Diagnostic Clinical Reasoning

The term clinical reasoning is a term used interchangeably with critical thinking, clinical judgement, decision making and problem solving. However, in nursing education there has been a shift away from the use of the word critical thinking to the word clinical reasoning to describe the way nurses think in clinical situations. Clinical reasoning denotes attention on patient care situation and exposing the nature of patient problems (Benner et al., 2010). Another research by Pesut and Herman (1998) described clinical reasoning as thinking that is reflective creative, critical and concurrent.

The patient that I have chosen for my diagnostic reasoning paper is a 47-year-ol-Hispanic female. The presenting problem that I have chosen to use as my patient’s chief complaint is back pain. The only other clues that I have to use in order to help narrow my focus is that she is a female, she is 47-years-old, and she is Hispanic. I do not know how long she has been experiencing pain or how severe her pain is. Given these parameters, I will “cast a wide net” as I evaluate my patient and create my list of differential diagnoses.

The second most likely diagnosis is dehydration. According to Arant and Canavan (2009), the diagnosis can be determined by if there has been vomiting, diarrhea, or decreased oral intake. The patient has had decreased tear production, a capillary refill time of more than two seconds, and decreased skin turgor (Arant & Canavan, 2009). All of this points to dehydration.

The first most likely diagnosis would be acute gastroenteritis. According to Aftab and Churgay (2012), the patient has acute gastroenteritis is “often defined as the onset of diarrhea in the absence of chronic disease, with or without abdominal pain, fever, nausea, or vomiting”. This 18-month year old patient has had 6 episodes of diarrhea and 4 episodes of vomiting per day that occurred for two days. The patient also has no history of having a chronic disease.

Often people forget that the community in which they live in plays a vital role on their lifestyle. Your community may influence you on how you experience others culture, it may predispose you to certain illnesses and crimes due to location. It may influence you to think big and want better for your future and your children’s future base on the people you are surrounded by. Communities sometimes influence its member’s careers paths base on merely the need of that community. The purpose of this paper is to assess the community of Stapleton, its demographic, needs and issues both

Diagnostic and therapeutic services “determine the causes of illnesses or injuries that may include the clinical laboratory. They are responsible for studying body tissues to determine abnormalities. The diagnostic imaging center determines lesions and abnormities on body parts in radiology, MRI, CT scans, even though ultrasounds. Emergency medicine provides emergency diagnostic and treatments for patients” (Malabrigo 3). The therapeutic side includes eight different factors like physical therapy for one. “Those who provide treatment to improve large muscle mobility and prevent or limit permanent disability. It includes rehabilitation medicine. Which helps restore optimal functions to people with injuries to the muscles, tissue and nervous system such as stroke patients.

The critique of clinical relevance is a necessary part of the appraisal process. It allows the reader to gain insight into the application of the research that has been conducted. The discoveries from this section provide direction to future health care providers in order to improve outcomes for patients in the clinical setting.

I regarded clinical guideline as panacea to all diseases and diagnosis, tried to memorize them without realizing that active thinking and logic reasoning are the ultimate foundation of being a successful physician. After that day, my own little magic box of thinking was opened and got wild: I got in love with deducing differential diagnosis, gather detailed and more detailed history, researching on different treatment plans to individualize best outcome for each patient, or in terms of being a healthcare "detective", each patient is a case to be solved - a deja vu of my childhood love on crime-solving stories. Yet this was just a

Reasoning that is considered a systematic approach to moral conflict and is directed toward analyzing an ethical dilemma, generating alternative solutions, and determining actions to be taken is known as ethical reasoning (Willard & Schell, 2014). I will rank the sixth clinical professional reasoning with a three. The current strongest form of reasoning for me is interactive thinking, which is the seventh clinical professional reasoning listed. This form of thinking is directed toward building positive interpersonal relationships with clients, permitting collaborative problem identification and problem solving (Willard & Schell, 2014). The last clinical professional reasoning is known as conditional reasoning and it is the blending of

Part two (B, D, and E) of the Diagnostic Criteria states that the symptoms do not meet criteria for a Mixed Episode or bipolar disorder, must cause significant distress or impairment in important areas of functioning, are not due to the direct physiological effects of a substance, and persist longer than two weeks. Catherine’s symptoms do meet the criteria for bipolar disorder: a disorder associated with episodes of mood swings ranging from depressive lows to manic highs. The symptoms Catherine possesses has not prevented her from living life, she chooses not to participate in most activities. The film does not mention any general medical conditions that Catherine may have or substances she possibly has taken. Lastly, the movie’s timeline is

A reliable and valid diagnosis is one which is correctly reasoned from a satisfying premise and agreed upon by psychiatrists using the same diagnosis system.

.Every year there are millions of people who receive an incorrect or untimely diagnosis from their physician(s). A prime example of this comes out of the city of Dallas, Texas. “On May 8th, 2013, Roberto Llanas Jr. was rushed to the hospital after colliding with a pole in John W. Carpenter Elementary School 's playground. The lawsuit, which alleges the boy was 'writhing in pain ' upon his arrival, says he was given an X-Ray, diagnosed with constipation and sent home.

Great post. I totally agree with your chosen diagnosis. In scenario 2, patient complained of dyspnea, hemoptysis and chest pain. On assessment, patient’s respiratory rate was 32 and labored; pulse 112, O2 sat 90%, skin cool and sweaty, heart rate was irregular. He also has 2+ edema on right calf, erythema, warmth, and tenderness. He also appeared anxious. These are classic signs of PE. Also, the NP ordered specific labs for the patient from the information and assessment she conducted. Diagnostic reasoning is a scientific process in which the practitioner suspects the cause of the patient’s symptoms and signs based on previous knowledge gathers relevant information, select necessary tests and recommend therapy (Dains, Baumann, & Scheibel,

Clinical reasoning is concerned with relationships and has concern for those they are caring for (Benner et al., 2008). It is a term used synonymously with decision making and clinical judgement (Simmons, 2010).

To listen to personal stories of what it is like to be unwell is an incredible way for medical students and doctors to learn about illness and gain firsthand insight into ‘Whole person care’. Earlier this year, I got the opportunity as part of our ELM3 Healthcare in the Community (HIC) group to meet and learn about a member of the community with a traumatic brain injury and her interactions with healthcare professionals and personal journey towards recovery. An open discussion allowed us to learn about her narrative, which provided many examples of the distinction between disease and illness and the importance of a patient-centered approach to healthcare.