Case Analysis: 

Thinking Critically to
Analyze Data
       A 45-year old male client was admitted with a chief complaint of abdominal
cramps. One day prior to admission, the client had a loose bowel movement of 6 times
that day. Upon interview, the client feeling stressed at work due to a 2 consecutive week
graveyard shift. The client verbalizes “I feel weak” and looks pale, with dry skin and
mucous membrane, poor skin turgor and a blood pressure of 90/60mmHg. The nurse
conducting the assessment has been working as a nurse for approximately 3 months.
The nurse is being evaluated by a nurse preceptor who will review the data and
interpretations for accuracy. 
 
          Several minutes later, the preceptor asks the nurse: “What nursing diagnosis
would be appropriate for this client?” The nurse responds that, the symptoms need
to be further explored by asking more questions. The preceptor and the nurse reenter
the exam room. The preceptor asks the client, “How is work going? Are you having
any problems at work? At this point, the client puts his head down, and his eyes fill up
with tears.

Questions:

1. After reviewing the data collected, the preceptor discusses critical thinking
and diagnostic reasoning with the novice nurse and explains how these
are vital to clinical practice. Explain why does critical thinking and
diagnostic reasoning is important in nursing practice?

Critical thinking is the skill that the nursing profession is expected to cultivate. Critical
thinking is an ability that is important in nursing because the understanding and decision
of a nurse will save lives. These skills can be extended to patient care using the system
known as the nursing process. Diagnostic reasoning often requires a complex thought
process that is a hypothesis and leads to a diagnosis that better describes the
symptoms and clinical findings of a given clinical situation. Both skills should be applied
in order to have a good and positive result.

2. The preceptor asks the client questions about his "work". Why do you
think such question is important in the case of the client?
According to the interview, the client's feeling depressed at work due to a 2-week
consecutive shift in the graveyard. And this may be the reason why a client has a high
degree of stress and a lack of physical strength and energy.

3. Identify an actual nursing diagnosis for the case of the client (following the
P+E+S format). 
The possible nursing diagnosis based from the data that I identified using the PES
format was diarrhea r/t, high stress level and client verbalization of “I feel weak” stress
at work, looks pale with dry skin and mucus membrane, poor skin turgor and loose
bowel movement six times the day of the scenario with the BP of 90/60mmHg.