Mrs Georgia Cook is a 39 year old lady who is day 3 post L) sided CVA. Three days ago, she was suddenly unable to verbalise words whilst talking on the phone. Mrs Cook was found by her husband 30 minutes later and taken to the Emergency Department; he stated that she didn’t seem to recognise him and was unable to move very much.

On arrival she had dense R) sided hemiplegia, was aphasic, incontinent and displaying signs of agnosia. A head/brain CT scan revealed an ischaemic area, no bleed was seen.
Medical History – Mrs Cook is a maths teacher at a middle school, she is mildly overweight, on the oral contraceptive pill (OCP), has mild hypercholesterolemia, Type II Diabetes Mellitus and had a cholecystectomy two years ago. Her medications include: OCP, atorvastatin, metformin and multi-vitamins.
Social History – Mrs Cook is married to Tom and they have 2 young teenagers (Sommer 13, Damon 15); she is active in her children’s school committees and plays social netball twice a week.
Nursing Notes – Overnight Mrs Cook received regular pressure area care. At times, she appeared uncomfortable; paracetamol was offered and eventually given with good effect. She remains hemiplegic though RN Bronwyn (the morning shift nurse) thought she elicited a response from her R) hand. Mrs Cook is now showing signs of expressive aphasia but is frustrated++. An NGT is insitu and she is for dietician review ASAP as her weight continues to decrease. The speech pathologist will also have some input to assess her dysphagia. Her BSL and vital observations remain stable though patient hypertensive -150/88
Medications charted: Clexane S/C, Aspirin 100mg, Atorvastatin, Ramipril, multivitamins, Omeprazole IV, Metoclopramide, N/Saline 8/24.
Currently Mrs Cook has an IDC insitu, draining well. Her bowels have been loose and she has developed some redness to her perianal area. There is also some concern about mild pressure area at her r) heel. RN Bronwyn also voiced some concerns about unilateral neglect; the doctor will investigate this further today.
Mrs Cook’s husband is handling the situation well as can be expected but is struggling with her condition and is worried about the future. When her children come in to see her they are unsure what to do or say. Often Mrs Cook is teary when they leave.
NUR251 Assessment 1: Case Study. Semester 2, 2015
150 words
(Intro & Conclusion)
30 marks
Essay Criteria A: 100 words/5 marks
– What sort of stroke has Mrs Cook had – provide rationale for your answer
Essay Criteria B: 200 words/10marks
– Discuss Mrs Cook’s medication in relation to her condition. Is there any other medication you would add or withhold?
Essay Criteria C: 200words/10 marks
– Is Mrs Cook at risk of developing Increased Intracranial Pressure (IICP)? Provide rationale for why/why not
– What are the signs and symptoms of IICP and what nursing assessments would you conduct to identify this?
Essay Criteria D: 1000 words/30 marks
– Highlight areas of concern (physical, mental, social, emotional…) throughout Mrs Cook’s case study and discuss nursing management care and rationale for these.
Essay Criteria E 200 words/10 marks
– Briefly discuss what the likely discharge planning, education and allied health input (if required) would be needed for Mrs Cook.
Essay Criteria F: 150 words/5marks
– What lifestyle choices or health promotion would you recommend to reduce the risk of someone developing a CVA? Provide rationale for your answers
Submission Outline:
? 2000 words (+/- 10% not including the reference list or in-text referencing)
Your assignment should be:
? In Essay format;
? MUST include brief introduction, main body and a
Conclusion – NO point form. You may use [eg] “Criteria A”
as sub-headings
? Font 12pt either calibri or arial preferred. 1.5 line spacing.
? Ensure you have a footer with page numbers and your
student name/number.
? No tables or diagrams.
? Do not use first person (no I/me) – use third person terminology
NUR251 Assessment 1: Case Study. Semester 2, 2015
? APA 6TH style,
? At least 10 references (Including a minimum of 7 peer-reviewed journal articles). You are expected to look beyond your set-text.
? References (not more than 10 years old)
Assessment Criteria: Assessment Criteria are presented in the form of a grading rubric (see below). The rubric will be graded out of 100% however this assignment contributes to 40% of your overall grade
Submission: Submit your assignment via the Safe Assignment link provided in Learnline. A practice/draft submission site is available to you for use prior to final submission which allows you to check your work for any plagiarism.
NUR251 Assessment 1: Case Study. Semester 2, 2015
Essay Rubric Unsatisfactory Limited Satisfactory Good Excellent Marks Ability to interpret and address essay criteria (40%) Evidence of ability to interpret the topic and provide a balanced development of responses, including logical discussion, critique and analysis (0-8) Understanding of the topic is poor. Few or no explanations or examples to illustrate or support points made. (9-16) Limited evidence of ability to interpret and correctly address the topic. Mostly descriptive with limited explanation or examples to illustrate or support points made. (17-24) Demonstrates a developing ability to interpret and address the topic. Some examples provided that illustrate or support points made. (25-32) Demonstrates proficiency in interpreting and addressing the topic, including evidence of critique and analysis. Uses well-chosen examples to illustrate and to support points made. (33-40) Demonstrates excellence in ability to interpret and address the topic, including a critical perspective that shows depth of critique and analysis. Uses a number of examples that support points made and illustrate deeper understanding.