Case study of demonstrating learning in practice

Case study of demonstrating learning in practice The purpose of this assignment is to provide evidence that will demonstrate my learning in practice. It will contain four reflective accounts that will display my ability to meet the learning outcomes of this module. Amulya (no date) describes reflection as a process of exploring your own actions and experiences, and further states that the purpose of reflection is to develop learning. Johns (2004), expands on this and describes different layers of reflection, for example reflection in action. This type of reflection occurs at the time of experience, pausing to make sense of the situation and proceeding to a desired conclusion. I will be reflecting on experiences, which is defined by Johns (2004 p 50) as â€Å"learning through experiences†, thus changing perceptions of myself, practice and gaining new insights. Benner (2001) supports learning from experience and states that through experiences it enables the nurse to move from, competent to proficient, further stating that th e proficient nurse will be able to hone in on the most important problems. These learning outcomes will be addressed in turn, discussing what I have learned and highlighting areas for future development. Further evidence can be viewed in Section 2, Appendix’s 1 to four and Section 3; these documents are my learning contracts from the placement I completed. Learning outcome 1 is to recognise and explain the inter-related nature of aetiology, pathophysiology and clinical features of named conditions that cause health care problems. The appropriate evidence based management required and the anticipated outcomes. Campbell (2006) states an understanding of physiology and pathophysiology is deemed necessary in the understanding of treatment and the management of patients, thus improving patient care. Dunning (2003) supports this view and says the nurses understanding of pathophysiology and classification of the disease process such as diabetes improves the care they provide. This i s a reflective account, of an episode of care, which I was involved in. My patient had been admitted for ketoacidosis. Diabetes UK (no date) describes ketoacidosis as acidity of the blood caused by excessive amounts of ketones. Johnson (2004) expands on this and states it occurs from the lack of glucose entering the cell which is used as energy. As a result the body then uses its own store of fat as an alternative for energy and this use of energy produces an acid known as ketones. Dunning (2003) describes clinical features as hyperglycaemia, which is a result of decreased use of glucose by the cells and the increased glucose produced by the liver; dehydration and electrolyte loss resulting from polyuria and lastly acidosis is due to the breakdown of fatty acids and production of ketones. They go on to say that symptoms include, increased thirst, this is the bodies attempt to flush out the ketones; fatigue, abdominal pain, kussmauls breathing and tachycardia. As the ketones rise the person may also start to vomit, however vomiting reduces the urine output thus reducing the flushing out of ketones. As a result a coma will develop and this if left untreated can be fatal. Diabetes National Service Framework: Standard (2002) states treatment for ketoasidosis , consists of the administration of insulin, potassium and fluids. Brunner & Suddarths (2004) says fluids are given intravenously to manage dehydration, insulin would be given as a 5 unit bolus every hour, however the amount of insulin to be administered is calculated by the amount of glucose detected in the blood. This is what is referred to as an insulin sliding scale, the set amounts are shown on the insulin recording documentation. Potassium is also given to manage the electrolyte loss.