Outline the causes, incidence and risk factors of the identified condition and how it can
impact on the patient and family (400 words)
2. List five (5) common signs and symptoms of the identified condition; for each provide a
link to the underlying pathophysiology (350 words)

a. This can be done in the form of a table – each point needs to be appropriately
3. Describe two (2) common classes of drugs used for patients with the identified condition
including physiological effect of each class on the body (350 words)
a. This does not mean specific drugs but rather the class that these drugs belong to.
4. Identify and explain, in order of priority the nursing care strategies you, as the registered
nurse, should use within the first 24 hours post admission for this patient (500 words).

• Students are to choose one (1) of the case studies below and answer the associated
questions. The assignment is to be presented in a question/answer format not as an
essay (i.e. no introduction or conclusion).
• Each answer has a word limit (1600 in total); each answer must be supported with
• A Reference List must be provided at the end of the assignment.
• Please refer to the marking guide available in the unit outline for further information.

Case Study 2
Ms Maureen Smith is a 24 year old female who presented to her GP for ongoing
gastrointestinal bleeding, abdominal pain and fatigue which has been worsening, and was
referred to the local hospital for further investigation.
Maureen was diagnosed with rheumatoid arthritis (RA) when she was 15 years old, and has
experienced multiple exacerbations of RA which have required the use of high dose
corticosteroids. She is currently taking 50mg of prednisolone daily, and has been taking this
dose since her last exacerbation 2 months ago.
Maureen also has type 2 diabetes which is managed with metformin. She is currently
studying nursing at university and works part-time at the local pizza restaurant.
On assessment, Maureen’s vital signs are: PR 88 bpm; RR 18 bpm; BP 154/106 mmHg; Temp
36.9ºC: SpO2 99% on room air. She has a body mass index (BMI) of 28kg/m2 and the fat is
mainly distributed around her abdominal area, as well as a hump between her shoulders.
Maureen’s husband notes that her face has become more round over the past few weeks.
Her fasting BGL is 14.0mmol/L. Blood test results show low cortisol and ACTH levels, and
high levels of low density lipoprotein cholesterol. She is awaiting a bone mineral density test
this afternoon, and is currently collecting urine for a 24-hour cortisol level measurement.
Impression: Cushing’s syndrome

Case Study 1
Mrs Sharon McKenzie is a 77 year old female who has presented to the emergency
department with increasing shortness of breath, swollen ankles, mild nausea and
dizziness. She has a past history of MI at age 65. During your assessment Mrs McKenzie
reports the shortness of breath has been ongoing for the last 7 days, and worsens when
she does her gardening and goes for a walk with her husband.
On examination her blood pressure was 170/110 mmHg, HR 54 bpm, respiratory rate of
30 bpm with inspiratory crackles at both lung bases, and Sp02 at 92% on RA. Her fingers
are cool to touch with a capillary refill of 1-2 seconds. Mrs McKenzie states that this is
normal and she always has to wear bed socks as Mr McKenzie complains about her cold
Her current medications include: digoxin 250mcg daily, frusemide 40mg BD, enalapril 5mg
daily, warfarin 4mg daily but she sometimes forgets to take all of her medications.
The following blood tests were ordered: a full blood count (FBC), urea electrolytes and
creatinine (UEC), liver function tests (LFT), digoxin test, CK and Troponin. Her potassium
level is 2.5mmol/L.
Mrs McKenzie also has an ECG which showed sinus bradycardia, and a chest x-ray
showing cardiac enlargement and lower-lobe infiltrates.
Impression: Congestive cardiac failure