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.

Module 2 – Background
Cell Chemistry
First, view the PowerPoint slide presentation Inside the Cell: Enzymatic Reactions, Energy Conversion, and Transport. As before, this presentation only introduces the material that is explored in more detail in the links provided below.
Now please read more about how chemical reactions are catalyzed by enzymes:
Farabee, MJ (2010) Reaction and Enzymes. Accessed February 12, 2012, at: http://www2.estrellamountain.edu/faculty/farabee/BIOBK/biobookenzym.html
Next read about the processes of photosynthesis and the structure of chloroplasts:
Farabee, MJ (2010) Photosynthesis. Accessed February 12, 2012: http://www2.estrellamountain.edu/faculty/farabee/BIOBK/BioBookPS.html
And work through this tutorial:
Photosynthesis (building sugars from the environment – plants/photosynthetic organisms/producers) http://www.phschool.com/science/biology_place/biocoach/photosynth/intro.html
Now proceed to reading about the processes of cellular respiration and the structure of mitochondria:
Kimball, John. (2011) Cellular Respiration. Accessed February 12, 2012. http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/C/CellularRespiration.html
View these videos on cellular respiration:
Glycolysis http://www.youtube.com/watch?v=gTv9y5dol-A
The Krebs Cycle http://www.youtube.com/watch?v=ncEHa-ZwX3M
Electron Transport Chain (Phosphorylation) http://www.youtube.com/watch?v=hqF5JOXi_K8
Cellular Respiration by Jay Phelan in, What is Life? A Guide to Biology, W. H. Freeman & Co. © 2010 W. H. Freeman & Co., and Sumanas, Inc. Accessed 3/11/2014 at http://www.sumanasinc.com/webcontent/animations/content/cellularrespiration.html
And complete these tutorials:
Cellular Respiration (utilizing sugars – most living organisms/aerobic organisms/consumers) http://www.phschool.com/science/biology_place/biocoach/cellresp/intro.html
SLP
Urakawa, H., Garcia, Juan C., Barreto, Patricia D., Molina, Gabriela A., Barreto, Jose C. (2012). A sensitive crude oil bioassay indicates that oil spills potentially induce a change of major nitrifying prokaryotes from the Archaea to the Bacteria. Environmental Pollution. 164:42-45
1.ESSAY NEEDED
Module 2 – Case
Cell Chemistry
Case Assignment
Now that you have learned the basics of energy conversion, enzymatic activity, and two important processes used by living organisms, you will focus on cellular respiration for this Case Assignment.
After viewing the videos on Cellular Respiration, answer the following questions in a 2- to 3-page paper:
1. What is the starting molecule in glycolysis (i.e., what is being metabolized. Be specific)?
2. Define these terms: substrate, enzyme, ATP, and describe why they are important in cellular respiration.
3. What do these enzymes do, generally speaking? Would the reaction occur if they were not present? Why or why not?
4. What are the byproducts of cellular respiration? Where do these byproducts end up (in the organism AND in the environment)?
Assignment Expectations
The Case Assignment is a written description of a problem or situation. Most cases are a “snapshot” of a particular situation within a complex environment.
The purpose of the Case Assignments in this course is to place the student in a position that will require research, synthesis of information, and critical thought. The student will be asked to distinguish pertinent facts from peripheral facts, identify central alternatives among several issues competing for attention, and formulate strategies and recommendations. This method provides an opportunity to sharpen problem-solving skills and to improve the ability to think and reason rigorously.
Your essay is considered a scholarly work. You will be provided with many scholarly references to begin each assignment. For any additional research you are required to do to complete your assignment, please use scholarly references such as a peer reviewed journal article or a government sponsored or university sponsored website. As you read through your sources, take notes from your sources and then write your paper in your own words, describing what you have learned from your research. Direct quotes should be limited and must be designated by quotation marks. Paraphrased ideas must give credit to the original author, for example (Murray, 2014). Direct copying from “homework help” websites will not receive credit.
When you write your essay, please organize your paper to include an introduction (overview of the assignment), body with subtitles (reflecting the requirements of the assignment), and a summary (develop connections between the required topics
2. SLP NEEDED
Module 2 – SLP
Cell Chemistry
SLP Assignment Overview
We will continue to analyze our study conducted in the oceans of the Gulf of Mexico in the article by Urakawa et al (2012), A sensitive crude oil bioassay indicates that oil spills potentially induce a change of major nitrifying prokaryotes from the Archaea to the Bacteria.
As you analyze the results in this study, think back to the evolution of life on our planet and the videos you watched in Module 1. One theory of the evolution of life suggests that life evolved in a chemical “soup” of ingredients that under the right conditions facilitated the collection of molecules into primitive cells. In order to maintain organization, these primitive cells needed to acquire resources from their oceanic environment, harvest the energy from these sources, and use it to maintain the structures that worked well and build new structures to accomplish future work and survival. This process is termed “metabolism,” and organisms have evolved many strategies in order to accomplish life-sustaining chemical transformations.
In order to continue your analyses, you must first be able to explain some of the important metabolic pathways described in the study. In this SLP assignment you will compare chemotrophic metabolic pathways to photosynthesis.
Write a 3-4 page paper that addresses each of the following topics. Use subtitles and headings to organize your paper. Research your answers to the questions below using scholarly sources, including national, university, and government websites, publications, and scientific journals. Cite your references throughout, and include a references section at the end.
1. Begin by describing the origin of crude oil deposits in the ocean. What role did photosynthesis play in this process?
2. Using full sentences in paragraph format define:
The difference between an autotroph and a heterotroph
The relationship between a photosynthetic autotroph and a chemotrophic autotroph
Nitrification
Ammonia oxidation
3. Why is nitrogen important to living systems?
4. How are these metabolic pathways similar to photosynthesis?
5. From the Urakawa et al. (2012) paper: Why was nitrite production used to measure the activity of the microbes in the study?
6. What is a bioassay? Why did the scientists use it in this study?
7. Which organisms showed sensitivity to oil toxicity? What happened to nitrite production in these organisms? How did nitrite production relate to growth?
Here is a diagram to help as you consider these metabolic pathways:
From Wikimedia Commons, the free media repository
SLP Assignment Expectations
The Session Long Project consists of an integrative project emphasizing the personalized application of each module’s concepts. For Modules 1–5, students are required to engage in an original integrative project reflecting their comprehensive knowledge of and ability to apply the course materials. Each component of the SLP will be graded on a modular basis.
Your essay is considered a scholarly work. You will be provided with many scholarly references to begin each assignment. For any additional research you are required to do to complete your assignment, please use scholarly references such as a peer reviewed journal article or a government sponsored or university sponsored website. As you read through your sources, take notes from your sources and then write your paper in your own words, describing what you have learned from your research. Direct quotes should be limited and must be designated by quotation marks. Paraphrased ideas must give credit to the original author, for example (Murray, 2014). Direct copying from “homework help” websites will not receive credit.
When you write your essay, please organize your paper to include an introduction (overview of the assignment), body with subtitles (reflecting the requirements of the assignment), and a summary (develop connections between the required topics).