Assessment Task 1: Case Study - Nursing & Medication Management
Due date Week 4 Tuesday 10th
December 2359hrs
Weighting 40%
Length 1800 words
Learning outcomes 1 & 2
National Competency Standards 3, 4, 5
Graduate Attributes Knowledge, communication, problem solving
Directions
Read the case study (Appendix A) and respond to the directions and questions that follow.
(Also see assessment help in Appendix B)
Marking Criteria (you will be assessed on your ability to:) Demonstrate understanding through the provision of detailed, accurate answers to each of the questions posed.
Substantiate points with reference to recent research and literature (using correct Harvard style).
Write clearly and logically in an appropriate academic style with correct spelling and grammar.
Appendix A
Case Study
Mrs. Amelia Middleton is a 68 year old retired receptionist who is bought in by ambulance to the
Emergency Department (ED) of her local hospital. Her son Paul is with her. Paul had called the
ambulance service earlier stating that his mother woke this morning complaining of a headache
and is now unable to lift her right arm and has been having difficulty speaking.
On examination Mrs. Middleton has a BP of 200/110, Pulse 78 and irregular, Respiratory Rate 16,
SpO2 98%, Glasgow coma scale 12, & Temp 36.8. Her blood sugar level is 4.8. She also has
paralysis of the right arm and face and loss of sensation to touch on the right side of her face and
right arm. She appears to understand what is being said to her but cannot respond verbally.
Mrs. Middleton’s history includes depression and lower gastro-intestinal bleeding associated with
haemorrhoids. She has no known allergies.
Mrs. Middleton was an only child, her father died of an anterior myocardial infarct at age 57 and
her mother died of breast cancer at the age of 72.
Mrs. Middleton currently lives with her son, due to the recent death of her husband, Geoff. They
are in the process of trying to sell the family home. She has three other children, all of whom live
interstate.
Amelia Middleton’s current medications are:
Sertraline 100mg mane
Rectinol HC topically as required
At the time of arrival Mrs. Middleton had a provisional diagnosis of CVA.
Mrs. Middleton was ordered a CT scan which was conducted 6 hours after her arrival to ED, the
results excluded the presence of a hemorrhagic CVA but indicated ischemic CVA.
A 12 lead ECG was also conducted on arrival and Mrs. Middleton was found to be in atrial
fibrillation.
Directions
In this case study you will need to explore the pathophysiology, nursing management and
medication management of the case and demonstrate your understanding in the answers you
provide to the following questions. Your answers should be informed by your reading of current
research and literature.
1) What is the pathophysiology associated with hemorrhagic and ischemic CVA and discuss
the precipitating factors for each?
2) How would you manage the nursing care of Mrs. Middleton in the first 24 hours? Justify
your answer.
3) Is thrombolysis indicated for Mrs. Middleton? Discuss the use of thrombolytic agents for
stroke patients and provide a rationale for your answer in this case.
4) The doctor is considering prescribing aspirin, carvedilol and atorvastatin for Mrs. Middleton
following her CVA. Do you agree with his decision? Outline your understanding of these
drugs and any benefits or risks associated with their use in this case.
5) What is the significance of atrial fibrillation in this case and discuss possible
pharmacological interventions that may be considered for Mrs. Middleton.
Appendix B
Helpful Hints for Assessment 1 – Case Study
• This assessment is to be presented in an essay format, and therefore we require you to write a very brief introduction and conclusion (at most one or two sentences). Do not rewrite the case study in your introduction.
• Please respond to the questions in a logical format. You may use a heading at the start of each new question.
• Dot points are not acceptable.
• References must be current, preferably from the past five years. Your reading should demonstrate wide reading from a variety of sources, such as texts, journals and clinical practice guidelines.
• Consider the quality rather than the quantity of the references you use. Wikipedia and the Better Health Channel are not acceptable references. At this point in your BN we expect you to engage with the practice literature.
• You may use tables, however they must be included as an appendix and the information must pertain and be integrated into the body of your paper that is, not simply added on to the end.
• You may use pictures and diagrams but they must be used to support your paper and be integrated. They must be clearly labeled and referenced.
• Spelling and grammar are very important, try to have another person read your paper prior to submission.
• Requests for extension must be in accordance with the SNM Assessment Policy (please see the SNM webpage) they won’t be accepted if requested within 24 hours of the due date.
• You will submit your paper online and receive you grade a feedback online
Recommended reading
Brotto,V and Rafferty, K.2012, Clinical dosage calculations for Australia and New Zealand
Crisp, J & Taylor, C (eds) 2012, Potter and Perry’s fundamentals of nursing Australian
Edition, 4th edn, Elsevier Mosby, Sydney.
Levett-Jones, T (ed) 2013, Clinical Reasoning: Learning to think like a nurse. Pearson,
NSW.
Tiziani, A 2010, Havard’s nursing guide to drugs, 8th edn, Churchill Livingstone, Sydney.
Tollefson, J 2010, Clinical psychomotor skills: Assessment tools for nursing students, 4th
edn, Cengage Learning, Melbourne
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