Clinical Judgment Model Concept Map
Title: _RPN______ Name:___Shahed Asfahani___ Date:___Jan 28 th, 2023____
Recognize Cues
Filter information from different sources
(eg: signs, symptoms, medical history, etc)
Analyze Cues
Organizing and linking the recognized cues
above to step to the client’s clinical
presentation. Candidates should establish
probable client needs, concerns, or
problems.
Prioritize Hypothesis
Evaluating and ranking hypotheses
according to priority (urgency, likelihood,
risk, difficulty, time, etc.)
Generate Solutions
Identifying expected outcomes and using
hypotheses to define a set of interventions
for the expected outcome
Take Action
Implementing the solution(s) that
addresses the highest priorities. Important
to recognize that sometimes no action is
an action itself
 Complains of fatigue, malaise and fever for 3
weeks.
 Temp ranging from 38.3 to 40 degrees in past
week reported by patient. On admission
temperature 37.8. Been taking acetaminophen
and ibuprofen every 6 hours. Last dose prior to
coming to hospital.
 Ready for discharge
 History of pre-hypertension and Reynaud’s
disease. No surgeries or home meds.
 Vitals at start of shift  blood pressure 113/80,
Heart rate 110 (tachycardia), Pulse Ox 95%,
respiratory rate 18, and temperature 38.3
 Baseline systolic reported by patient 130-140.
 Became diaphoretic and pale, Blood pressure
dropped to 96/72, temperature at 39.2, heart
rate 130
 150mL of tea coloured urine
 a lactate of 7 and pH is 7.2 on the iStat
 Dehydration – patient feeling extremely week,
Tea coloured urine, Low BP, high HR.
 All symptoms can be possible of sepsis  temp,
malaise, increase HR
 Patient lethargic.
 Early signs of Sepsis
 Increase risk of Dehydration
 Risk for Falls
 Report findings to NP, advocate for patient
 Expect new orders and patient to be admitted
to the hospital.
 Obtain routine lab orders.
 Bolus to increase blood pressure
 Initiate antibiotics as per order.
 Establish IV access to initiate bolus STAT for
Blood pressure.
 Repeat vitals q 5 minutes
 Start telemetry
 Start 1g vancomycin after blood cultures and
blood work is drawn
 Monitor patient LOC
 2nd bolus given after lactate and ABG results
  Request transfer to ICU
Evaluate Outcomes Expect patient to respond to antibiotics and
Comparing observed outcomes against restore vitals signs to normal baseline
expected outcomes