Patient Profile
• Name: Ron
• Age: 70
• Cultural Background: Pitjantjatjara Elder, Stolen Generations survivor
• Occupation: Road-train driver
• Location: Alice Springs
• Family: Single father of two school-aged sons (12 and 15 years old)
• Living situation: Lives in a unit requiring access via one flight of stairs
Physical Characteristics
• Height: 176 cm
• Weight: 84 kg
• BMI: 27.1 (overweight but not obese)
Presenting Situation
Ron is a 70-year-old male Aboriginal Elder from Alice Springs who underwent an elective triple
coronary artery bypass graft (CABG) at the Royal Adelaide Hospital (RAH) for unstable angina.
Four days postoperatively, he was transferred to Alice Springs Hospital (ASH), arriving on a
Saturday. His recovery was initially uncomplicated, but a lack of physiotherapy input and
delayed mobilisation over the weekend contributed to clinical deterioration.
By Day 5 post-op, Ron became febrile, hypoxic on room air, and developed coarse crackles on
auscultation. He was diagnosed with hospital-acquired pneumonia (HAP) affecting the right
lower lobe. Further blood tests revealed impaired kidney function consistent with CKD Stage
3a, requiring consideration for renal dosing of medications and increased monitoring.
Relevant Medical History
• Type 2 Diabetes Mellitus (HbA1c: 10.8%, uncontrolled)
• Hypertension
• Hyperlipidaemia
• Obesity (or overweight depending on BMI clarification)
• CKD Stage 3a (eGFR 47.2 mL/min, Cr 153 μmol/L, ACR 40 mg/mmol)
• Osteoarthritis (Left knee)
• Current smoker (resumed post stress)
• Post-CABG with recent HAP
Medications
Ron is currently prescribed:
• Perindopril (ACE inhibitor) – monitor renal function
• Amlodipine – continues for hypertension/angina
• GTN spray – PRN for angina
• Metformin – to be withheld during acute illness; reconsider post-discharge
• Oxycodone – PRN for post-op pain (monitor kidney function)
• Panadol Osteo – OK to continue
• Rosuvastatin – aggressive lipid control post-CABG
• Clopidogrel + Aspirin – dual antiplatelet therapy post-CABG
• Cefazolin – used as peri-operative prophylaxis
• New considerations (leave these out of Nursing in week 3 and they can be explored
in week 4 by the pharmacy team):
o Insulin glargine may be initiated for glucose control during acute illness
o Nicotine patches to support smoking cessation
o Laxatives to manage opioid-induced constipation
o Beta-blocker (e.g., metoprolol or atenolol) recommended post-CABG
o Empiric antibiotics (e.g., piperacillin-tazobactam) for HAP
o Future T2DM medications (post-discharge): empagliflozin (pending PBS
criteria), linagliptin, or semaglutide
Clinical Findings (Day 5 Post-op at ASH)
• Temperature: 38.9°C
• Heart Rate: 110 bpm
• Respiratory Rate: 24
• BP: 140/85 mmHg
• SpO₂: 88% on room air
• Breathing: Shallow, accessory muscle use
• Lung Sounds: Coarse crackles at right base
• Sputum: Thick, purulent
• Pain: Interfering with sleep and mobility
• Additional Pathology:
o CRP: 120 mg/L (elevated)
o WBC: 13.3 x 10⁹/L (elevated)
o HbA1c: 10.8%
o Serum Creatinine: 153 μmol/L
o eGFR (Cockcroft-Gault): 47.2 mL/min
o Urine ACR: 40 mg/mmol
o ESR: 75 mm/hr (elevated)
Nursing Issues Identified
• Clinical deterioration (HAP) requiring escalation and MDT coordination
• Inadequate pain control affecting breathing and mobility
• Impaired renal function impacting medication safety and dosing
• Cultural and psychosocial factors influencing care engagement
• Discharge complications: physical deconditioning, stairs at home, no local cardiac
rehab
• Uncontrolled diabetes needing medication review and acute management
• Health promotion needs: smoking cessation, cardiac rehab, diabetes control
Social and Cultural Considerations
Ron is a Stolen Generations survivor, with past traumatic experiences relate to healthcare
providers and how they communicate.
As the sole parent of two children, his recovery is critical. His Aboriginal identity, cultural
responsibilities, and past experiences means that care must be delivered in a culturally safe
and respectful way. The additional complexity of managing CKD and diabetes requires
sensitive,
careful navigation of complex health education and planning, preferably with supported
culturally appropriate services.
Scenario Continuation
You are part of the nursing team caring for Ron. As his condition deteriorates, care is escalated.
Ron is started on appropriate empiric antibiotics for HAP (e.g., piperacillin-tazobactam). Due to
acute illness and CKD, metformin is withheld and insulin introduced. Medications are reviewed
for renal dosing, and nicotine patches are prescribed to support cessation efforts.
Task Instructions:
Word Count: 2500 words ±10%
Weight: 50%
Due Date: Week 8 – Sunday 13 September 2026 by 11:59 pm
Learning Outcomes: LO1, LO2, LO3, LO4
Purpose:
This assessment challenges you to apply evidence-based nursing knowledge to a complex clinical scenario while demonstrating how insights from other health disciplines can inform holistic, patient-centred care.
Note: Students are required to attend each of the interdisciplinary lectures (Nursing, Physiotherapy, and Pharmacy) or view the recordings to learn about the case study and ensure they can draw on interdisciplinary perspectives in their analysis of Ron’s case. Failure to engage with these lectures will limit your ability to successfully complete the assignment.
Learning Outcomes Assessed:
Apply underpinning knowledge of anatomy and physiology to support clinical reasoning, evidence-based practice and person-centred nursing care.
Explain the pathophysiological process of dysfunction or potential dysfunction of body systems across the lifespan in response to acute and chronic conditions.
Plan, implement and evaluate appropriate nursing interventions within the scope of a novice to advanced beginner nursing student in a simulated environment.
Assessment Tasks
Part A: Clinical Reasoning and Interdisciplinary Synthesis (500 words)
Summarise Ron’s presenting problem and risk of clinical deterioration using a structured clinical reasoning model (e.g. ISBAR or Clinical Reasoning Cycle).
Explain the pathophysiology of Ron’s hospital-acquired pneumonia in relation to his surgery and comorbidities.
Integrate insights from the physiotherapy (mobility and discharge) and pharmacy (medication management) lectures into your understanding of Ron’s care needs.
Part B: Evidence-Based Nursing Care Plan (1500 words)
Identify four (4) priority nursing problems related to clinical deterioration and interdisciplinary care needs.
For each problem, include:
A clear statement of the problem and its link to Ron’s presentation.
A SMART goal for each problem.
At least two to three evidence-based interventions that incorporate relevant insights from the other disciplines (e.g. safe mobilisation strategies from physiotherapy, medication monitoring from pharmacy).
Rationale for each intervention supported by current literature (minimum 5 peer-reviewed references across the plan).
Evaluation criteria to determine the effectiveness of interventions.
Note: Students are encouraged to use a combination of narrative paragraphs and dot points to structure their care plan, ensuring clarity and academic rigour.
Part C: Reflection on Interdisciplinary Collaboration (300 words)
Reflect on how the insights from physiotherapy and pharmacy influenced your nursing care plan.
Discuss one challenge you foresee in integrating interdisciplinary perspectives into clinical practice and propose a solution.
Additional Requirements
APA 7th referencing.
At least 10 peer-reviewed references from 2018–2025.
Professional language, third-person narrative except for the reflection section.
Submit via Turnitin.
AI Use Statement – Assessment 2: Interdisciplinary Nursing Case Report and Care Plan
Generative AI tools may be used for this assessment with the following restrictions and conditions:
Students may use AI tools (e.g., ChatGPT, Claude, Microsoft Copilot) only for:
Clarifying task instructions;
Brainstorming potential topics or clinical reasoning steps relevant to Ron’s case;
Exploring general concepts in nursing, pathophysiology, or interdisciplinary practice as a learning aid.
Students must not use AI tools to:
Generate, rewrite, or improve any part of the written assignment (including grammar, structure, or tone);
Draft or assist in writing SMART goals, care plan rationales, or reflective content;
Generate or suggest references or citation content;
Summarise academic articles or evidence;
Submit any content that has not been critically reviewed and written independently by the student.
All academic writing must represent a sincere demonstration of your individual understanding, clinical reasoning, and evidence-based decision-making. Use of AI must be acknowledged in a brief AI statement included at the end of the submission (e.g., under the heading “AI Use Declaration”).
Any inappropriate use of AI or failure to declare AI use will be considered a breach of academic integrity and managed according to CDU policy.
Assessment Rubric
Criteria
High Distinction (85–100%)
Distinction (75–84%)
Credit (65–74%)
Pass (50–64%)
Fail (<50%)
Part A: Clinical Reasoning & Interdisciplinary Synthesis (15%)
Demonstrates a sophisticated understanding of Ron’s clinical deterioration with a clear, structured analysis. Integrates relevant and insightful contributions from physiotherapy and pharmacy, showing deep interdisciplinary synthesis. Pathophysiology is accurate, comprehensive, and connected to the case.
Demonstrates a strong understanding of clinical deterioration with a mostly clear structure. Integrates relevant points from physiotherapy and pharmacy, showing good interdisciplinary insight. Pathophysiology is accurate and mostly well explained.
Demonstrates an adequate understanding of clinical deterioration with some structure. Some integration of physiotherapy and pharmacy perspectives, though superficial. Pathophysiology is generally accurate but lacks depth.
Demonstrates a basic understanding of clinical deterioration with limited structure. Minimal integration of interdisciplinary perspectives. Pathophysiology is brief and may have some inaccuracies.
Demonstrates poor understanding of clinical deterioration; lacks structure. No integration of interdisciplinary perspectives. Pathophysiology is inaccurate or missing.
Part B: Evidence-Based Nursing Care Plan (50%)
Four priority nursing problems are highly relevant and clearly articulated. SMART goals are specific, measurable, achievable, realistic, and time-bound. Interventions are comprehensive, evidence-based, and show excellent integration of physiotherapy and pharmacy insights. Rationales are sophisticated, using high-quality recent evidence (including guidelines and journal articles). Evaluation criteria are detailed and appropriate.
Four priority nursing problems are relevant and mostly clear. SMART goals are mostly appropriate. Interventions are evidence-based and integrate physiotherapy and pharmacy insights well. Rationales are clear and use good quality evidence. Evaluation criteria are appropriate but may be less detailed.
Four priority nursing problems are somewhat relevant but may lack detail. SMART goals are somewhat appropriate. Interventions show some evidence-based rationale and limited interdisciplinary integration. Rationales are adequate but rely on minimal references. Evaluation criteria are present but basic.
Nursing problems are vaguely defined or only partially relevant. SMART goals may be missing or poorly constructed. Interventions are minimal with limited evidence. Rationales are weak with little referencing. Evaluation criteria are incomplete.
Nursing problems are unclear or irrelevant. Goals are missing. Interventions are missing or unsafe. Rationales are missing or unsupported. Evaluation criteria are absent.
Part C: Reflection on Interdisciplinary Collaboration (15%)
Insightful and reflective analysis of interdisciplinary learning. Demonstrates deep understanding of how physiotherapy and pharmacy insights inform nursing practice. Identifies a key challenge in interdisciplinary integration with a clear, practical solution.
Strong reflection on interdisciplinary learning. Demonstrates good understanding of physiotherapy and pharmacy insights. Identifies a relevant challenge with a reasonable solution.
Some reflection on interdisciplinary learning. Mentions physiotherapy and pharmacy but with limited analysis. Identifies a challenge but solution is vague.
Minimal reflection on interdisciplinary learning. Little or no mention of other disciplines. Challenge identified but not explained.
No reflection on interdisciplinary learning. No mention of other disciplines. No challenge identified.
Use of Evidence and Referencing (10%)
Excellent integration of peer-reviewed references (minimum 10) with critical use of current, high-quality evidence from 2018–2025. APA 7th edition referencing is flawless.
Good integration of references (at least 10) with mostly high-quality evidence. APA 7th edition referencing has minor errors.
Adequate references (minimum met but may be borderline). Some reliance on textbooks. APA referencing has occasional errors.
Limited use of evidence (fewer than 10 references). Over-reliance on textbooks or non-peer-reviewed sources. APA referencing inconsistent.
Poor or no use of evidence. No or inadequate references. APA referencing absent or incorrect.
Academic Writing and Presentation (10%)
Highly professional academic tone, free of errors. Clear, coherent, and well-organised structure. Appropriate use of third-person narrative (except reflection).
Mostly professional tone with minor errors. Generally clear structure and organisation.
Some lapses in academic tone, with occasional errors. Structure mostly clear but some sections may be confusing.
Frequent errors in academic tone and grammar. Weak structure.
Poor academic tone. Multiple errors. Lacks structure and clarity.
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