• Subject Name : Nursing

Clinical Reasoning Cycle

Table of Contents


Key aspects of CRC step 1.

Potential elements of CRC stage 2.

Discussion about COPD pathophysiology.

Information interpretation for CRC step 3.

Prior nursing challenges.

Significant influence of COPD..



Introduction to Effective Communication in Nursing Practice

Clinical Reasoning Cycle (CRC) is proved to be important for the nursing practice, as this can offer platform through which the healthcare professionals gather cues, processing relevant sets of information for better understanding the patient’s health issues (Blakey, Guinea & Saghafi, 2017). The discussion is highlighting the aforementioned factor step-wise for better understanding the health issues of Ms A. Abimbola, a 56 years old woman.

Key Aspects of CRC step 1

Based on the available information regarding CRC, it can be identified that the concerned healthcare model plays pivotal role in nursing, as this helps the caregivers to gather and interpret health related information about the patient. This improves the medication practice for the healthcare professionals as well. According to Croft et al. (2018), the aforementioned model of nursing can be classified in to certain stages (8) for ensuring better performance in treatment, especially for aged people. In-depth analysis of the stages of CRC, it can be identified that in the first stage, the caregivers are considering the patient’s current health situation. Contextually, the case study evaluates that Ms Abimbola has been suffering acute breathing shortness. As commented by Daly, (2018), first stage of CRC involves mind mapping for the caregivers, through which they are arranging the required actions and making proper decisions about the patient’s health.

Patient’s Situations Considering

This can be the tool for the nurses to understand preventable characteristics of the disease. This helps to make better diagnosis by highlighting symptoms and signs (Du et al. 2018). In this process of treatment, the initial assessment of the caregiver for the affected lady and the medications like 5mg salbutamol nebuliser repetition in every 20 minutes and other aspects can be made (Miravitlles et al. 2017).

Potential Elements of CRC Stage 2

After considering the patient’s health situations, the caregivers would like to concentrate on finding cues related to health factors of Ms Abimbola. As opined by Du et al. (2018), this practice will help the healthcare professionals to identify the reasons of the disease and offer effective treatment. After accumulating information regarding the lady, it can be identified that she is a single parent, hence; has to lead hectic life for looking after her three daughters. The patient was earlier diagnosed by her GP as increasing short breathing two weeks earlier. Additionally, she had been diagnosed as overnight sleep CPAP, hypertension, and type 2 diabetes three years ago. These information sets collective guide the caregivers to identify the lady’s disclosure towards industrial dust. The available information seeking also helps in understanding that the lady has COPD. According to Brett & McCullough, (2017), these previous medical histories can help the caregivers to plan current medication along with present vital signs.

Discussion about COPD Pathophysiology

After accumulating data sets of the lady from previous medical reports, the healthcare professionals are required to process those in current treatment. Based on the characteristics COPD (Chronic obstructive pulmonary disease) is the abnormal inflammatory lungs response due to ill reversible airflow (Trimmer, 2017). Based on the available information, it can be identified that the lady has shortness in breathing while preparing breakfast for her daughters. Hence, the change in the physiological aspects is easy tiredness. Additionally, it can be sensed that the lady positively reflects the pathophysiology regarding COPD.

Information Interpretation for CRC step 3

The information sets like vital symptoms of CPAP, type 2 diabetes, hypertension, and other health related factors of Ms Abimbola, through which the further medication decisions can be made in the fourth stage of CRC treatment. Hence, it can be sensed that the priory, the caregiver of the lady needs to analyse her past medical reports and health issues, then the lady can be guided to Spirometry testing by following guidelines from Australian healthcare (copdx.org.au, 2020). Moreover, the nurse can implement Calgary-Cambridge Guide for combining COPD pathological description along with patient’s subjective illness experiences (Iversen et al. 2020).

Prior Nursing Challenges

After accumulating relevant data sets from the previous analysis, it can be identified that the nurses are required to be high skilled and cooperative to analyse the patient’s past medical reports and make proper medication practice. The potential challenge in this process is communication development with the patients. The low-skilled caregivers fail to develop communication with the patients. Thus, they failed to gather vital information from them before further treatment (Bello, 2017). Unskilled healthcare professionals cannot decode the previous medical reports and fail to identify core reason for the health issue.

Significant Influence of COPD

After going through previous analysis, it can be identified that COPD impacted on health of the patients, which includes breathing shortness, increasing coughing, fatigue, along with sputum increasing due to exacerbation symptoms (Gao et al. 2016). These can enhance the SGRQ-C severity as well for the patients. 

Three activities to manage COPD can be guided by using Roper-Logan & Tierney model in nursing. Through this, the healthcare professionals can guide the patients to leave their smoking habits by nicotine replacement process, guides the individuals to do exercises for muscle strength development and beat of walking for everyday (COPD Guidelines, 2020). The medication practice can be guided to be maintained effectively through this as well.

Conclusion on Effective Communication in Nursing Practice

Hence, in a collective note, it can be identified that the discussion is dealing with the CRC model of treatment. The study identifies the issues of Ms Abimbola, a 56 years old lady. In-depth analysis of the previous sections, it can be identified that the healthcare professionals are guided to implement Roper-Logan & Tierney model for managing COPD by gathering information from previous medical reports of the patients and advice medication by setting up communication with patients.

References for Effective Communication in Nursing Practice

Anderson, E., Wiener, R. S., Resnick, K., Elwy, A. R., & Rinne, S. T. (2020). Care Coordination for Veterans With COPD: A Positive Deviance Study. The American journal of managed care26(2), 63-68. Retrieved on: 3rd September 2020 from: http://ajmc.s3.amazonaws.com/_media/_pdf/AJMC_02_2020_Anderson%20final.pdf

Bello, O. (2017). Effective communication in nursing practice: A literature review. Retrieved on: 3rd September 2020 from: https://www.theseus.fi/bitstream/handle/10024/130552/OPE%20THESIS%20Final%20submitted.pdf?sequence=1&isAllowed=y

Blakey, N., Guinea, S., & Saghafi, F. (2017). Transforming undergraduate nursing curriculum by aligning models of clinical reasoning through simulation. Retrieved on: 29th August 2020 from: https://researchbank.acu.edu.au/cgi/viewcontent.cgi?article=11524&context=fhs_pub

Brett, A. S., & McCullough, L. B. (2017). Getting past words: futility and the professional ethics of life-sustaining treatment. Perspectives in biology and medicine60(3), 319-327. Retrieved on: 3rd September 2020 from: https://muse.jhu.edu/article/684809/summary

COPD Guidelines (2020) The COPD-X plan Retrieved on: 3rd September 2020 from: https://copdx.org.au/

Croft, H., Gilligan, C., Rasiah, R., Levett-Jones, T., & Schneider, J. (2018). Thinking in pharmacy practice: a study of community pharmacists’ clinical reasoning in medication supply using the think-aloud method. Pharmacy6(1), 1. Retrieved on: 29th August 2020 from: https://www.mdpi.com/2226-4787/6/1/1/pdf

Daly, P. (2018). A concise guide to clinical reasoning. Journal of evaluation in clinical practice24(5), 966-972. Retrieved on: 27th August 2020 from: https://www.academia.edu/download/60227954/A_Concise_Guide_to_Clinical_Reasoning_prepublication.pdf

Du, G., Li, X., Hu, H., & Ouyang, X. (2018). Optimizing Daily Service Scheduling for Medical Diagnostic Equipment Considering Patient Satisfaction and Hospital Revenue. Sustainability10(9), 3349. Retrieved on: 3rd September 2020 from: https://www.mdpi.com/2071-1050/10/9/3349/pdf

Gao, Y. H., Guan, W. J., Liu, Q., Wang, H. Q., Zhu, Y. N., Chen, R. C., & Zhang, G. J. (2016). Impact of COPD and emphysema on survival of patients with lung cancer: A meta‐analysis of observational studies. Respirology21(2), 269-279. Retrieved on: 3rd September 2020 from: https://onlinelibrary.wiley.com/doi/pdf/10.1111/resp.12661

 Iversen, E. D., Wolderslund, M. O., Kofoed, P. E., Gulbrandsen, P., Poulsen, H., Cold, S., & Ammentorp, J. (2020). Codebook for rating clinical communication skills based on the Calgary-Cambridge Guide. BMC Medical Education20, 1-9. Retrieved on: 3rd September 2020 from: https://link.springer.com/content/pdf/10.1186/s12909-020-02050-3.pdf

Miravitlles, M., Alvarez-Gutierrez, F. J., Calle, M., Casanova, C., Cosio, B. G., López-Viña, A., ... & Plaza, V. (2017). Algorithm for identification of asthma–COPD overlap: consensus between the Spanish COPD and asthma guidelines. European Respiratory Journal49(5). Retrieved on: 3rd September 2020 from: https://erj.ersjournals.com/content/erj/49/5/1700068.full.pdf

Trimmer, J. (2017). Chronic Obstructive Pulmonary Disease (COPD). Retrieved on: 3rd September 2020 from: https://digitalcommons.otterbein.edu/cgi/viewcontent.cgi?article=1224&context=stu_msn

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