthur, C. (2016). Medical reasoning of nursing school college students on medical placement: Medical educators' perceptions. Nurse education in observe, 18, 73-79.

Levett-Jones, T., Andersen, P., Reid-Searl, Okay., Guinea, S., McAllister, M., Lapkin, S., ... & Niddrie, M. (2015). Tag employees simulation: An revolutionary technique for promoting full of life engagement of contributors and observers all through group simulations. Nurse Coaching in Observe, 15(5), 345-352.

Mather, C. A., McKay, A., & Allen, P. (2015). Medical supervisors' views on delivering work built-in finding out: A survey analysis. Nurse education as we converse, 35(4), 625-631.

Nishikawa, M., & Sakakibara, H. (2013). Impression of nursing intervention program using abdomen palpation of Leopold’s maneuvers on maternal-fetal attachment. Reproductive properly being, 10(1), 12.

Ricci, S. S. (2013). Requirements of maternity, new little one, & women’s properly being nursing. Wolters Kluwer Effectively being| Lippincott Williams & Wilkins, pp 70-78

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