1. An accompanying commentary of approximately 2000 words excluding references.
The HACEK organisms are fastidious Gram-negative rods. They are normal commensals of the oral and respiratory tract but can cause endocarditis or other infections of normally sterile sites, such as meningitis or osteomyelitis. The type of endocarditis caused by the HACEK group is characterised by diagnosis after a long duration of symptoms, large vegetations and a tendency for emboli to form. The organisms are:
1. Haemophilus species
2. Aggregatibacter actinomycetemcomitans (previously called Actinobacillus actinomycetemcomitans)
3. Aggregatibacter aphrophilus (its old name was far better though – Haemophilus aphrophilus!)
4. Cardiobacterium hominis
5. Eikenella corrodens
6. Kingella kingae
Introduce the HACEK organisms, discuss their key characteristics, and describe some of the main infections/diseases caused by the HACEK group and the treatment. For each organism you have to introduce it separately and mainly disease they cause is Endocarditis.
You should discuss how HACEK infections are detected in the clinical microbiology lab, showing appreciation of some of the challenges in HACEK diagnosis. It is important to cite each paragraph to avoid any plagiarism.

Case Study Report: Length: 2000 Words
Case Study for Part A
Angela is a 69 year old lady who was born in England and moved to Australia when she was 14 with her family. She is married and lives with her 74 year old husband, and has three daughters who live close by, and has seven grandchildren that she helps care for when her daughters work.
Angela has a 24 pack per year history of smoking and has been diagnosed with Chronic Obstructive Pulmonary Disease (COPD), with an FEV1/FVC ratio of 52%. She quit smoking 6 years ago, but her husband continues to smoke. Her inhalers for COPD include Symbicort 400/12mcg (Budesonide and Eformetorol) and Spiriva 18mcg (tiotropium Bromide). She uses salbutamol via inhaler as required.
Angela worked as a cleaner for many years and has some arthritic changes related to the wear and tear secondary to this work. She takes paracetamol only to manage this. Angela is compliant with all medications and efforts to manage her COPD and arthritis.
On a routine visit with her GP, Angela was noted to be hypertensive with a BP of 164/96. She has been commenced on an angiotensin converting enzyme inhibitor, perindopril arginine, 2.5mg daily, to be reviewed in 4 weeks. Her weight has increased from 64kg to 72kg in the 3 months since her last review and she reports increased discomfort when mobilising, particularly from her spine. This is limiting her ability to exercise and she is now finding she is increasingly breathless when walking any distance, and is finding caring for the grandchildren more difficult.
Rationale
It is known that chronic disease is the leading cause of death across the world (Johnson & Chang, 2014). Nurses need to be able to provide care to all health consumers, with a significant role in assessing a person, planning care, communicating with colleagues and ensuring that the holistic needs are met and evaluated. The ongoing nature of the conditions can result in longer term debilitating outcomes if not addressed appropriately. Children, young people, adults and older adults all experience the full range of health issues yet manage them differently.
This assessment task addresses the following subject learning outcomes:
• Plan nursing care for patients with complex co-morbidities demonstrating rationale for how one affects the other.
• Plan nursing care of a patient with a co-morbidity in consultation with individuals/groups significant others and the interdisciplinary health care team in the clinical setting.
• Explain and describe common physiological, mental health and developmental chronic conditions.
Requirements:
Discusses the Pathophysiology of the mentioned Chronic and Complex Conditions and their Related Clinical Manifestations
There is a detailed, succinct and accurate discussion of the disruptions to normal physiological processes that underlie each condition, with consistently clear links to all of the clinical manifestations.
All clinical manifestations are clearly linked to underlying pathophysiology
Explains the Concepts of Co-morbidity, Chronicity and Complexity
The definitions of each of the key terms have been integrated into a detailed, succinct and accurate discussion of the chronicity and complexity of the patient’s condition.
Discusses the Impact of Chronic and Complex Conditions on the Patient
There is a comprehensive, accurate and integrated discussion of two ways in which the conditions may impact on each other and the possible effects of the conditions on the patient in the case study, with substantial links made to the previously discussed pathophysiology and clinical manifestations.
Use of Evidence to Support the Discussion
An extensive range of highly relevant and current sources have been located, evaluated and synthesised to
substantially support the discussion throughout the paper
Academic Writing and Presentation
The report is logically and succinctly structured according to academic writing conventions.
The content is presented in such a manner that it creates a cohesive, coherent and analytical report.
There is use of formal academic language throughout, including the accurate use of nursing terminology.
The content consistently adheres to grammatical conventions. There are no spelling mistakes or errors in punctuation.
Referencing
All sources are explicitly acknowledged in-text.
APA guidelines for in-text referencing and the reference list are consistently adhered to.
All sources cited-in text match those cited in the reference list.