accordance with academic conventions

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Assignment Format
The assignment is not an essay, i.e. it does not require an introduction or conclusion. However, it must be written in accordance with academic conventions, i.e. full sentences, not dot points. Headings must be used to organise your assignment and please ensure appropriate use of paragraphs. Please set out your assignment clearly as it makes it much easier for tutors to read and assess your work accurately.
This assessment focuses on the clinical knowledge and critical thinking you have gained in the topic and your ability to apply it using critical thinking. You need to demonstrate that you understand the concepts of Pathophysiology and Pharmacology and their effects on the human body.
This is a case study, not a general discussion of CVA. It is important that only information relevant to the specific case be discussed in this assignment. Information that is not directly relevant to the case study should not be included.
Appropriate Resources and Referencing
Referencing must be in line with the School’s referencing guidelines (APA referencing guide). Reference lists do not count towards the word total – but ‘in-text’ citations are included in the word count. References from consumer-based websites & Wikipedia WILL NOT be accepted, this includes but not limited to MyDR, Better Health Channel, Health Direct and WebMD. Please use journal articles, appropriate nursing textbooks etc. References must be no older than 10 years. Please seek clarification if you are uncertain as to whether a referencing source is reliable. Minimum twelve (12) credible references are EXPECTED to be used.
All work must be in your own words (i.e. paraphrased), with references included. All claims or assertions must be supported with evidence form the literature, using APA6 referencing guidelines. This means that everything that is not an original idea needs to be referenced. Copying sentences/paragraphs directly from resources will is not acceptable. Should you not know how to paraphrase, or need guidance with this, please refer to the above resources, and to the academic integrity informational videos under the Assessment 2 tab on FLO. Please check your Turnitin report prior to submitting your assignment (appropriate time management to allow this is your responsibility). Please also refer to the Flinders University Academic Integrity policy and resources:
NURS 2003 AV1 Assessment 2: Case Study
Steven is a 61 year old man who lives with his wife Marie in suburban Adelaide. Steven is a Senior Partner in a Law firm and recently reduced his working hours to 30 hours per week, from 60 hours.
This morning while eating breakfast, Steven experienced sudden onset slurring of speech, had facial droop on his left hand side with weakness in left side upper and lower limbs. Marie spotted these sudden onset of symptoms and immediately called for an ambulance, which arrived within 15 minutes.
Steven was taken to ED where on arrival he had a BP of 165/90 mmHg, HR 95, RR 25, SpO2 94% on room air and a temperature of 37.2. He was diagnosed with an ischaemic CVA.
PMHx:
Asthma – Dx Aged 8
Hypertension – Dx 5 years ago
Prediabetes – Dx 3 years ago
Medication Hx:
Seretide Accuhaler
Ventolin (As Required – Not Required for over 1 Year)
Thiazide
Social Hx notes:
Planning on retirement in 1 – 2 years.
Lives in a Bungalow with his wife Marie, who is a recently Retired Teacher. 2 Adult Children, both married with their own children – 1 lives close by, the other lives overseas. Lifestyle Changes implemented over past 2 – 3 Years following Dx Prediabetes.
Outside work he enjoys golf, usually playing at least 2-3 per week. Also enjoys playing Bridge with Friends.
Took up walking 3 Years ago following Dx Prediabetes. Walks 5 – 6 days per week for between 30 – 45 mins.
Ex-Smoker – Hx Smoking 30 Years x 10 – 15/day – Quit 3 Years ago following Dx Prediabetes.
Social Beer Drinker 10 – 15 Standard Drinks per week with 3 – 4 per session, although sometimes after Golf may be more.
Steven is transferred to the neurological ward. On assessment he is FAST +ve, has left facial droop, left motor weakness (upper limb 0/5, lower limb 2/5) and slurred speech. He is scheduled to see the speech pathologist and the physiotherapist later today.
The doctors have ordered the following medications for discharge:
Apixaban 5 mg PO daily
Atorvastatin 40 mg PO daily
Ezetimibe 10 mg PO daily
Perindopril 2 mg PO daily Amlodipine 10 mg PO daily
Assignment Instructions
2000 words (+/- 10%)
35%
Identify the most likely type and cause of Steve’s CVA
Your answer must include a rationale for this selection and explain how and why this cause can lead to a CVA from a pathophysiological perspective.
Include in your answer the pathophysiology of Steven’s CVA.
In other words, discuss the pathogenesis of the most likely cause and how it can lead to CVA. Consider his past medical history.
20%
Identify two (2) other risk factors that Steven has for CVA
For each of these risk factors explain how & why they can increase the risk of & lead to CVA.
Select two (2) signs and/or symptoms that Steven had as a result of his CVA
For each sign/symptom explain how & why it can occur after a CVA, again from a pathophysiological perspective.
35%
Select three (3) of Steven’s discharge medications and explain why each of the three (3) medications was ordered for Steven
Your discussion should include the pharmacodynamics and pharmacokinetics of each medication, including relevant adverse effects and contraindications.
Each of Steven’s discharge medications is to be administered orally. This means they will all undergo the first pass effect. Explain what first pass is and the implications this has for a drug’s bioavailability.

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Performance Standard:
Assessment Criteria:
%
Excellent
Good
Satisfactory
Unsatisfactory
Pathophysiology: Discuss the pathophysiology of Steven’s CVA showing clear understanding of altered physiology.
Identify the most likely cause of Steven’s CVA. Include a rationale for this cause and explain how and why it can lead to a CVA from a pathophysiological perspective. In other words, discuss the pathogenesis of the most likely cause and how it can lead to a CVA.
35%
☐Comprehensive understanding of pathophysiology in case study ☐Comprehensive discussion/ excellent understanding of cause/ rationale presented ☐Comprehensively supported with relevant evidence.
☐Good understanding of pathophysiology in case study ☐Sound discussion/ good understanding of cause/ rationale presented ☐Sound support of discussion with relevant evidence
☐General understanding of pathophysiology in case study ☐General discussion/ limited understanding of cause/ rationale presented ☐Discussion supported with minimal relevant evidence
☐No or unsatisfactory understanding presented of pathophysiology. ☐Not linked to case study ☐Cause/ rationale not presented / incorrect ☐No or inappropriate evidence utilised to support discussion.
Risk Factors/ Signs & Symptoms: Identify 2 other risk factors that Steven has for a CVA. For each of these risk factors explain how & why they increase the risk of & lead to a CVA.
On transfer to the neurological ward, select 2 signs or symptoms from Steven’s assessment data and explain for each, how & why they occur after a CVA, again from a pathophysiological perspective.
20%
☐Comprehensive understanding / rationale of risk factors and signs and symptoms presented (2 risk factors & 2 signs/symptoms addressed) ☐Linked to case study ☐Comprehensively supported with relevant evidence.
☐Good understanding / rationale of risk factors and signs and symptoms presented (2 risk factors & 2 signs/symptoms addressed) ☐Linked to case study ☐Sound support of discussion with relevant evidence
☐General understanding / rationale of risk factors and signs and symptoms presented (2 risk factors & 2 signs/symptoms addressed) ☐Linked to case study ☐Discussion supported with minimal relevant evidence
☐No or unsatisfactory understanding / rationale of risk factors and signs and symptoms (2 risk factors & 2 signs/symptoms not addressed) ☐Not linked to case study ☐No or inappropriate evidence utilised to support discussion.
Pharmacology: Discuss the rationale for why Steven has been ordered three of his discharge medications. Also, include the pharmacokinetics and pharmacodynamics of each medication, including relevant adverse effects and contraindications.
Each of Steven’s discharge medications is to be administered orally, which means they all undergo the first pass effect. Explain what first pass effect is and the implications this has for a drug’s bioavailability.
35%
☐Comprehensive understanding of indications, pharmacokinetics, pharmacodynamics of each medication, including relevant adverse effects and contraindications. ☐Comprehensive understanding presented of first pass effect and bioavailability. ☐Linked to case study, no irrelevant information included ☐Comprehensively supported with relevant evidence.
☐Good understanding of indications, pharmacokinetics, pharmacodynamics of each medication, including relevant adverse effects and contraindications. ☐Good understanding presented of first pass effect and bioavailability. ☐Linked to case study, no irrelevant information included ☐Sound support of discussion with relevant evidence
☐General understanding of indications, pharmacokinetics, pharmacodynamics of each medication, including relevant adverse effects and contraindications. ☐General understanding presented of first pass effect and bioavailability. ☐Linked to case study, no irrelevant information included ☐Discussion supported with minimal relevant evidence
☐No or unsatisfactory understanding of indications, pharmacokinetics, pharmacodynamics of each medication, including relevant adverse effects and contraindications. ☐No or unsatisfactory understanding presented of first pass effect and bioavailability. ☐Not linked to case study / irrelevant information included ☐No or inappropriate evidence utilised to support discussion.
Academic requirements: Meets all style and academic requirements. Accurate referencing (APA6) Word limit met Clear, concise flow Spelling, grammar and punctuation correct.

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10%
☐All CNHS academic requirements met. No errors. ☐Word limit met, clear, concise flow with correct spelling, grammar and punctuation.
☐All CNHS academic requirements met. ☐Word limit met +/- 10% Logical flow and clarity. All spelling, grammar and punctuation correct.
☐All CNHS academic requirements met with minor errors / omissions. ☐Word limit met +/- 10% Mostly clear, concise flow with minimal spelling, grammar and punctuation issues.
☐Limited or omission of CNHS academic requirements. References presented incorrectly/ inconsistently. ☐Word limit below or exceeds+/- 10% Unclear, poor flow Many spelling, grammar and punctuation issues.
Marker’s Name:

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