NURBN 2012: Nursing Practice 3 –Pathophysiology and Pharmacology Applied to Nursing
Assessment Task 2 – Clinical Scenario Assignment
For this assessment task, you are required to write a 2000 word report which addresses the main issues
associated with providing nursing care for Robert and assisting him to manage both the physical and
psychological impacts of his diagnosis. You will need to explore the pathophysiology, pharmacology and
nursing management of the scenario and demonstrate your understanding in the answers you provide. Your
answers should be informed by your reading of current research and literature.
An introduction and conclusion are not necessary in a report format. Use headings to structure your report.
Do not use dot points. Do not write in the first person. Use APA referencing throughout your assignment.
Appropriately referenced and labelled tables, diagrams or images may be used in the body of the paper.
Alternately, any tables, diagrams or images may be added as an appendix, as long as the information
pertaining to same is integrated into the body of your paper.
References must be current, preferably from the past five years and no older than ten years, unless it is of
historical significance, in which case a brief statement of the historical significance must be included when
citing the source. Your writing should demonstrate wide reading from a variety of sources, such as journals,
texts and clinical practice guidelines.
You are required to cite no less than 10 references. Consider the quality of the references you use.
Wikipedia, Web MD, the Better Health Channel and blogging websites are not acceptable references. Any
non-reliable sources in your reference list will not count toward the number of required references, and this
will result in a loss of marks. At this point in your BN you are expected to engage with best practice
literature.
Criteria for grading
Marking of this assessment task will be undertaken by academic and teaching staff. Pre-marking
moderation will be undertaken for this assessment task.
Marks will be allocated for each section of the essay. A copy of the marking rubric is provided on Moodle.
Marks will be allocated for each section according to the rubric, use this as a guide when writing your
assignment.
CRICOS Provider No. 00103D NURBN 2012 Semester 1, 2018 Clinical Scenario Assignment Page 2 of 3
Background to Clinical Scenario
Robert is a 51 year old man who lives with his wife in regional Victoria. He has been admitted to your ward
from the Intensive Care Unit (ICU), where he had a 3 day stay for an acute exacerbation of COPD, caused
by community acquired pneumonia. He required several days of non-invasive ventilation whilst in ICU.
Robert tells you his wife (Jill) was very frightened when he was admitted to ICU, and he doesn’t want ‘to put
her through that anymore’. He would like some help to understand and manage his COPD. Robert said he
was diagnosed with COPD about 18 months ago by his GP, but admits he was sick for ‘a while’ before that.
He is a current smoker, and has smoked for about 40 years. He has unsuccessfully attempted to quit on
more than 5 occasions. Robert worked for many years on his chicken farm, but now finds he becomes
breathless very easily and Robert and Jill have had to hire a farm helper.
Robert’s medications include:
Salbutamol 2 – 4 puffs PRN
Budesonide/Efomoterol fumarate dehydrate 2 puffs daily
Metoprolol 25mg daily
Aspirin SR 100 mg daily
Pathophysiology
1.1 Describe the pathophysiology of COPD. Include in your answer the two disease processes
contained in the umbrella term ‘COPD’ and how they develop.
Robert has been diagnosed with a severe exacerbation of COPD, caused by Community Acquired
Pneumonia.
1.2 Explain the term ‘acute exacerbation of COPD’. What factors put patients like Robert at high risk
for exacerbations of COPD? What else may contribute to an exacerbation of COPD?
1.3 Describe the pathophysiology of pneumonia. Include in your answer the differences between
Community Acquired, Hospital Acquired and Health Care Associated Pneumonia.
Pharmacology
The Respiratory Physician who reviewed Robert in ICU suggested some changes to his current inhaler
regime. The physician suggested that Robert cease his Budesonide/Efomoterol fumarate dehydrate, and
commence on Tiotropium 2 puffs daily.
2.1 For each of the three inhalers (Salbutamol, Budesonide/Efomoterol fumarate dehydrate and
Tiotropium), describe the
Mechanism of action in COPD
Contraindications and Adverse Reactions
Nursing Considerations and Patient Education Points
Include in your answer why the respiratory physician might have changed Robert’s
medication regime.
CRICOS Provider No. 00103D NURBN 2012 Semester 1, 2018 Clinical Scenario Assignment Page 3 of 3
Robert was diagnosed with Community Acquired Pneumonia, and Streptococcus pneumoniae was cultured
from his sputum.
2.2 Identify three antibiotics that could be used to treat Streptococcus pneumoniae in Robert’s case.
For each antibiotic, describe the
Mechanism of action
Contraindications and Adverse Reactions
Nursing Considerations and Patient Education Points
Psychosocial issues
3.1 Discuss three evidence-based interventions to help Robert manage his COPD.
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CRICOS Provider No. 00103D NURBN 2012 Clinical Scenario Assignment Marking Rubric, Semester 1, 2018 Page 1 of 2
NURBN 2012 Clinical Scenario Assignment Marking Rubric
Criterion 5 marks 4 marks 3 marks 2 marks 1 mark 0 marks Mark
1.1 Identification
of the underlying
pathophysiological
processes in
clinical scenario
Excellent discussion of the
pathophysiology of COPD.
Both diseases processes
discussed comprehensibly.
Very good discussion of the
pathophysiology of COPD.
Both diseases discussed in
detail.
Good discussion of the
pathophysiology of COPD.
Disease processes discussed
briefly.
Inadequate discussion of COPD.
Only one disease process discussed
comprehensively.
Attempted discussion but
inadequate explanation of
COPD, or one or more disease
processes inadequately
discussed.
No attempt to answer
the clinical scenario
question.
/5
1.2 Identification
of the underlying
pathophysiological
processes in
clinical scenario
Excellent explanation of
‘exacerbation of COPD’.
Excellent linking of Robert’s
presentation to his underlying
pathophysiology.
Very good discussion of
‘exacerbation of COPD’.
Very good linking of Robert’s
presentation to his underlying
pathophysiology.
Good discussion
‘exacerbation of COPD’.
Good attempt at linking of
Robert’s presentation to his
underlying pathophysiology.
Inadequate discussion ‘exacerbation
of COPD’. Did not link of Robert’s
presentation to his underlying
pathophysiology.
Attempted discussion of
‘exacerbation of COPD’ but
inadequate explanation. Did
not link underlying
pathophysiology.
No attempt to answer
the clinical scenario
question.
/5
1.3 Identification
of the underlying
pathophysiological
processes in
clinical scenario
Excellent discussion of the
pathophysiology of
pneumonia. Comprehensive
differentiation of the different
types of pneumonia.
Very good discussion of the
pathophysiology of
pneumonia. Very good
differentiation of the different
types of pneumonia.
Good discussion of the
pathophysiology of
pneumonia. Good
differentiation of the different
types of pneumonia.
Inadequate discussion of the
pathophysiology of pneumonia.
Attempted differentiation of the
different types of pneumonia, but
missing key points.
Inadequate discussion of the
pathophysiology of pneumonia.
Limited or absent differentiation
of the different types of
pneumonia.
No attempt to answer
the clinical scenario
question.
/5
2.1 Identification
of
pharmacological
issues relevant to
clinical scenario
All relevant pharmacological
concepts and mechanisms of
action are included and
correct. Good explanation of
reason for drug change
All relevant pharmacological
concepts and mechanism of
action included. Adequate
explanation of reason for drug
change.
Most relevant
pharmacological concepts
and mechanism of action
included. Inadequate
explanation of drug change.
Few relevant pharmacological
concepts and mechanism of action
included. Inadequate explanation of
drug change.
Attempted discussion, but
inadequate understanding of
pharmacological concepts and
mechanism of action included.
Inadequate explanation of drug
change.
No attempt to answer
clinical scenario
question.
/5
2.2 Identification
of
pharmacological
issues relevant to
clinical scenario
All relevant pharmacological
concepts and mechanisms of
action are included and
correct. All relevant
contraindications, adverse
reactions, nursing
considerations and patient
education points included.
All relevant pharmacological
concepts and mechanisms of
action are included and
correct. Most relevant
contraindications, adverse
reactions, nursing
considerations and patient
education points included
Most relevant
pharmacological concepts
and mechanisms of action are
included and correct. Some
relevant contraindications,
adverse reactions, nursing
considerations and patient
education points included.
Few relevant pharmacological
concepts and mechanisms of action
are included or correct. Some
relevant contraindications, adverse
reactions, nursing considerations
and patient education points
included.
Attempted discussion, but
inadequate understanding of
medications, pharmacological
concepts and mechanisms of
action. Few relevant
contraindications, adverse
reactions, nursing
considerations and patient
education points included.
No attempt to answer
clinical scenario
question.
/5
CRICOS Provider No. 00103D NURBN 2012 Clinical Scenario Assignment Marking Rubric, Semester 1, 2018 Page 2 of 2
3 Identification of
patient
issues/needs in
clinical scenario
Provides a meticulous and
holistic representation of the
care issues and needs
identified in the clinical
scenario.
Provides a thorough
representation of the care
issues and needs identified in
the clinical scenario.
Provides an adequate
representation of the care
issues and needs identified in
the clinical scenario, with
some omissions.
Provides a basic representation of
the care issues and needs identified
in the clinical scenario. Focuses
mostly on physical needs.
Provides an inadequate and
muddled representation of care
issues and needs. Significant
omissions.
No attempt to answer
clinical scenario
question.
/5
4. Academic
writing, sentence
structure,
grammar, and
spelling
All sentences are well
constructed and have varied
structure and length. No
errors in grammar or
spelling. Meets the word limit
within 10%.
Most sentences are well
constructed and have varied
structure and length. Minor
errors in grammar or spelling
that do not interfere with
understanding. Meets the
word limit within 10%.
Most sentences are well
constructed and have varied
structure and length. A few
errors in grammar, and/or
spelling that do not interfere
with understanding. Requires
a more formal tone. Meets the
word limit within 10%.
Most sentences are well
constructed, but have similar
structure and/or length, and require
a more formal tone. Several errors
in grammar, and/or spelling that
occasionally interfere with
understanding. Meets the word limit
within 10%.
Sentences sound awkward, are
distractingly repetitive, informal
or are difficult to
understand. Many errors in
grammar and/or spelling that
significantly interfere with
understanding. Word limit over
or under 10%.
Sentences are poorly
constructed with
numerous errors in
grammar and/or
spelling that severely
interfere with
understanding.
Severely under or over
the word length.
/5
5. APA 6th ed.
formatting and
referencing
Reference list provided. Intext
citations included. No
APA formatting or referencing
errors. 10 or more
references. All references
from reliable or scholarly
sources. Correctly formatted
title page provided.
Reference list provided. Intext
citations included. Minor
APA formatting or referencing
errors. 10 or more references
provided. All references from
reliable or scholarly
sources. Title page provided
but not in APA format.
Reference list provided. Intext
citations included. Minor
APA formatting and
referencing errors. 10 or more
references provided. Most
references from reliable or
scholarly sources. Title page
provided but not in APA
format.
Reference list provided. In-text
citations included. Major APA
formatting and referencing errors.
Less than 10 references provided.
Most references from reliable or
scholarly sources. Title page
provided but not in APA format and
some information missing.
Reference list provided but no
in-text citations. No adherence
to APA style. Less than 10
references provided.
References not from reliable or
scholarly sources. No title page
provided.
Reference list not
provided, no in-text
citations. No title page
provided.
/5
Total Marks /40
