Nursing Care Plan In Nursing

Detect the problem
The first priority nursing diagnosis is ineffective breathing pattern r/t presence of secretions AMB tachypnea, productive cough and low oxygen saturation. Excess fluid volume r/t problems in the kidney AMB pulmonary congestion and pitting edema +1, is the second diagnosis. The third one is activity intolerance r/t disturbances in the oxygen supply and oxygen demand AMB unstable vitals and chest pain with activity.

Formulate goals At the end of the duty the patient will be able to demonstrate pursed lip breathing, report reduction in the chest pain episodes and know how to monitor the recurrence of fluid excess. The long term goals will be met after 5 days from the nursing interventions, such as; patient will have a normal

This cycle contains 6 steps and those stages are “description, feelings, evaluation, analysis, conclusion and action plan” (Williams, Woolliams & Spiro, 2013). The incident happened with Ms. W, I asked my preceptor to take Ms. W for my nursing care plan. My preceptor advised me not to take this patient, because she is elderly. She asked me to take one handsome male and she said believe me, you will enjoy more. I was shocked from her, but I smiled. I was scared to talk to her, because I do not want to damage our relationship. After a few hours, I chatted with her about what happened in the evening. She was surprised from me, she said I thought you are cool and you want to enjoy your time. What was sad in this incident is the discrimination happened from a nurse. My preceptor falls into an error due to her personal bias and it is called ascertainment bias. In this type of clinical reasoning error the person’s thinking will be controlled by previous assumptions, such as ageism, stereotyping and stigmatism (Volacu, 2017). The lesson from this incident is to separate my personal biases and provide an equal care to all

Clinical reasoning cycle is applied to reflect on the clinical decision making process. Ms. W case was an application of the clinical reasoning cycle with. She was diagnosed with MI which is an abnormal balance between the oxygen delivery and supply due to the accumulation of plaque. All evidence based practices are supporting the implementation of the clinical decision making process during the nursing school period to help them and the nursing profession. There are multiple factors that impede the correct implementation of the clinical reasoning process such as stereotyping, preconception and the personal bias. Future nurses must be will oriented about these factors to prevent them from falling into clinical reasoning