Case Study Using Critical Thinking
Directions: a) Read the case study; b) research diagnosed disease: Diabetes Type
1. (Use American Diabetes Association, CDC, or Mayo Clinic) & answer the
following questions:
Miss Jones is a 16-year-old female who was brought to the Emergency
Department (ED), after collapsing at school. She is currently alert & oriented, but
pale and weak. A blood glucose performed by the paramedics read “High/Max.”
1. What additional assessment should be performed at this time?
a) Perform patient assessment/ obtain vitals/ obtain allergies
b) administer Insulin to allow the body to absorb the excess glucose
2. What history question would you like to ask of the patient and/or her
parents?
a) has anyone in your family been diagnosed with diabetes?
b) have you been diagnosed with diabetes before?
c) has this ever happened before?
d) do you exercise regularly?
e) do you have any allergies to any medication?
3. What additionally diagnostic tests should be run for Miss Jones?
a) additional diagnostic test for diabetes type 1
b) mental health check diagnostic
c) diagnostic check for electrolytes
d)diagnostic check for glucose levels
e) diagnostic check for genes that can increase risk for type 1 diabetes
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A serum glucose level shows that Miss Jones’ is 535 mg/dl and her urine was
positive for ketones. The provider states that Miss Jones is most likely diabetic.
Her parents are shocked as she has been a healthy and athletic child. The parents
ask the nurse “How can she be diabetic when she is so skinny and exercises all the
time”
4. What is an appropriate response by the nurse?
a) administer a glucose tolerance test
b) educate patient and family on diabetes type 1
6. What treatment do you expect to be ordered for Miss Jones at this time?
a) insulin
b) diet
c)exercise
d)nutrition counseling
Miss Jones is treated for ketoacidosis for the next two days and is feeling
much better. The Diabetic Nurse comes to teach Miss Jones how to selfadminister SubQ insulin, using the insulin pen. Miss Jones states “I can’t stand
needles, isn’t there a pill I can tale instead?
5. What is the most appropriate response by the nurse?
a) educate patient on different methods of administering insulin
6. What options does Miss Jones have for insulin administration?
a) insulin inhaler (least invasive according to needles)
b) insulin pump
c) Insulin pen ( Most invasive according to needles)
Miss Jones demonstrate proper technique for glucose monitoring and selfadministration insulin with the insulin pen. Her blood glucose remain stable
between 120 mg/dl to 180 mg/dl and the provider said that she can go home
today.
This study source was downloaded by 100000839690859 from CourseHero.com on 05-06-2023 00:31:09 GMT -05:00
https://www.coursehero.com/file/181642737/Case-Study-Using-Critical-Thinking-1docx/
6. In addition to the insulin education, she already received, what other
education topics should be included in the discharge teaching?
a) Diet for diabetes type 1
b) when to seek medical attention if insulin pen isn’t enough or out of reach
c) understanding appropriate range for blood sugar level
d) understanding appropriate range for blood pressure
e) understanding complications and risks for hypoglycemia and hyperglycemia
This study source was downloaded by 100000839690859 from CourseHero.com on 05-06-2023 00:31:09 GMT -05:00
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CRITICAL THINKING: THE LOST ART
OF ASKING WHY
November 8, 2021|Graduate Nurse, Registered Nurse
Corey Hardin BSN, RN, CV-BC, CCRN-CMC
What do you think of when you hear the words “critical thinking”? An exceptionally
detailed form of assessment? The ability to think through complex situations? Do you
imagine it’s only for those that work in high stress environment which requires quick
thinking staff that respond to fast paced changes? The nursing profession is beginning
to lose the art of critical thinking. Advanced assessment and decision-making skills are
being replaced with patient care protocols and standardized flowcharts, leaving little
room for a nurse to rationalize through a given situation and conjure possible solutions.
Nurses are trained to treat the human body as a machine with conditional If-Then
assumptions. IF the patient does this, THEN the nurse does that. This analog style of thinking
leaves no room to account for the one truth in medicine, that is, there are no absolutes. Not every
patient will display the same symptoms to a condition or respond in the same manner to a
specific medication. There are too many known and unknown variables in play to teach nurses to
think in absolutes. Instead, we should train our nurses to assess everything by asking “WHY.”
The single most important piece of critical thinking is simply asking WHY and to never
stop. In mental health rotations, nursing students are taught to refrain from asking why
because it may sound accusatory and cause defensiveness. Many times we take this
lesson and then apply it to our entire nursing practice. As a toddler, if we wanted to
know something we would ask WHY and continue until we understood it, but
somewhere along the way we stop. Our inquisitive nature takes a backseat to following
orders and listening to directions. The nursing profession is full of orders and protocols
that limit ones need to ask WHY and critically think. We become task managers rather
than independent thinkers, but in reality, the most important task we should be
completing is asking WHY.
Asking WHY activates the creative left side of your brain and begins the art of critically
thinking. WHY is an open-ended question that causes a nurse to ponder the possibilities
and rationales? For nurses, it is the beginning and the catalyst for deductive
reasoning. WHY did the patient’s blood pressure Increase? Is he in pain, is he anxious,
or is there something else going on? Asking WHY causes a nurse to dig a little bit deeper
than maybe they normally would. Asking Why doesn’t allow the individual to take things at face
value, but rather to investigate the possible causes and solutions. Asking WHY will lead a nurse
to obtain a cascade of further knowledge and understanding. Identifying the patient’s elevated
blood pressure due to abdominal pain led to the discovery of a small bowel obstruction. The
cascading WHY’s lead to the discovery of the origin of pain that could have been missed without
them.
Nursing staff should always ask WHY with every task they need to complete and every
order they receive. If a nurse receives an order from a physician, they should ask
themselves why is this written? If they can answer the question, then they identified that
they have the knowledge and understanding. If the nurse is unable to answer the WHY,
then there is one of two reasons for this. Either the nurse lacks the knowledge and
needs to learn, or an error has occurred, and the nurse can prevent harm to the patient.
Nursing staff have substituted the art of critical thinking with the directives from
protocols and clinical flowcharts. In order to provide the greatest care possible, a nurse
must be willing to continually critically think by asking the WHY in every situation
possible.
Case Study Using Critical Thinking
Directions:
a) Read the case study; b) research diagnosed disease: Diabetes Type 1.
b) (Use American Diabetes Association, CDC, or Mayo Clinic) and:
c) Answer the following questions:
d) Have a reference page
Miss Jones is a 16-year-old female who was brought to the Emergency
Department (ED), after collapsing at school. She is currently alert & oriented, but
pale and weak. A blood glucose performed by the paramedics read “High/Max.”
1. What additional assessment should be performed at this time?
a)
b)
2. What history question would you like to ask of the patient and/or her
parents?
a)
b)
c)
d)
e)
3. What additionally diagnostic tests should be run for Miss Jones?
a)
b)
c)
d)
e)
A serum glucose level shows that Miss Jones’ is 535 mg/dl and her urine was
positive for ketones. The provider states that Miss Jones is most likely diabetic.
Her parents are shocked as she has been a healthy and athletic child. The parents
ask the nurse “How can she be diabetic when she is so skinny and exercises all the
time”
4. What is an appropriate response by the nurse?
a)
b)
6. What treatment do you expect to be ordered for Miss Jones at this time?
a)
b)
c)
d)
Miss Jones is treated for ketoacidosis for the next two days and is feeling
much better. The Diabetic Nurse comes to teach Miss Jones how to selfadminister SubQ insulin, using the insulin pen. Miss Jones states “I can’t stand
needles, isn’t there a pill I can tale instead?
5. What is the most appropriate response by the nurse?
a)
6. What options does Miss Jones have for insulin administration?
a)
b)
c)
Miss Jones demonstrate proper technique for glucose monitoring and selfadministration insulin with the insulin pen. Her blood glucose remain stable
between 120 mg/dl to 180 mg/dl and the provider said that she can go home
today.
6. In addition to the insulin education, she already received, what other
education topics should be included in the discharge teaching?
a)
b)
c)
d)
e)