This assessment task requires you to submit a written report (1000 words) that demonstrates your ability to apply selected phases of the clinical reasoning process, at an introductory level, to your assigned patient scenario from Assessment Task 2A: 

Part 1: 

1. Provide a summary of your assigned patient scenario. This is the introduction of your written report. You should consider the patient situation in this section. 
2. List the objective and subjective data that you have gathered from reviewing the patient scenario information provided. 
3. Analyse and interpret the identified objective and subjective data. Then consider: 
   • what further cues* you want to collect, and 
   • explain the significance of the cues that you want to collect in relation to the patient's context and principles of anatomy and physiology. 

Part 2: 

Critically reflect on your clinical skills to gather vital signs data (Assessment Task 2A). 

You should take the peer‐review feedback from your partner into account when you prepare for writing this section of the report. 

∙ Identify one aspect of your practice for improvement (something you did not do so well or did not do at all during the skills assessment, e.g. professionalism, quality and safety standard, etc.). Briefly explain what you should do differently next time and why this is important for promoting a positive patient outcome. Outline at least one course of action (what further learning do you need to do) for improving this aspect of your practice. 

Part 1 should be approximately 750 words. Part 2 (critical reflection on the vital signs skills assessment) should be approximately 250 words. 

You will need to use relevant scholarly sources of information (textbooks, journal articles, evidence‐based practice guidelines or clinical care standards) to support your analysis of your patient's health information and critical reflection.

Part 1

Summary

Mr. John Yu (17 years old student) in the presented clinical scenario presented with the signs and symptoms of skin flushing, heat sensation, rapid heartbeat, and fatigue. His vitals proved to be reportedly abnormal (including elevated respiratory rate, pulse, and temperature) on the day of skills assessment after the match. However, the blood pressure of Mr. Yu appeared normal following the vitals assessment.

Analysis of the Identified Cues

Indeed, Mr. Yu's vital signs (recorded during initial assessment after the match) affirm the state of his disturbed homeostasis. The external environment (attributing to the scorching heat and elevated humidity) impacted Mr. Yu's internal body homeostasis (Modell, et al., 2015). This internal disturbance of Mr. Yu's body's physiology became evident through the abnormal vitals. Mr. Yu's blood pressure at rest was reportedly found to be 110/60mmHg. Mr. Yu's pre-hypotensive state is evident from his blood pressure reduction at rest (NIH, 2018). However, on the day of initial assessment (immediately after the sporting activity), the change in Mr. Yu's blood pressure (to 120/70mmHg) occurred under the impact of his body's adaptive regulatory response and oxidative load (Raven & Chapleau, 2014). Mr. Yu's respiratory rate at rest was found to be within the normal range of 12-20 breaths per minute (Badawy, et al., 2017). However, the respiratory rate abnormal elevation following the sporting activity was indicative of a disruption of Mr. Yu's CO2 homeostasis. Indeed, an abnormal reduction in Mr. Yu's arterial PCO2 (under the impact of exercise-induced oxidative stress) resulted in breathing stimulation under the impact of muscle-based reflexes and central command (Guyenet & Bayliss, 2015). This stimulation is indicative of the need for normalizing the pH and arterial PCO2 levels under stressful conditions. Patient's pulse rate recording (i.e., 140 beats per minute) immediately after the match is indicative of an abnormal pulse rate (Pickering, 2013). Mr. Yu's pulse rate elevation/rapid heartbeat after sporting intervention is indicative of the reduction in the augmentation index and central blood pressure. Mr. Yu's pulse rate elevation after sporting activity occurred for establishing the circulatory system homeostasis (Reule & Drawz, 2012). Mr. Yu's skin flushing was indeed the result of his exercise-induced autonomic dysreflexia that resulted in sweating, abnormal heart rate and sweating (Cragg & Krassioukov, 2012). Furthermore, Mr. Yu's temperature elevation after the sporting activity is indicative of temperature dysregulation, increased metabolic demand, dehydration and insensible fluid loss (Dick & Diehl, 2014).   

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