Case Study 1
Henry Parks is a 68-year-old male who presented to the emergency department with the following signs and symptoms
• extreme fatigue
• dyspnoea which worsens when lying down
• persistent cough
• pulmonary crackles evident upon auscultation
• bilateral pitting odema to lower limbs.
Medical history:
• Hypertension
• Heart failure
• Chronic back pain
• Constipation
Henry states that he takes oxycodone 10mg bd for his chronic back pain however it does not completely relieve the pain and he has difficulty sleeping and mobilising. He is also on medication to manage his heart failure and hypertension which he forgets to take sometimes.
Social History;
Henry lives with his wife, Joan in a rental property which has stairs to the front door which Henry is finding extremely difficulty to navigate. He spends most of his day watching TV and feels frustrated he is unable to enjoy his past interests of gardening and going to the community centre with his wife. They both receive the aged care pension however find that after paying rent, bills and food there is not much money left for any extra expenses. Currently Joan does all the cooking and cleaning as Henry simply cannot help due to his chronic pain, fatigue and limited mobility. Joan states that she doesn’t know how long she can keep going and is finding it difficult to keep up with the housework and cooking. She said that sometimes Henry goes for days without showering. Besides their son who visits them about once a month they don’t really see anyone as it is too difficult to go out.
On arrival to ED Henry’s observations were:
• RR 28 breaths per minute
• Sp02 88% on room air
• HR 120bpm
• BP 160/100
• Temp: 36.9 degrees celcius
• GCS 14
Mr. Parks was diagnosed with pulmonary oedema due to an exacerbation of his heart failure. He was treated with oxygen therapy 8L Hi Flow humidified oxygen and 80mg IV frusemide. Investigations ordered were Chest X-ray and pathology which did not show any infection. Mr. Parks responded to treatment and his observations improved.
Q1. Explain Mr. Parks presenting signs and symptoms in relation to his medical history (what are the pathophysiological changes that are occurring)
• extreme fatigue
• dyspnoea which worsens when lying down
• persistent cough
• pulmonary crackles evident upon auscultation
• bilateral pitting oedema to lower limbs.
Q2. Explain why the medical officer ordered Hi-flow oxygen and frusemide.
Q3. Discuss in detail 3 examples of non-pharmacological pain management strategies for Henry. (Provide referencing)
Q4. What strategies could be suggested to Henry to manage the symptoms of heart failure and reduce the risk of re-admission due to exacerbation of heart failure? Explain why. (Provide referencing)
Q5. Discuss the impacts of ALL of Henry’s chronic conditions on Henry and Joan. Discuss the likely social, emotional, physical, psychological and financial impacts.
SOCIAL
• Henry
• Joan
EMOTIONAL/PSYCHOLOGICAL
• Henry
• Joan
PHYSICAL
• Henry
• Joan
FINANCIAL
• Henry
• Joan
Q6. What are the likely causes of constipation for Henry and what nursing interventions could be implemented?
Q7. Suggest which interdisciplinary health teams in the hospital would be able to support Henry and explain in detail the support they provide. (Provide referencing)
Q8. Identify community based care services that would be able to assist Henry and how he could access them (think of government funded programs) and explain why they would be of benefit. Research this carefully keeping in mind that he will not be able to access services that are not in Australia. (Provide referencing)
Q9. Besides healthcare professionals which people are the most important ones to involve when developing the self-management strategies for Henry? Explain why.
Q10. How would you evaluate the effectiveness of any health education that you provide to Henry. Suggest at least 2 strategies.
Case Study 2
Voula Papadopoulos, 75 years of age has been admitted with exacerbation of Chronic Obstructive Pulmonary Disease (COPD). She came to emergency department with increased work of breathing, shortness of breath and productive cough.
On assessment:
• Restless and agitated
• Temp 36.1
• HR 113
• RR 32 with audible wheeze
• SpO2 80% on room air
• Weight 40kg
• Height 1.52m
Medical Management:
• Oxygen 2L per nasal prongs
• Salbutamol 5mg 4hourly
• Ipratropium bromide 500mcg QID
Past medical history
• Osteoarthritis in the knees (uses a walking frame)
• Stroke (resulting in slight left arm hemiparesis and slurred speech)
• Urinary incontinence
Social history:
She lives in a low care aged care facility, and has a daughter who lives nearby. She is a smoker for 40 years a packet a day.
Q11. Evaluate Voula’s presenting signs and symptoms and assessment data and explain any abnormalities in relation to her medical history (what are the pathophysiological changes that are occurring)
• increased work of breathing
• shortness of breath
• productive cough
• Restless and agitated
• Temp 36.1
• HR 113
• RR 32 with audible wheeze
• SpO2 80% on room air
• Weight 40kg, Height 1.52m
Q12. Explain why Voula requires a walking frame (refer to the pathophysiological changes occurring in the body) and how it assists her.
Q13. What preventative strategies could be suggested to Voula reduce the number of episodes of incontinence. (Provide referencing)
Q14. Discuss the impacts of ALL of Voula’s chronic conditions, including the: social, emotional, physical, psychological and financial impacts.
Social:
Emotional/Psychological:
Physical:
Financial:
Q15. List the risk factors specific to Voula that would have contributed to the development of osteoarthritis?
Q16. Suggest which interdisciplinary health teams would be able to support Voula with ALL her health conditions and discuss the support they could provide.
Section 2 – Assessment Task Submission Information
Submission Details Due date: Midnight
1. The assessment task must be submitted as a word document via Canvas.
2. The submission will be run through turnitin which is a plagiarism checker. Ensure that all your responses are your own words. You cannot copy and paste answers.
3. You must include in the header of your assessment:
your name
student ID
You can do this by right-clicking with the mouse over this area and then clicking edit header.
4. Submissions received after the submission date must be approved by your teacher.
Summary of Evidence to be Submitted
Correct answers to all questions in the assignment
The task will be assessed as satisfactory when all of the required evidence listed has been satisfactorily demonstrated.
* If applicable, for graded units, the task must be satisfactorily completed before marks will be allocated. Refer to your unit outline for more information.
Section 3 – Assessment Task Criteria and Outcome
All items/criteria must be demonstrated satisfactorily to achieve this task. The items/criteria for this activity will be assessed as S – Satisfactory or US – Unsatisfactory.
Items/criteria S/US
1. Student explains the presenting signs and symptoms in relation to Henry’s medical history and details the pathophysiological changes that are occurring
2. Student accurately explains why the medical officer ordered Hi-flow oxygen and frusemide
3. Student provides 3 detailed examples of non-pharmacological pain management strategies for Henry and provides reference(s)
4. Student provides appropriate strategies to manage the symptoms of heart failure and to reduce the risk of re-admission due to exacerbation of heart failure and provides rationale and reference(s)
5. Student addresses the likely social, emotional/psychological, physical and financial impacts of all of Henry’s chronic conditions on Henry and Joan
6. Student accurately identifies the likely causes of constipation for Henry and states at least three relevant nursing interventions.
7. Student identifies the interdisciplinary health teams in the hospital which would be able to support Henry and explains in detail the support could they provide and provides reference(s)
8. Student identifies relevant community based care services that would be able to assist Henry and Joan and explains why and provides reference(s)
9. Student accurately identifies which people are the most important ones to involve when developing the self-management strategies for Henry and explains why.
10. Student provides at least 2 effective strategies to evaluate the effectiveness of any health education.
11. Student accurately explains the pathophysiological changes which relate to Voula’s presenting signs and symptoms and assessment data
12. Student is able to accurately explain the pathophysiological changes that result in Voula requiring a walking frame and also explains how the frame assists her.
13 Student is able to list preventative strategies that would assist Voula to reduce the number of episodes of incontinence and has provided reference(s)
14 Student has accurately discussed the social, emotional/psychological, physical and financial impacts of ALL of Voula’s chronic conditions
15 Student accurately lists the risk factors for Voula that would have contributed to the development of osteoarthritis?
16 Student accurately lists the interdisciplinary health teams who would be able to support Voula with ALL her health conditions and discuss the support they could provide.
Section 4 – General Assessment Information
Decision Making Rules • Assessment submissions, except tests and other in-class assessments, are due before midnight of the due date and can only be submitted through Canvas.
• All written assessments must be submitted through Canvas.
• Students are assessed as either S (satisfactory) or US (unsatisfactory) for each task. Each task explains how students are assessed. For graded tasks – Satisfactory submissions are then graded between 50% and 100% using marking guides or rubrics which are in the assessment task documents.
• Every task must be completed satisfactorily to be assessed as competent in the unit.
• Submissions graded unsatisfactory must be resubmitted fourteen (14) days post feedback been given. IT IS THE STUDENTS RESPONSIBILITY TO CHECK CANVAS FOR ASSESSMENT RESULTS AND FEEDBACK AND RESPOND ACCORDINGLY.
• Late submissions, over 10 days, if satisfactory, cannot receive more than 50%.
• The student will lose 5% for each day the assessment task is submitted late.
• There are two (2) attempts only for each graded theory-based assessment tasks to achieve 50% or above and up to three (3) attempts for competency-based assessment tasks and practical-based assessment tasks to achieve or demonstrate a satisfactory result.
• No resit or re-assessment will be allowed if the final mark for first attempt is less than 30%.
• The maximum you can achieve for any second attempt is 50%.
Please see your teacher as soon as possible if you have any issues with completing your assessment tasks including meeting the due date
Plagiarism There are serious penalties for plagiarism that may include repeating a new assessment task or being withdrawn for the unit / course.
Students must ensure that all assessments are their own work (or group work and clearly noted as such).
Refer to https://www.swinburne.edu.au/current-students/manage-course/exams-results-assessment/plagiarism-academic-integrity/plagiarism-misconduct/
Reasonable Adjustment Students may request reasonable adjustment for assessment tasks.
Reasonable adjustment usually involves varying:
the processes for conducting the assessment (eg: allowing additional time, varying the venue)
the evidence gathering techniques (eg: oral rather than written questioning, use of a scribe, modifications to equipment)
However, the evidence collected must allow the student to demonstrate all requirements of the unit.
If you have any other issue that may impact your ability to undertake the assessment, please discuss with your teacher.
