Diagnostic reasoning is a dynamic thinking process that leads to the identification of a hypothesis that beat explains the clinical evidence. Nurses in advanced practice today frequently diagnose the origin of medical and nursing problems that develop in acutely and critically ill adults. Inherent in the specialty fields of acute and critical care are unique factors that can affect the quality of diagnostic reasoning and can potentially complicate the process. An understanding of the basic principles underpinning diagnostic reasoning and the associated common errors is essential for clinicians and students to improve their diagnostic skills

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