Assessment And Management Of The Clinical Problems

Question:

Dsicuss regarding the Assessment and Management Of Clinical Problems.

Answer:

A clinical reasoning cycle can be described as the process through which healthcare professionals use their inductive and deductive cognitive skills for making clinical decisions to provide safe care to patients.

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According to Wills & Kelly (2018), clinical reasoning is an approach that uses scientific knowledge.

Clinical reasoning cycles include critical thinking, which is considered to be part of clinical reasoning. It helps professionals make decisions that will lead to the best possible outcomes for patients (Tate and al., 2016,).

The professionals must then evaluate the outcomes and learn from them.

This assignment will demonstrate how professionals can use CRC cycles to follow the case of Peter, and assist him with interventions to improve his quality life.

Peter Mitchell is 52 years old and divorced. He has two sons.

Sons don’t have close relationships with their father. They rarely visit him since they live in other cities.

He is also known to have diabetes and does not know how it can be controlled for a better quality of life.

He also has obesity and regularly smokes around 20 cigarettes per day.

He is also believed to be in the initial stages of depression. He has become isolated from his friends.

H e is very embarrassed by his weight which could be another reason for his depression.

Nursing professionals should give priority to his disorder of obesity.

The chronic conditions of obesity and diabetes have two significant connections.

His uncontrolled obesity caused his diabetes to become more severe.

According to Brown et al. 2017, overweight people can put stress on the membranous networks within their cells, called the endoplasmicreticulum.

The networks start sending alarming messages when these organelles are able to carry more nutrients.

These signals are sent to the cells of your body to decrease or dampen the insulin receptors that are found in cells below.

Insulin resistance results in increased blood sugar levels and a decrease in cell activity.

Researchers also believe that obesity is linked to diabetes.

Obesity causes fat cells in the abdomen to produce a certain type of chemical called pro-inflammatory chemicals.

They make the body less sensitive for insulin.

Pro-inflammatory chemicals can cause cells to become less responsive to insulin (Cook eta., 2018).

Obesity hyperventilation is most commonly caused by ill-managed weight.

The patients experience difficulty breathing deeply and quickly.

This causes high blood carbon dioxide levels and low oxygen levels in the blood.

In the future, this could lead to lung problems.

According to nurses, Peter’s diet was not properly managed and there is no health literacy that can be used to manage obesity and diabetes.

He has serious conditions such as sleep apnoea, obesityhyperventilation syndrome and increased hunger. His basal glucose level is also high.

He will have a better quality of life if both conditions are properly managed.

It is clear from the case that Peter struggles with his ability to adjust to different methods of losing weight, even though he knows the importance of these interventions in his life.

Peter should learn about his diabetes and the dangers it poses to his health.

The nurse should counsel Peter on how they can help him to be more self-motivated and determined to follow their recommendations (Lewis et. al., 2016).

Once Peter has agreed to their suggestions, the nurse should create a diet plan.

Peter should begin light exercise that would burn off extra calories.

Begin with an easy exercise that lasts less than 10 mins. Later, you can add more time to the exercises.

He should also be advised to make sure he is not sitting too much and that he engages in various light activities (Teixeira and co., 2015).

A diabetes educator can be assigned to him to help him learn how to monitor his blood glucose levels, manage medications, and check them frequently.

Nursing professionals must also pay attention to controlling blood pressure. This will help prevent hypertension.

The average blood pressure for patients is 120/80mmHG.

In this case, however, the patient’s blood pressure is 180/92 mmHg.

This puts the patient at high risk for heart attacks, stroke, and other conditions.

The professionals need to take measures to keep his blood pressure under control in order to prevent stroke and heart attacks (Hunter, 2012).

Peter smokes approximately 20 cigarettes per days, making him more susceptible to high blood pressure.

The main reason this disorder could occur is because nicotine can cause an increase in blood pressure and heart rate (Butcher and al., 2018).

Researchers believe that nicotine may cause narrowing of the blood vessels called vasoconstrictions and hardening the walls of the arterial arteries.

This can cause blood to clot and thereby put stress on the heart (Brown, et al. 2017).

This can lead to heart attacks or strokes.

Plaques are also a form of fat that can build up in your arteries, causing blood pressure to increase (Boddenheimer and Baul, 2016).

Peter needs to be supported by nurses in order to stop him from smoking so his blood pressure can be controlled.

A substance abuse counselor can help Peter quit smoking. He will be motivated and self-determined to give up his old habits and to start over.

It is possible to suggest Nicotine Replacement Therapy to him. This helps individuals overcome their nicotine cravings and habits (Martinez et. al., 2014).

You can also suggest nicotine replacement products to him such as Nicotine nasal Spray, Sublingual Nicotine Tablet, Nicotine Lozenge, and Nicotine Inhaler. (Con et. al., 2015).

It is important that he learns how to measure his blood pressure so that he can determine if his blood pressure is stable, unstable, or requires him to consult a health professional.

A teaching session should be held by the nurse professional to discuss with Peter the importance and benefits of drug therapy, nutritional therapy, home monitoring of BP, as well as quitting smoking.

Peter would be encouraged to modify his lifestyle if he or she decides to start weight loss.

The diet would include eating several portions of fish every week.

He should also consume plenty of vegetables, fruits, and other healthy foods.

Additionally, he should consume lots of fibers and water.

DASH is a diet that can help lower blood pressure.

He should also be told to limit his sodium intake and to avoid adding salt to his meals.

Regular physical activity such as walking, running, swimming and other activities can help maintain weight and lower blood pressure.

Stress can also contribute to high blood pressure. It is therefore important that the nurse practitioner introduce relaxation therapy.

The combination of guided imagery and biofeedback can also reduce blood pressure.

Peter’s behaviors should be closely observed by the nurses to determine if the coping strategies are effective.

She should assess how well Peter can communicate his feelings and concerns.

This will allow the nurses to assess how self-motivated he would be to follow the care plans.

Peter should be counseled if his self-determination is lacking.

The clinical reasoning cycle was able to help the professionals reflect on each aspect of Peter’s health. They also created a plan that would establish two of Peter’s priorities.

Peter required proper interventions to overcome his ill-health, gain health literacy, feel empowered, so that he can live a good quality life, free from life’s threats.

Rethinking primary care workforce: A expanded role of nurses.

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Lewis’s Medical Surgical Nursing: Assessment & Management of Clinical Problems.

Systematic review and meta analysis of interventions to improve medication adherence among hypertensive people.

Current hypertension news, 17(12), 95.

Adult obesity 2: Treatment and management options to lose weight and maintain it.

Miller’s nursing to promote wellness in older adults.

Sydney: Wolters Kluwer/Lippincott Williams and Wilkins.

Clinical reasoning: Learn to think like an nurse.

E-Book Medical-Surgical Nursing: Assessment and Management Of Clinical Problems.

E-Book Medical-Surgical Nursing: Assessment and Management Of Clinical Problems.

Substitution of primary care physicians by nurses: a systematic review & meta-analysis.

BMC health services Research, 14(1), 214.

Deconstructing interventions: Approaches to studying behaviour change techniques across the spectrum of obesity interventions.

Translational behavioral medicine 6(2), 236-243.

An analysis of self-regulation mediators that have been proven to be successful in reducing obesity in adults.

Systematic review: What can be done to reduce obesity among nurses.

Occupational Medicine.

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