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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?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?

by | Jun 19, 2022 | Questions & Answers

CRICOS Provider No. 00103D NURBN 2012 Semester 1, 2018 Clinical Scenario Assignment Page 1 of 3
NURBN 2012: Nursing Practice 3 – Pathophysiology and Pharmacology Applied to Nursing
Assessment Task 2 – Clinical Scenario Assignment
Due Date: Monday 14th May at midday
Directions
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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