Case Study 1
Ms Singh (Sangeeta) is a 69-year-old retired secretary who lives close to her daughter and grandchild.
Other than hypertension she has had nil significant medical history to report. Ms Singh immigrated to
Australia 20 years ago from India. English is her second language and she practices the Hindu religion.
Last night Ms Singh was brought in by ambulance (BIBA) to the emergency department after her daughter
found her on her bathroom floor. Ambulance staff report that she was found naked and unable to call for
assistance for almost 18 hours. She was diagnosed as having had a cerebrovascular accident (CVA) with
residual right (R) sided hemiplegia, dysphagia and dysphasia.
She is soon transferred to the acute medical ward where you work and is accompanied by her daughter
(Nita) who is obviously quite distressed. Ms Singh appears quiet and drowsy. She is currently Nil by Mouth
(NBM) whilst awaiting a speech therapist review.
Her vital signs on arrival are: T 36.9 degrees C; P 115; R 26; SpO2 94% and BP 170/95.
1. Identify the factors that you would need to consider prior to and during an assessment. Include an
issues that may impact on discharge? (min 50 words)
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2a) Identify which of the following vital signs provided above are outside normal range and provide the
correct ranges.
• Temperature
• Pulse
• Respirations
• Blood Pressure
• Oxygen saturation
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b) Using the information in the case study, identify which of the vital signs may be usual for Ms Singh?
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3. The registered nurse asks you to perform neurological observations on Ms Singh. Identify what data
you would collect and how you would perform a neurological assessment. (min 100 words)
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4. You are now asked to complete an admission document for Ms Singh. Considering Ms Singh’s
gender, age, cultural, spiritual and religious data, identify six ways in which these could be
addressed in a plan of care.
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5. While in hospital identify how Ms Singh’s condition would affect her ADLs and describe how this
would impact on the care she will require while in hospital. (min 150 words)
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After 5 weeks on your ward Ms Singh’s condition has shown no improvement. She requires full assistance
with all aspects of her ADLs and still has dysphagia and dysphasia. Her daughter approaches you in tears
stating “What’s going to happen to mum now? I work fulltime and cannot look after her. Surely she can’t go
home?”
6a) Considering Ms Singh’s dysphagia, outline any potential risks at mealtimes for Ms Singh? (minimum
50 words)
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b) What strategies could you used to reduce these risks at mealtimes? (min 50 words)
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7. What is the nurse’s role in the discharge planning of Ms Singh? In your answer include:
• when the discharge planning process should commence
• the members of the multidisciplinary team that should be involved
• any community services she may require
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Case Study 2
Ella is a 6-year-old girl who has cerebral palsy who had been brought into hospital with a chest infection.
You have been asked to perform a health assessment for Ella who is distress at being in hospital.
1. Cerebral palsy can cause different degrees of developmental delay but in order to understand the
impact the condition has on a person you need to be aware of the stage of growth and development a
person should be at.
Discuss the stage of human growth and development that you would expect Ella to be at as a six-year
old? (min 100 words)
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2. Referring to the Person Centred Health Care Assessment and the Development of Health Care Plans
Core Standards for Practitioners to answer this question.
a) Identify at least 6 potential health issues associated with cerebral palsy.
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b) List the 4 essential skills that you need to draw upon when completing a health care assessment on
Ella?
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c) Identify at least 6 components of a comprehensive care health plan and provide the reasons why they
are included in a person’s plan?
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3. Ella becomes more distressed as you are performing the health care assessment. Using problem
solving strategies and techniques, discuss the actions you could take to reduce Ella’s distress. (min
100 words)
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You speak with Ella’s mum, Karen, who is staying in hospital with Ella and she tell you that their family like
to take a wellness approach to health.
4. Explain what a wellness approach to health means and provide at least 3 examples of how a wellness
approach could be used for Ella. (min 100 words)
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5. As a family with a young child, identify some of the family health care needs that Ella and her family
may require. (min 50 words)
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6. When checking Ella’s vital signs one afternoon you note that her respiratory rate has increase from 22
to 32 and that her SpO2 has decreased from 98% to 92%. Identify what actions you would take. In
your answer, discuss the following:
• who you would inform of Ella’s condition
• what clinical signs suggest that there is a deterioration in Ella’s condition. (min 50 words)
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Case Study 3
Sandra is a 42-year-old woman who has been admitted to hospital for some investigations as she has been
trying for some time to become pregnant. Sandra has a 14-year-old son from a previous marriage.
1. Identify at least 3 possible causes for infertility.
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2. Discuss the impact of infertility on Sandra. In your answer ensure that you cover the physical,
emotional and psychosocial impacts. (min 150 words)
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3. When talking to Sandra about her family, she mentions that her son, Dean, has been very moody
lately and is difficult to talk to. What information about adolescent growth and development could you
share with Sandra? (min 150 words)
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4. When Sandra’s son visits, you notice that he is physically very similar to his mother, they both have
red hair, blue eyes, freckles and both are tall.
Discuss the influence of both genetics and the environment on growth and development. (min 150
words)
