The healthcare setting is an ever-changing and unpredictable environment, challenging nurses to various situations that come about in clinical practice (Caldwell & Grobbel, 2013). In such situations, the ability of the registered nurse to demonstrate effective clinical reasoning and critical thinking skills is an essential component of nursing competence (Pinnock & Welch, 2014). The following essay will explore the experience of a registered nurse during a time of clinical decision-making and patient interaction. With reference to the Levett-Jones et al., (2010) Clinical Reasoning Cycle, the progression of critical thinking will be demonstrated during this process, utilizing the eight steps involved in the cycle. This situation will then reflected upon, with reference to The Gibbs model, (1998), in order to enhance future nursing practice.
Tracey is a 60-year-old woman, who was diagnosed with Chronic Kidney disease (CKD) over four years ago. Tracey presents to her local emergency department, as she feels her health has been deteriorating in …show more content…
Her legs and ankles are swollen and her skin appears dry and scaly. These are common presenting symptoms of CKD (National Kidney Foundation, 2010). Tracey’s blood pressure is recorded at 210/90mmhg, which is a high reading in comparison to a normal range of 100 to 140mmhg systolic and 60 to 90mmhg diastolic (National Heart Foundation, 2015). Tracey’s blood test results reveal her Glomerular filtration Rate (GFR) is 30ml/minute and tests display a high reading of creatinine in the blood. A low GFR indicates the kidney’s are severely damaged and can no longer function properly (National Kidney Foundation, 2015). As a result, creatinine levels increase in the blood, as the kidneys are no longer filtering this waste through (National Kidney Foundation, 2015). The nurse recalls Tracey’s medical history and reviews her current medications, in order to identify a cause for the high blood
Tracey is a 60-year-old woman, who was diagnosed with Chronic Kidney disease (CKD) over four years ago. Tracey presents to her local emergency department, as she feels her health has been deteriorating in …show more content…
Her legs and ankles are swollen and her skin appears dry and scaly. These are common presenting symptoms of CKD (National Kidney Foundation, 2010). Tracey’s blood pressure is recorded at 210/90mmhg, which is a high reading in comparison to a normal range of 100 to 140mmhg systolic and 60 to 90mmhg diastolic (National Heart Foundation, 2015). Tracey’s blood test results reveal her Glomerular filtration Rate (GFR) is 30ml/minute and tests display a high reading of creatinine in the blood. A low GFR indicates the kidney’s are severely damaged and can no longer function properly (National Kidney Foundation, 2015). As a result, creatinine levels increase in the blood, as the kidneys are no longer filtering this waste through (National Kidney Foundation, 2015). The nurse recalls Tracey’s medical history and reviews her current medications, in order to identify a cause for the high blood