Clinical Reasoning Cycle

Assignment Task: NRSG264 Question:  Reflect on the scope, nature and rationale for assessment of the client in this case study (video) with particular reference to the components of the Mental State Examination (MSE).  Written reflection outlining the student’s reflection on what they learned while watching a video of a patient requiring completion of a Mental State Examination (MSE).   Detailed instruction: For additional instruction and presentation of this assessment please refer to p.17 of the unit outline for the rubric for this assessment task. This document has been prepared to assist you with how to structure your assessment to align with the marking rubric criteria and the Clinical Reasoning Cycle (CRC). I have posted instructions in a blue coloured text throughout. The blue instructions and headings should not appear in your reflection and are there to serve as prompts and as a guide through the stages of the CRC while you construct your reflective paper. The black text with the are the beginning lines of a sentence that you can complete with the necessary information. I have left this document as a Word Doc in order that you can ‘cut and paste’ the content to structure your document. You can start with an introductory sentence that aligns to step 1 of the CRC being: Consider the patient situation. As stated above use the opening lines of the sentences below to insert your information. This paper intends to provide a reflection upon a case study of ‘Alison’ a 38 year old single mother of two, with a current working diagnosis of Clinical Depression.  In consideration of her current situation financially There are significant stressors being However there are some protective factors. Your 2nd step of the CRC is to: Collect cues and information – NRSG264 There are many areas to assess as the aetiology of mental health issues has been linked to a range of factors. As a clinician you need to know what areas these are and the rationale for incorporating them. The assessment of Alison requires a biopsychosocial approach (A good idea to insert some references here; perhaps something from Nizette &Evans). A key feature of this is the mental status examination (MSE). In Alison’s case this was undertaken by the GP. A summary of the findings was that her general appearance was Her behaviour demonstrated Cognitively she was Her speech was Thought process was… Thought content was devoid of any classical delusional themes however contained cognitive distortions o Her affect was Mood state was and Perception indicates that there was no response to or report of Her level of insight was with judgement being Your 3rd step of the CRC is to: Process the information By analysing the available data from this broad approach and more specifically from the MSE, her diagnosis of Depression can be described by the DSM-5 (Good idea to reference the DSM-5 here) as a (Select what type of depressive episode and with what features)  In review of the risk assessment findings she is currently risk for Your 4th step of the CRC is to: Identify problems/issues Alison’s current financial situation coupled by her current level of functioning may impact upon her two children aged by Her relationship with Dave. Your 5th step of the CRC is to: Establish goals In the process of establishing a treatment plan, mindful of a Recovery oriented approach, the plan is to (This is a good place to source some literature to cite) Your 6th step of the CRC is to: Take action – NRSG264 When an individual under treatment presents with symptoms of depression, with compounding financial and personal issues, as a nurse I (as this is a reflection, you can use first person) would need to consider (Also a good place to source and cite evidence based approaches i.e. Cochrane Database and peer reviewed literature). Your 7th step of the CRC is: Evaluate outcomes In order to evaluate clinical outcomes I may need to discuss at a later date with the individual the mutual set goals. Other means of evaluation could be Your final step of the CRC and this assessment is: Reflect on process and new learning  Through the case study and assessment of Alison I have learned that My broader learning around mental health assessment was I believe that in my future practice this will Finish the assessment task by using a concluding sentence This paper imbedded steps of the Clinical Reasoning Cycle (ref) for the purposes of reflecting upon the scope, nature and rationale for assessment of the client in this case study.

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