2.4.2 Professional Task: A Case History with Guided Questions
Weight: 30%
Type of Collaboration: Individual
Due: Tuesday 2nd April 2019 at 1700
Submission: on line
Format: All assignments are to be typed.
Typing must be according to the following format. Required format:
Length: as designated by assignment
3 cm left and right margins
Double Spaced
Font: Arial or Times New Roman
Font size: 12pt
All borrowings from other sources must be properly referenced and a reference list must
be included at the end.
Length: 1,000 words
Curriculum Mode: Case Study
Case study with guided questions
Eleanor Brown has been admitted to hospital with complications of ulcerative colitis. Eleanor, now 48 years old, was
diagnosed with ulcerative colitis when she was 31 years old. Over the years she has had numerous admissions to
hospital for acute episodes of ulcerative colitis. Eleanor's ulcerative colitis has been managed with a combination of
diet, medication (infliximab) and medical monitoring.
Eleanor has been experiencing an acute exacerabation of ulcerative colitis over the last two weeks. She has had up
to fourteen episodes of diarrhoea with blood and pus per day with severe pain in her lower abdomen. She has been
experiencing a sensation of abdominal bloating and cramping pain. Eleanor states that she been feeling too ill to eat
and drink much and she has lost nine kilograms in the last two weeks. She also states that she is feeling fatigued and
has been unable to complete daily activities.
A colonoscopy performed four years ago revealed that Elenaor has developed a large number of pseudopolyps in
her descending and sigmoid colon. Due to her current exacerbation of ulcerative colitis, Eleanor's gastroenterologist
ordered an MRI scan of Eleanor's abdomen because of the risk of perforation and haemorrhage of her bowel. The
MRI scan revealed that Eleanor had now developed pancolitis. The gastroenterological surgeon has recommeded that
Eleanor has a total colectomy and construction of an ileostomy.
On examination, Eleanor has a painful and distended abdomen. Her skin is dry, pale and cool to touch with poor
turgor. Eleanor's capillary refill is slow and she has flat neck veins. She states she has had reduced urinary output
over recent weeks.
Observations on admission:
Blood pressure: 90/50 mm/Hg
Pulse rate: 120 beats/minute
Respiratory rate: 25 breaths/ minute
Temperature: 38.4C
Sa02: 97 % in room air
Weak peripheral pulses
Weight: 54 kilograms
Height: 165cm
Urinalysis:
specific gravity: 1040
dark coloured urine
no other abnormalities
Initial pathology results:
Haemoglobin: 86g/L (normal range 117-157g/L)
Haematocrit: 52% (normal range 35-47%)
White cell count ( WBC): 16780/mm3 ( normal range 3500-1100/mm3)
Erythrocyte sedimenation rate (ESR) : 31.3mm/hour ( normal range 0-20mm/hour)
C-reactive protein (CRP) : 33.6mg/d1 (normal range 2Orng/d1)
Albumen: 22.8g/L ( normal range 35-50g/L)
Medical Officer ordered the following:
Morphine 15mg intramuscularly (IMI) QID PRN
Metoclopramide ( Maxolon) 10mg IMI TDS
1000mIs Hartman's solution over 6 hours
Methylprednisolone 20 mg IVI TDS
Nil by Mouth.
Questions
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Question 1. (10 marks. Suggested word limit 400 )
Describe the structural and functional changes in the disease process that led to Eleanor's weight loss? Students
answers must be supported by relevant academic references. References are not included in the word limit.
Question 1. (10 marks. Suggested word limit 400 )
Describe the structural and functional changes in the disease process that led to Eleanor's weight loss? Students
answers must be supported by relevant academic references. References are not included in the word limit.
Question 2. (5 Marks suggested word limit 200)
Explain the pain pathway and how Morphine alters the consicious perception of pain.
Students must support their answers with relevant academic references. References are not included in the word
limit.
Question 3. (2.5 Marks suggested word limit 200)
Identify the clinical manifestations that may indicate the deterioration of Eleanor's ulcerative colitis condition and
explain why these may occur.
Students answers must be supported by academic references. References are not included in the word limit.
Question 4. (2.5 Marks suggested word limit 200)
Explain the characteristics of the intravenous fluid that was ordered for Eleanor and the rationale for the administra-
tion of the IV fluid relating to Eleanor's specific fluid balance. Students answers must be supported with academic
references. References are not included in the word limit.
Please note there is a word limit of 1000 words. Academic references will not be included in the assessment word
limit.
Students should note that if the word limit is exceed by more than 10% the marker will stop marking. This
word limit will be strictly enforced
Submission of the assessment is via the online assessment module on the HV1 VOWS site under Assessment 2 on
the left side of the HV1 VOWS site.
Resources:
See week one and week two lecture and tutorial materials on the HV1 VOWS site. See recommended reading mate-
rials also on the HV1 VOWS site.
Marking Criteria:
Criteria High Distinction Distinction Credit Pass Unsatisfactory
Question 1 Accurately, clearly and comprehensively describes the structural and functional changes in the disease process that led to Eleanor's weight loss. Provides an accurate, clear and comprehensive description of the structural and functional changes in the disease process that led to Eleanor's weight loss. Provides an accurate and clear description of the structural and functional changes in the disease process that led to Elenaor's weight loss. Provides an accurate description of the structural and functional changes in the disease process that led to Eleanor's weight loss. Provides a basic description of the structural and functional changes in the disease process that led to Eleanor's weight loss. Provides a superficial description of the structual and functional changes in the disease process that led to Eleanor's weight loss
Mark 10 9.5-10 8.5-9 7-8 5-6.5 _,
Question 2 Accurately, clearly and comprehensively describes the pain pathway and how Morphine alters the consicious perception of pain. Accurately, dearly and comprehensively describes the pain pathway and how Morphine alters the conscious perception of pain. Accurately and clearly describes the pain pathway and how Morphine alters the conscious perception of pain. Accurately describes the pain pathway and how Morphine alters the consicous perception of pain. Provides a basic description of the pain pathway and how Morphine alters the conscious perception of pain. Provides a superficial description of the pain pathway and how Morphine alters the conscious perception of pain.
Mark 5 4.5-5 4 3.5 2.5-3 -2
Question 3 Accurately, clearly and comprehensively identifies the clinical manifestations that indicates the deterioration of Eleanor's ulcerative colitis. Accurately, clearly and comprehensively identifies the clinical manifestations that indicates the deterioration of Eleanor's ulcerative colitis. Accurately and clearly identifies the clinical manifestations that indicates the deterioration of Eleanor's ulcerative colitis. Accurately identifies the clinical manifestations that indicates the deterioration of Eleanor's ulcerative colitis. Provides a basic description of the clinical manifestations that indicates the deterioration of Eleanor's ulcerative colitis. Provides a superficial description of the clinical manifestations that indicates the deterioration of Eleanor's ulcerative colitis.
Mark 5 4.5-5 4 3.5 2-5-3 -2
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Criteria High Distinction Distinction Credit Pass Unsatisfactory
7
Criteria High Distinction Distinction Credit Pass Unsatisfactory
Question 4. Accurately, clearly and comprehensively explains the characteristics of the IV fluid ordered for Eleanor and the rationale for the administration of the IV fluid relating to Eleanor's specific fluid balance. Accurately, clearly and comprehensively explains the characteristics of the IV fluid ordered for Eleanor and the rationale for the administration of the IV fluid relating to Eleanor's specific fluid balance. Provides and accurate and clear description of the characteristcs of the IV fluid ordered for Eleanor and the rationale for the administration of the IV fluid relating to Eleanor's specific fluid balance. Accurately Provides a basic description of the characteristics of the IV fluid ordered for Eleanor and the rationale for the administration of the IV fluid relating to Eleanor's specific fluid balance. Provides a superficial description of the IV fluid ordered for Eleanor and the rational for the administration of the IV fluid relating to Eleanor's specific fluid balance.
describes the characteristics of the IV fluid ordered for Eleanor and the rationale for the administration of the IV fluid relating to Eleanor's specific fluid balance.
Mark 5 4.5-5 4 3 2.5 -2
Language use Sentences are clearly constructed and expression and meaning are clear. There are no spelling, Sentences are clearly constructed and expression and meaning are clear. There are no spelling, grammatical or punctuation errors. The APA referencing style is used correctly for both the in-text citations and the reference list. At least three academic references including a journal article are utilised. References must be current and within the last five (5) years. Sentences are clearly constructed. Expression and meaning are generally clear. There are minor errors in a few sentences in relation to spelling, grammar and punctuation. Sentences are generally clearly constructed. Expression and meaning are generally clear. More than half of the sentences are free of errors in spelling, grarnmer and punctuation. The APA referencing style is mostly used correctly with errors both in the in-text citations and in the reference list. At least one academic reference including a journal article is utilised. References must be current and within the last five (5) years Sentences are mostly well constructed. Expression and meaning are basically clear. Half of the sentences are free of errors in relation to spelling, gramrner and punctuation. Sentences are not well constructed. Expression and meaning are generally confusing. More than half the sentences have errors in grammer, spelling and punctuation
grammtical or punctuation errors. Referencing and in text citations The APA referencing style is used correctly for both in -text citations and the reference list. At least three academic references including a journal article are utilised. References must be current and within the last five (5) years. The APA referencing style is generally used correctly with minor errors for both in- text citations and the reference list. At least two academic references including a journal article are utilised. References must be current and within the last five (5) years The APA referencing style is utilised but there are significant errors in both the in-text citations and in the reference list. Only one academic reference is utilised. Reference must be current and within the last five (5) years The APA referencing style is incorrct with major errors in both the in-text citations and reference list. Non academic references have been utilised. References are not current or within the last five (5) years.
Mark 5 4.5-5 4 3.5 2.5-3 -2
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