1500011658609100915035 7340036300 150001165860837008418830Mariyam shiuna bn 5th sem (000-052-964)734008000Mariyam shiuna bn 5th sem (000-052-964)150001165860455004576445Critical AnalysisFoundation Studies In Nursing 27340036300Critical AnalysisFoundation Studies In Nursing 24500349250center290090900Contents TOC o “1-3” h z u Introduction PAGEREF _Toc11451708 h 2Clinical scenario PAGEREF _Toc11451709 h 3Subjective data PAGEREF _Toc11451710 h 4Objective data PAGEREF _Toc11451711 h 4Inference PAGEREF _Toc11451712 h 5Methods to clarify PAGEREF _Toc11451713 h 6Nursing Abilities PAGEREF _Toc11451714 h 6Critical thinking and nursing process PAGEREF _Toc11451715 h 71)Assessment PAGEREF _Toc11451716 h 72)Diagnosis PAGEREF _Toc11451717 h 73)Planning PAGEREF _Toc11451718 h 84)Implementation PAGEREF _Toc11451719 h 85)Evaluation PAGEREF _Toc11451720 h 8Conclusion PAGEREF _Toc11451721 h 9References PAGEREF _Toc11451722 h 10IntroductionCritical thinking has been identified as a vital element of nursing. It is an essential component in nursing practice for providing safe, competent care. Critical thinking is defined as an intellectual process which, in a decided, deliberate, and self‐regulated manner, seeks to arrive at a reasonable decision CITATION Zur17 l 1033 (Zuriguel-Pérez, 2017).This essay is based on critical thinking, and the use of critical thinking in nursing practice during clinical. I selected a patient during my 2 weeks posting to ADK NS6, to carry out a critical analysis. In this essay, I will include a scenario, I will identify the objective data and the subjective data from the scenario. With the help of the data then I will identify what inferences I could make, and then analyze the inferences further to build up a diagnosis, or to support the diagnosis the patient already has. Furthermore, the abilities required to develop in order to ensure the author has the capability to identify accurate nursing diagnoses and how critical thinking is used in each stage of nursing process are also included.Clinical scenarioMoosa Nizaar is a 48-year-old male, with known case of type 2 diabetes mellitus for more than 10 years. He was on Galvus met 1000mg TDS, and Glicazide 50mg throughout these years. This patient got admitted in ADK NS6 on 16/04/19, under Dr. Damodar with the complaints of frequent urination, increased fatigue, and headache. The patient complains of having severe headache and weakness for the past few days. He claims that he checks his blood sugar regularly pre and post meals. The patient’s wife states that the patient is very careful about his diet and he is now very concerned about rising his blood sugar level. He denies having any fever, but disclose that he vomited twice before coming to the hospital. According to the patient, he is eating well, but still feels hungry and extreme thirst all the time. The patient’s wife standing at the bedside stated that her father in-law (patient’s father) was diagnosed with diabetes three years before when he passed away, and was having hypertension for more than fifteen years.Upon physical assessment, his vital signs was, blood pressure: 100/60mmHg, Temperature: afebrile, pulse: 88b/min and respiration: 16/min. His saturation was 95% on room air. His eyes look sunken, and skin looks dry. He weighs 63kgs. The patient drinks lots of water and passes 200-300ml of yellow hazy urine every hourly.Moosa Nizaar’s laboratory results revealed RBS 340mg/dl, HbA1c 8.2%, Subjective dataSubjective data are the information that is collected through communication. During assessment, whatever the patient states about physical symptoms or how he/she feel are considered as subjective data. The subjective data obtained from the above scenario are as follows:Severe headacheWeaknessSevere hungerExtreme thirstFrequent urinationFatigueFamily history of diabetes and hypertensionObjective dataObjective data are the signs of the patient which can be observed. These signs can be observed through seeing, hearing, smelling and touching. The objective data gained from the patient are:Sunken eyesDry skinYellow hazy urineRBS 340mg/dlHbA1c 8.2%InferenceMaking inference involves using what you know to guess what you don’t know. In nursing, inferences can be made with the help of the data collected to diagnose the patient. The inferences which could make for Moosa Nizaar are as follows.Type 2 diabetesDiabetic ketoacidosisUrinary tract infectionRenal diseaseThe inferences are then classified in to three groups; certainly valid, probably valid, only possibly valid.Certainly valid Probably valid Only possibly validType 2 diabetes Urinary Tract Infection Diabetic ketoacidosisRenal disease Methods to clarifyThe inference type 2 diabetes is certainly valid because both the subjective and objective data supports this inference. The patient’s blood test revealed RBS of 340mg/dl and HbA1c of 8.2% both indicating diabetes. The patient also complains of frequent urination, extreme thirst and hunger which are symptoms of diabetes. He also have family history of diabetes and hypertension. Urinary Tract Infection and renal disease are both probably valid. More laboratory tests should be done to rule out these inferences. Urine R/E and urine C/S can be done to look for white blood cells, red blood cells and bacteria in order to rule out Urinary tract Infections. The nurse may ask more questions to the patient whether he has any pain or discomfort during micturition. So as to rule out renal disease, blood sample should be taken to look for rapidly rising urea and creatinine which may reveal renal disease since these two substances are used to measure kidney function. Patient should be asked about having any abdominal pain. Since the blood glucose level of the patient is high, diabetic ketoacidosis can be possibly valid. Therefore to rule out this blood acidity and ketone levels can be analyzed. CITATION Myo18 t l 1033 (staff, 2018)Nursing AbilitiesNurses should be competent and independent during their work. They must be able to handle any situation they might face throughout their clinical, using critical thinking and reasoning. The ability to provide safe and appropriate clinical care is dependent upon the capacity of nurses to reason and make appropriate choices. During diagnostic reasoning, the nurse analyzes the subjective and objective data obtained from the patient in order to make inferences accurately. In clinical decision making, the nurse takes action based on the problems identified in order to provide best outcome for the patient. The nurse should also develop good interpersonal and interviewing skills to obtain subjective data from the patient through communication. These skills are important to provide safe and appropriate care for the patient, and hence the nurse should develop these skills to make accurate nursing diagnosis and to give care accordingly.Critical thinking and nursing processEveryday nurses overcome many situations where they need to be a critical thinker and a clinical decision maker. They need to handle the situation wisely. The nursing process involves five consecutive steps. During each step, the nurse should take appropriate actions with the help of critical thinking. Nurses should always work with the aim of providing the best holistic care for their patients throughout the nursing process. The five consecutive steps of nursing process are as follows:AssessmentAssessment in the nursing process involves collecting relevant data from the patient and relatives. The data collected will be both objective and subjective data. Objective data are the signs which nurses can observe and measure, whereas subjective data are the verbal statements of the patient and the bystander. Nurses documents the collected data in a form. While thinking critically, the nurse analyzes these data to make a nursing diagnosis and to plan further interventions.DiagnosisA nursing diagnosis, according to NANDA, is defined as a clinical judgment about responses to actual or potential health problems on the part of the patient, family or community. Nurses uses the data collected during the assessment to analyze and build up nursing diagnosis. The diagnosis made are then prioritized according the needs of patient. Nurses should have the ability to take independent decisions based on the analysis of the data obtained, and must have the quality to think critically during this stage.The following nursing diagnoses can be relevant for the above scenario.Hyperglycemia related to disturbances of usage of insulin by the body as evidenced by elevated blood sugar levelImbalanced nutrition: less than body requirements related to insulin deficiency (decreased uptake and utilization of glucose by the tissues, resulting in increased protein/fat metabolism)Risk for impaired sensory perceptionFluid volume deficit related to frequent urination as evidenced by low blood pressureImpaired skin integrityDeficient knowledgePlanning Planning is the third stage of the nursing process. It involves the development of a nursing care plan, which will direct the nurse how the patient’s care will progress, and specifically how the nursing diagnoses will be resolved. The nursing diagnoses will be prioritized according to the needs of the patient and. Patient-specific goals and desired outcomes are then formulated separately to each of the diagnoses, which directly impact the patient care. The goals should be “SMART” goals. S- SpecificM- MeasurableA- AttainableR- RealisticT- Time oriented ImplementationImplementation is the step which involves action. The nurses’ carryout activities and treatments aimed at resolving the nursing diagnoses. The interventions carried out by the nurses are written in proper documents.EvaluationThis is the final step of the nursing process, and is very important to a positive patient outcome. Whenever nurses implement care to a patient, they must reassess the patient to see whether the goal or desired outcome has been met or not. The nursing care plan must be updated based on new assessment findings.ConclusionCritical thinking is a vital tool in nursing which every nurse should practice in order to provide quality holistic care for the patients. Nurses should be competent and be able to work independently by taking their own clinical decisions whenever needed. If the nurses are using the nursing process along with critical thinking, they can provide care appropriately without messing up with what to do next. Nurses should be knowledgeable with the most recent and fresh information always. The patients will also be more satisfied with the care they get from the nurses.References BIBLIOGRAPHY staff, M. c. (2018, June 12). Patient care & health information> diseases & Conditions. Retrieved from Myo Clinic: https://www.mayoclinic.orgZuriguel-Pérez, E. (2017). Development and Psychometric Properties of the Nursing Critical Thinking in Clinical Practice Questionnaire. Worldviews on evidence-based nursing, 257 – 264. Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. M. (2013). Fundamentals of Nursing (8th ed.). St.