Dynamic Process of Clinical Judgement Discussion Paper

Dynamic Process of Clinical Judgement Discussion Paper

Dynamic Process of Clinical Judgement Discussion Paper

Competency

Evaluate factors integral to clinical reasoning. Dynamic Process of Clinical Judgement Discussion Paper

Explain the impact of relational inquiry when recognizing and analyzing cues to action in the process of clinical reasoning.

Integrate modes of inquiry to generate and evaluate hypotheses in the context of clinical reasoning.

Determine appropriate responses when integrating situated cognition into clinical reasoning.

Modify clinical judgement within an iterative, outcome-based cycle of clinical reasoning and client needs.

Scenario

You are a student in the last term of a BSN Program. You are preparing for an end of term exam. To help you prepare, your instructor developed three real world clinical scenarios to provide opportunities for you to apply clinical reasoning and clinical judgement. The instructor stated, “You received reports on these clients. Decide which one you need to see first and then make appropriate nursing decisions based on relevant information to promote positive client outcomes.”

The three scenarios include: Dynamic Process of Clinical Judgement Discussion Paper

Patient 1

JR is a 55 yr old male admitted 8 hrs ago for 24 hr hold to evaluate for possible myocardial infarction. Serial troponins within normal range, and 12 lead ECG indicate evidence of prior right anterior wall myocardial damage. Dynamic Process of Clinical Judgement Discussion Paper

Patient 2

EH is a 40 yr old admitted within the past hour with acute onset severe right upper quandrant pain and vomiting for the past 36 hr. Waiting on labs, ECG monitoring showing occasional premature ventricular contraction (PVCs)

Patient 3

BW is a 21 yr old male athlete admitted yesterday with fever of 103 and diagnosis of influenza. He rested well overnight. Morning chest xray revealed mild infiltrates in left lower lobe. Dynamic Process of Clinical Judgement Discussion Paper

Instructions

Record your answers to these statements. Dynamic Process of Clinical Judgement Discussion Paper

• Rank the three scenarios provided in order of priority related to which client you will assess first, second and third.
• Defend your selection for the three ranked scenarios.
• Review the data below for the priority client to determine what to assess first.

Chest X-ray no abnormalities noted

Abdominal X-ray :diffuse gas throughout the small intestine

Hyperactive bowel sounds in all 4 quadrants and abdomen painful to touch

Pain level 10/10

Sodium (Na+) 147 mmol/L

Potassium (K+) 2.9 mmol/L

Chloride (Cl-) 100 mmol/L

Magnesium (Mg2+) 1.4 mg/dL

Calcium (Ca2+) 9.2 mg/dL

Phosphorus (P+) 2.3 mg/dL

Glucose 188 mg/dL

Serum albumin 3.0 g/dL

Amylase 185 unit/L

Serum Creatinine 0.5 mg/dL

BUN 15 mg/dL

Alkaline Phos. 155 unit/L • Protein 8.6 g/dL Bilirubin 3.5 mg/dL

Formulate three hypotheses based on cues provided

Select the priority hypothesis

Defend your selection

Describe an evaluation plan for the priority hypothesis based on expected client outcomes

Describe the next steps in the clinical judgement model including:

• Actions if satisfied with client outcomes
• Actions if not satisfied with client outcomes

Provide headings for each section to keep it organized

Accurately ranks the three scenarios provided in order of priority related to which client will be assessed first, second and third. Provides a clear and detailed defense for the three ranked scenarios including internal and external cue recognition.

Formulate three hypotheses based on cues provided and select a priority hypothesis including a clearly stated, detailed defense for your priority selection.

Provide a clearly stated, detailed description of an evaluation plan for the priority hypothesis based on expected client outcomes.

Provide clearly stated, detailed description of the next steps in the clinical judgement model including if satisfied with client outcomes and if not satisfied with client outcomes. Dynamic Process of Clinical Judgement Discussion Paper

Do not use 1st person in scholarly writing. Use 3rd person only. APA format. Formal style reflected throughout the document, including no spelling, grammar, or APA format errors. Adequate references with adequate in text citation. Please do this assignment using only research published within the past 5 years. Plagiarism free

ADDITIONAL INSTRUCTIONS FOR THE CLASS –

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• Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

• Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week. Dynamic Process of Clinical Judgement Discussion Paper

• APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition. Dynamic Process of Clinical Judgement Discussion Paper

• Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

• LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score. Dynamic Process of Clinical Judgement Discussion Paper

• Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading. Dynamic Process of Clinical Judgement Discussion Paper

• Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours. Dynamic Process of Clinical Judgement Discussion Paper

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We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium. Dynamic Process of Clinical Judgement Discussion Paper

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