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Clinical Reasoning

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Submitted By monkey99881
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Crackles
Alelectasis

Pneumonia
- accumulation of secretion in alveoli, affecting gas exchange
- decrease ventilation
- predominant in inspiration
- louder breath sounds
- brichophone, ecophony, whisper peridctoquay

Wheezes
Asthma
Broncospasm, inflammation and odema increase respiration and viscous mucus
- increase RR audible wheeze, SOB< accessory muscles, cyanosis, retraction of intercostal spaces
- wheezing
Predominant on expiration

Emphasema
- irreversible damage to alveoli, increase airway resistnece
- enlargement of air sacs , on expiration
- hyperinflated lungs
- altered breathing
- barrel chest, use of accessort muscles, tripod position, SOB
- decreased breath sounds

Pleural friction rub
- inflammation of the pleura
- pain

Pneumothorax
- free air in the pleural space of the lung causes a collapse
- inspection: unqual chest expansion, tachynopnea, cyanosis, bulging in inerspaces
- palpation: tracheal shift, unequal chest expansion, tachycardia, decrease B
- no sound

The clinical reasoning cycle
- way of thinking that allows the nurse to make clinical judgements
- has a positive impact in the patient normal steps are
- patient situation, collect cues, process information, identify issues, establish goals, action, evaluate goals, reflect
Patient context: within their context of care
Cues: what already know, what new information is needed and recall what is needed
Process information:
- normal/abnormal
- relevant and irrevant information
- cluster cues
- infer
- match
- predict a potential outcome indentify problems: synthesis the facts and inferences to make a definitive diagnosis about the patient and define the most urgent issue or problem for the patient establish goals: what you want to happen take action: select a course of action and who is the best person to

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