Reference no: EM133873137

Question

As a first-year nursing student in an aged care facility, you have been assigned to care for Mrs Mala Chen, an 82 year old woman.

Mrs Chen suffered a cerebrovascular accident (CVA or stroke) five years ago. Mr Chen was unable to care for his wife following the CVA and so she moved into an aged care facility. Following the CVA, Mrs Chen uses a 4 wheel walker when mobilising due to reduced function in her left leg. Mr Chen remains living in the family home and visits Mrs Chen daily. Mrs Chen's daughter and her family also live close by and visit her regularly.

The previous day Mrs Chen had a fall from bed and was found to be incontinent of urine and faeces. Mrs Chen is now complaining of throbbing pain in her left elbow and, on examination, the area appears to be swollen. An x-ray was performed, and no fracture was noted on the x-ray. Mrs Chen has been ordered, and administered, regular analgesic and anti-inflammatory medications. Mrs Chen is also reluctant to eat her meals or drink fluids, stating she is worried about falling again when trying to get to the bathroom.

Discuss this patient case scenario, using the first three steps of the clinical reasoning cycle as outlined below:

Step 1

Review Mrs Chen's situation and describe your initial impression considering the context, person and situation.

Step 2

Identify relevant cues from the case scenario using review and recall and provide a brief rationale, with support from the literature, for these cues.

Describe what information you need to gather and provide a brief rationale, with support from the literature.

Step 3

Using the cues and information from the patient case scenario, analyse the facts using interpret, discriminate, relate and/or infer with support from the literature.