Case Study Assessment 1: Musculoskeletal, Integumentary, Digestive Disorders

CRS176
Revision 101
July 2017
Page 1 of 11
Assessment Task 2: Case Study Assessment 1
Student Version: Report, Project, Portfolio
Student information
Student name: Click here to enter text.
Please use the student’s full name
(no abbreviations or nicknames).
Student ID:
Section A – Program/Course details
Qualification code: HLT54115 Qualification title: Diploma of Nursing
Unit code: HLTAAP002 & HLTAAP003 Unit title: Confirm physical health
status
Analyse and respond to client
health information
Section B – Assessment task details
Assessment number: 1 of 6 Semester/Year: Enter Semester/Year.
Due date: To be provided by your
Assessor.
Duration of assessment: .
Assessment task
results:
This assessment task will be marked as:
☐ Ungraded result: Satisfactory or Not Satisfactory
☒ Other (eg points): Graded
Section C – Instructions to students
Task Instructions:
Knowledge Evidence required for this assessment:
 Students will be assessed according to the marking guide provided
 This assessment is to be completed in the student’s own time
 There are three (3) case studies in this assessments
 Students are to answer all questions
Answer the questions listed in relation to the following case studies
Case Study 1 – Musculoskeletal, integumentary, digestive disorders
Daisy Brown is a 67-year-old female who presents to her GP (General Practitioner) with a long standing history of
joint pain in her knees, psoriasis and GORD.
She does not smoke, maintains a healthy diet and has no other relevant past medical history apart from psoriasis
which flare up when Daisy is feeling stressed and physically tired.
Question 1 - Provide an overview of the function of the musculoskeletal system. You answer should include
at least three (3) functions of the musculoskeletal system.
The three different kinds of muscles in the human body (smooth, skeletal and cardiac muscles)
along with the skeleton made of rigid bones constitute as the skeletomuscular system. This
organization is responsible for movement and locomotion of an organism. Besides that, this
system also helps in maintaining of body balance and correct posture.
Holmesglen 26-Nov-22 /tmp/tmp7gf8oqqg3501283_882176235_326733199469149632673131748625.docx
lk

CRS176
Revision 101
July 2017
Page 2 of 11
Section C – Instructions to students
Question 2 - List three (3) specific signs and/or symptoms of osteoarthritis. Identify which signs or
symptoms you think Daisy may present with
The classical symptoms of osteoarthritis are exemplified by:
1. Pain along with stiffness in the joints
2. Formation of bone spurs
3. Swelling of the soft tissues around the joints.
It is evident that the joint pain in case of Daisy shows effects of osteoarthritis.
Questions 3 - List three (3) signs and or symptoms of GORD. Your answer must also include what GORD
acronym stands for
GORD (Gastro-oesophageal reflux disease) is typically characterized by an irritable burning
sensation in the thoracic region, tooth decay along with bad breath and difficulty in
swallowing.
Question 4 - Daisy is taking Ibuprofen (this is a NSID) for her knee pain. Describe what effect this may have
on her GORD.
Effects of non-steroidal anti-inflammatory drugs (NSAIDs) have been directly associated as a
factor for gastrointestinal disorders like acid reflux or GORD. Studies involving more than
900 patients have shown that drugs like ibuprofen are involved in GI tract bleeding as well.
However, in healthy patients with no history of GI tract-related disorders but evidence shows
that patients already affected from GORD have chances of worsening after the
administration of NSIDs (Bjarnason et al., 2018) (Cryer & Spechler, 2000).
Question 5 - Describe three (3) health professionals who will be involved in Daisy’s care. At least one (1) of
these health professionals should be medical and one (1) should be an allied health professional.
1. A gastroenterologist should be consulted for the treatment of disorders of the digestive
system.
2. A rheumatologist should be consulted for the knee pain caused due to osteoarthritis.
3. Physiotherapist should be appointed for the knee pain and restoration of muscle strength
via exercises.
Case Study Two – Cardiovascular and respiratory disorders
Mr John Allen is a 62-year-old male with a history of hypertension and angina. Both conditions are managed with
medication and regular consultations with his GP (General Practitioner).
John has presented to the emergency department with chest pain radiating to his left arm. He mentions that he first
felt the chest pain whilst walking this morning. It subsided for an hour when he rested. John is a smoker, moderately
obese and sits for long periods of time. His diet is poor and his father died, aged 55 of a heart attack. He often
experiences shortness of breath due to smoking.
A full set of vital signs is performed by the nurse and the following readings are documented:
 HR 98bpm
 RR 22 breaths per minute
 BP 110/60
 Temp 37.2
 Sp02 94% on room air
At the hospital the Emergency Room doctor reviews Mr Allen and orders an electrocardiogram (ECG)
Question 6 - Describe the two (2) main structures of the cardiovascular system, providing their function
The cardiovascular system is responsible for the circulation of the oxygen and nutrients
throughout the body along with the removal of toxic waste products. The two main
components of the cardiovascular system include heart and blood vessels.
Heart: The blood pumping organ with two auricles and two ventricles, heart is made up of
Holmesglen 26-Nov-22 /tmp/tmp7gf8oqqg3501283_882176235_326733199469149632673131748625.docx
lk

CRS176
Revision 101
July 2017
Page 3 of 11
Section C – Instructions to students
the cardiac muscles. It ensures that the oxygenated blood and the deoxygenated blood
never get mixed at any point of the circulation.
Blood Vessels: The blood vessels act as the routes for the transport of blood throughout
the body. There are two major types of blood vessels, the arteries and the veins carrying
respectively oxygenated and deoxygenated blood except for pulmonary veins and
pulmonary artery.
Questions 7 - Describe the pathophysiology of angina
Angina, often called angina pectoris is the medical term for chest pain. It is almost typically caused
by a coronary heart disorder. The heart is responsible for pumping blood throughout the
body and angina results when the heart demands more oxygenated blood that it is receiving.
Under the normal circumstances, the blood vessels carry the adequate amount of blood to
the heart but in a patient suffering from heart conditions, the plaques formed in the arteries
hinder the blood flow, thus raising a need of blood reaching the heart and causing chest
pain.
Question 8 - List three (3) signs and/or symptoms of angina. Link at least one (1) of these symptoms to
John’s presentation
1. Pain in the thoracic region
2. Shortness of breath
3. Nausea, fatigue and dizziness
John first experienced the chest pain when he was walking. Our body’s need for oxygen
increases when we are exercising or walking. Evidently, due to arterial blockages John’s heart
did not receive this increased oxygen requirement because of which the pain started in his
chest, later spreading to his left arm. He also experiences shortness of breath due to smoking
which is another obvious sign for angina (Mutin et al., 1999).
Question 9 - Describe the three (3) main structures and one (1) substructure of the respiratory system,
providing their function
Three main structure of the respiratory systems include:
1. Lungs: The primary respiratory organ of the human is present in pairs. It is protected by the
covering of the double membrane (pleura) and consists of alveoli which is the place for
gaseous exchange in the body.
2. Nasal Cavity: The nose is a cartilaginous organ of the human body with two orifices
separated by a septum. The nasal cavity is the path of introduction of the air into the lungs
though the trachea.
3. Trachea: The hollow, tube like structure that connects the nasal cavity to the lungs is called
the trachea. This cartilaginous part of the respiratory system is also commonly termed as
the windpipe. It extends from the larynx and branches into two primary bronchi just before it
enters the lungs.
Larynx: This substructure of the respiratory system that connects the pharynx to the trachea.
Three of the cartilages that majorly constitute the larynx include the thyroid cartilage (anterior),
cricoid cartilage (inferior) and epiglottis (superior) of which the former is the largest.
Question 10 - Describe three (3) health professionals who will be involved in John’s care. At least one (1) of
these health professionals should be medical and one (1) should be an allied health professional.
1. Cardiologist for consultation about his heart conditions since angina is associated with
heart diseases in almost all cases.
2. A dietician is required to fix a proper healthy diet plan. Under these circumstances, low
cholesterol diet can prove to be beneficial since he is already moderately obese.
3. Cardiac surgeon, if his condition requires a surgery for the removal of arterial blockages
(Posma et al., 2018), (Piel-Julian et al., 2018).
Case Study Three – Immune system
Sita Shrestha is a 37-year-old nurse. Her GP (general practitioner) referred her to hospital following a blood
Holmesglen 26-Nov-22 /tmp/tmp7gf8oqqg3501283_882176235_326733199469149632673131748625.docx
lk

CRS176
Revision 101
July 2017
Page 4 of 11
Section C – Instructions to students
test that showed her haemoglobin was 8mmol/L. Sita is a strict vegetarian. She tells you that her gums bleed
when she brushes her teeth and last week one of her teeth just fell out. She has been admitted to your ward
with a diagnosis of acute leukaemia.
Question 11 - List the four (4) main components of blood
The four primary components of blood are: plasma, white blood corpuscles (WBCs), red blood
corpuscles (RBCs) and platelets.
Question 12 - Define acute leukaemia
Acute leukaemia is described as the malignancy of the blood and bone marrow cells that causes
rapid and uncontrolled immature blood cells; instead of mature ones (Lee et al., 2018).
Question 13 - Describe the relationship between a vegetarian diet and a low haemoglobin. How does this
related to Sita? Your answer should include two (2) aspects of the relationship
Many people turn to vegetarian or vegan diets for a variety of reasons. However, diets such as
that may impose a risk of anaemia due to the lack of iron-rich food items in daily diet, which
is symptomized by low haemoglobin count. But in this case the subject shows optimum
levels of haemoglobin.
On the other hand, it is not uncommon for leukaemia patients to develop anaemia resulting in the
drop of blood haemoglobin. This is due to the fact that in the malignancy of WBCs, the
formation of normal, healthy RBCs is outweighed due to the malfunctioning of the bone
marrow. Also, leukemic patients can become anaemic due to the loss of appetite as a result
of radiation and chemo therapies. Hence, proper care should be taken to ensure that Sita’s
blood haemoglobin level does not drop below the normal level by imposing a healthy, iron-
rich, wholesome diet (Mauro et al., 2000).
Question 14 - Describe three (3) nursing interventions you would use to manage Sita’s oral care
Three measures that can be taken to ensure proper oral care and prevention of dental infections
include:
1. Regular brushing and flossing
2. Use of mild antibacterial mouthwash
3. Regular oral check-up for any lesions or bacterial infections (Zimmermann et al., 2015)
Question 15 - Describe three (3) health professionals who will be involved in Sita’s care. At least one (1) of
these health professionals should be medical and one (1) should be an allied health professional.
1. Oncologist for the treatment of cancer.
2. Haematologist for the diagnosis and treatment of blood-related disorders.
3. Primary Care Provider for providing assisted medical care on a regular basis.
References:
Bjarnason I., Scarpignato C., Holmgren E., Olszewski M., Rainsford K. D., Lanas A. (2018),
Mechanisms of Damage to the Gastrointestinal Tract From Non-steroidal Anti-inflammatory
Drugs, Gastroenterology, Accessed July 03, 2019, doi: 10.1053/j.gastro.2017.10.049.
Cryer, B., & Spechler, S. J. (2000). Effects of non-steroidal anti-inflammatory drugs (NSAIDs) on
acid reflux in patients with gastroesophageal reflux disease (GERD). Gastroenterology,
118(4), A862. Accessed July 03, 2019 doi:10.1016/s0016-5085(00)85589-4
Lee, L., Bruyere, H., Barnett, M. J., Broady, R., Forrest, D. L., Gerrie, A. S., Hogge, D. E., Nantel,
S. H., Narayanan, S., Power, M., Sanford, D., Song, K., Sutherland, H. J., Toze, C. L., White,
J., & Abou Mourad, Y. (2018). Unsuccessful Cytogenetics and Outcomes in Acute Leukemia.
Blood, 132(Suppl 1), 2673. Accessed July 02, 2019. https://doi.org/10.1182/blood-2018-99-
110470.
Mauro, F. R., Foa, R., Cerretti, R., Giannarelli, D., Coluzzi, S., Mandelli, F., & Girelli, G. (2000).
Autoimmune hemolytic anemia in chronic lymphocytic leukemia: clinical, therapeutic, and
prognostic features. Blood, 95(9), 2786-2792. Accessed July 02, 2019. Retrieved from
Holmesglen 26-Nov-22 /tmp/tmp7gf8oqqg3501283_882176235_326733199469149632673131748625.docx
lk