Theoretical Aspect Of The Clinical Reasoning Cycle

Mrs Williamson is a 76-year-old woman admitted to your Orthopaedic ward from the Emergency Department (ED) after she had a fall at home. The ED doctor has referred Mrs Williamson for investigations regarding a possible left foot metatarsal bone fracture and ordered further investigations. Mrs Williamson has had an initial dose of 1000mg Panadol in ED 3 hours ago; with an ongoing order of 1000mg of Panadol PRN 6 hourly. The physical exam shows that Mrs Williamson has pain and redness of her left foot, which has increased over the last 3 hours despite analgesia, and her pain level now is 8/10. She is unable to bear weight on the affected foot. Mrs Williamson is oriented and alert, but concerned as she was brought to the hospital alone.
Mrs Williamson has a history of high blood pressure (hypertension) and she is on antihypertensive medication, Avapro 150mg/day. Mrs Williamson was an active member at the local bowling club and local church, but since her husband died 12 months ago, she has not attended church or bowling. When you introduce yourself to Mrs Williamson, she tells you that she “does not want to be in hospital” and asks you “when can I go home?”
Mrs Williamson’s vital signs upon admission to the ward are:
• Blood pressure 145/90 mm Hg
• Temperature 36.8° Celsius
• Pulse rate 110 beats per minute
• Respiration rate 18 breaths per minute
• Oxygen saturation 95%
Note: The purpose of this assessment is to gain knowledge of the theoretical aspect of the Clinical Reasoning Cycle.
Required Reading