Critical Thinking Question....Need help

[4labdogs]

Male 68 yo cardiac/diabetic patient is acting oddly. During night shift report, the RN told you that he was alert and oriented. When you talk to him about his breakfast, he mumbles to himself and doesn't talk clearly. You ask a question and he doesn't answer you. What do you think is happening here?

What is the problem or issue at hand?

What assumptions (beliefs) have you formed regarding your identified problem?

Is there any other information that you would like to have that is not included in the scenario?

Select the "best" resolution (method to resolve the problem) you'd like to use: Write one positive and one negative outcome for the method you decided to use to resolve this problem:

Method: _________________________________________________

Positive: What "good" would happen if you used this activity or method to resolve the problem?

Negative: What "bad" would happen if you used this activity or method to resolve the problem?

[BBFRN, BSN, PhD]

Thread moved to Nursing Student Assistance forum.

To the OP: if you could possibly post what answers you have come up with on your own so far, that would be a great start. We encourage students to seek assistance with their homework, but you may find that others will not be willing to do your work for you. Good luck to you.

[TessaMae]

Maybe an electrolyte imbalance or a blood sugar issue? I'd start by checking the vitals. What ideas do you have of your own?

[Daytonite, BSN, RN]

critical thinking and the nursing process go hand in hand. so, when you are asked to think critically or solve a problem, your best tool to use is the nursing process. it is a tool. utilize its 5 steps. this is how it will work to help you solve this problem (answer these questions):

step 1 assessment - collect data, do a physical assessment of the patient, assess adl's, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology - the first information that you want to know is the patient's medical history. this man has a heart problem of some sort and diabetes. what do you know about complications of either? arrhythmia problems can cause arrhythmias and lead to perfusion problems and, thus, confusion, can they not? and what about diabetes? if the blood sugar becomes high or low what kind of symptoms might the patient have? so, you need to review these things about the general conditions before moving on. knowing that the patient was ok at report now has sudden onset of mumbling and doesn't answer a question right before breakfast is a significant change in his condition. could it be cardiac related? how? what heart problems could cause sudden onset of difficulty speaking or uncommunicability? stroke? look up diabetes and hypoglycemia. do you suppose he got his insulin early and his breakfast try is delayed?

• cardiac/diabetic
  

step #2 determination of the patient's problem(s) - make a list of the abnormal assessment data

• during night he was alert and oriented
  
• when you talk to him about his breakfast, he mumbles to himself and doesn’t talk clearly; you ask a question and he doesn’t answer you
  

what do you think is happening here? now can you answer these questions?

what is the problem or issue at hand?

what assumptions (beliefs) have you formed regarding your identified problem?

is there any other information that you would like to have that is not included in the scenario?

write one positive and one negative outcome for the method you decided to use to resolve this problem: this will depend on what you decide the problem is and what interventions you want to apply to the situation. outcomes are the predicted results you expect to see when your interventions have been performed and are usually a reversal of the symptoms the patient is displaying or an obliteration of what is causing the problem.

scenarios like this are designed to have you examine all kinds of possibilities and not just nail down one specific problem. they are asking you to write down your thinking process as to what could possibly be going on in all cases first and then decided on one and what you would do for it.

[ZanatuBelmont]

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by 4labdogs

registered user

join date: apr 2007

posts: 2

"male 68 yo cardiac/diabetic patient is acting oddly. during night shift report, the rn told you that he was alert and oriented. when you talk to him about his breakfast, he mumbles to himself and doesn't talk clearly. you ask a question and he doesn't answer you. what do you think is happening here?

what is the problem or issue at hand?"

maybe he has low or high glucose levels? bottoming out? experiencing a stroke?

[4labdogs]

I was already thinking hypoglycemia. But I was thinking that was just to quick and easy. Not so much of critical thinking. I thought info that would be helpful was his recent BP R and last BS. Maybe some Hx on his cardiac condition may be helpful too. It could be helpful to see if he is on insulin and when he received it last. Thank you for reminding me that the nursing process will help make this easier! Could it be he just woke up and some men just mumble. LOL. I think knowing his vitals and BS is very important. Thanks for the help so far.