Clinical reasoning is embedded in the way of nurses’ thinking for patient care (Levett-Jones 2013). It is a spiral continuous mental process underpinned by critical thinking and a sound body of nursing knowledge to make clinical judgement (Levett-Jones 2013). Eight elements: consider patient’s situation, collect cues, process information, identify problems, establish goals, take action, evaluate outcomes and reflect on process are involved in the clinical reasoning cycle (Levett-Jones 2013). Nursing practice for registered nurses is guided both by National Competency Standard (Nursing and Midwifery Board of Australia 2006) and Nursing Practice Decision Flowchart (Nursing and Midwifery Board of Australia 2010) to challenge the medical assumptions
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Prior to this incident, Mr. Brown has experienced severe vomiting and diarrhoea caused by food poisoning and resolved only in the 24 hours. Bacterial enterotoxin from food poisoning as primary causes of diarrhoea is a form of large volume of secretory diarrhoea which decreases the opportunities for fluid absorption in the GI tract (McCance & Huether 2010). This may suggest that he has been losing a great amount of body fluid, and therefore result in dehydration, which could lead to low BP. His cold and pale skin may also resulted from poor peripheral perfusion. Low BP leads to decreased cerebral perfusion pressure (Saladin, Sullivan & Gan 2015), which could contribute to Mr. Brown’s dizziness, lightheaded or …show more content…
Studies constantly suggest that older adults are more susceptible to dehydration due to the age-related decreased thirty sensitivity, self-care deficits and decreased renal function (Wotton, Munt & Crannitch 2008; Schols et. al 2009; Maughan 2012). Currently, Mr. Brown’s body tries to compensate for decreased BP by increasing the heart rate and vasoconstriction, however, once the compensatory mechanism starts to fail, the body would undergo hypovolemic shock, which leads to organ failure and ultimate death (McCance & Huether 2010). Thus, it is imperative for nurses to recognise these
Prior to this incident, Mr. Brown has experienced severe vomiting and diarrhoea caused by food poisoning and resolved only in the 24 hours. Bacterial enterotoxin from food poisoning as primary causes of diarrhoea is a form of large volume of secretory diarrhoea which decreases the opportunities for fluid absorption in the GI tract (McCance & Huether 2010). This may suggest that he has been losing a great amount of body fluid, and therefore result in dehydration, which could lead to low BP. His cold and pale skin may also resulted from poor peripheral perfusion. Low BP leads to decreased cerebral perfusion pressure (Saladin, Sullivan & Gan 2015), which could contribute to Mr. Brown’s dizziness, lightheaded or …show more content…
Studies constantly suggest that older adults are more susceptible to dehydration due to the age-related decreased thirty sensitivity, self-care deficits and decreased renal function (Wotton, Munt & Crannitch 2008; Schols et. al 2009; Maughan 2012). Currently, Mr. Brown’s body tries to compensate for decreased BP by increasing the heart rate and vasoconstriction, however, once the compensatory mechanism starts to fail, the body would undergo hypovolemic shock, which leads to organ failure and ultimate death (McCance & Huether 2010). Thus, it is imperative for nurses to recognise these