Clinical Reasoning Cycle and Delirium Practice Flashcards

VOCABULARY-style flashcards covering the clinical reasoning cycle steps, delirium characteristics, and specific patient case studies including vital signs and nursing assessments.

Clinical Reasoning Cycle

A systematic process used by healthcare professionals to assess, diagnose, and treat patients, following the phases: Consider the patient, Collect cues/information, Process the information, Identify problems/issues, Establish goals, Take action, Evaluate outcomes, and Reflect on the process.

Subjective Data

Information provided by the patient or their family, such as what the patient tells you or reports from family members (e.g., a daughter reporting an acute change in her mother's baseline behavior).

Objective Data

Measurable and observable clinical information, including vital signs, assessment findings, medical history, medications, and laboratory results.

Delirium

A clinical state characterized by an acute onset that develops over hours or days, fluctuates, commonly involves impaired attention, is often caused by an underlying illness, and can be reversible.

Indicators of Delirium

The combination of an acute change from baseline, fluctuating confusion, and impaired attention.

Margaret Brown Scenario Cues

An 82-year-old patient with a recent UTI presenting with sudden confusion, restlessness, agitation, and vital signs including $RR: 24/min$, $HR: 108/min$, $BP: 104/68\,mm\,Hg$, and a temperature of $38.2^{\circ}C$.

Post-operative Hip Surgery Patient Cues

A 75-year-old patient one day post-surgery with an acute change in cognition, pulling at a cannula, and vital signs including $RR: 22$, $HR: 105$, $BP: 100/62$, $SpO_2: 92\%$, temperature $37.9^{\circ}C$, and pain level $7/10$.

Robert Scenario Cues

A 79-year-old male with a UTI experiencing an acute change in cognition, restlessness, and vitals of $HR: 110$, $BP: 102/69$, $O_2: 91\%\ \text{on}\ RA$, $GCS: 13$, and temperature of $38.0^{\circ}C$.

SMART Goals

Clinical goals that are patient-centered, measurable, achievable, and timely.

Problem Prioritization

The process of ranking patient issues using the ABC (Airway, Breathing, Circulation) framework and the risk of clinical deterioration.

Potential Causes of Delirium

Underlying physiological problems including infection, pain, dehydration, hypoxia, medication effects, and urinary retention.

Neurological Status Assessment

Evaluations conducted to monitor the patient for deterioration, covering level of consciousness, orientation (to person, place, and time), behavior, and cognition.

Nursing Interventions for Agitated/Confused Patients

Maintaining a safe environment (e.g., bed in appropriate position, call bell within reach), providing close observation, using simple language to orient the patient, and investigating the underlying physiological cause.

Evaluation of Delirium Interventions

Assessing for improvements such as the patient becoming calmer, being able to identify their location, following simple instructions, and vital signs returning to stable ranges.

Clinical Reasoning Phase 8: Reflect on the Process

A review stage where the nurse considers what went well, what could be done differently, if deterioration was recognized early, and if communication was appropriate.