HLTENN043 – Case Study: Implementing Care for a Person with an Acute Health Condition (Stroke)

Assessment Task: Written Case Study – Acute Stroke Care Plan

Course / Unit Details

Qualification: HLT54121 Diploma of Nursing – TAFE Queensland
Unit: HLTENN043 Implement and monitor care for a person with acute health conditions
Assessment type: Individual written case study (theory assessment)
Length: 1,500–2,000 words (approximately 4–5 pages)
Weighting: Refer to the Unit Assessment Overview in the Study Guide
Mode of submission: Online via Connect (Word or PDF format)

This assessment evaluates the student’s ability to apply the nursing process in acute care, demonstrate clinical reasoning, and integrate evidence-based practice within the Enrolled Nurse scope under Registered Nurse supervision.

Scenario

You are an Enrolled Nurse working in a public hospital medical ward under the direction and supervision of a Registered Nurse. You are allocated the care of a 52-year-old person admitted with an acute ischaemic stroke affecting the left cerebral hemisphere. The person presents with right-sided weakness, slurred speech, and difficulty swallowing. They are receiving acute stroke management including neurological observations, intravenous therapy, and allied health referrals.

You must use the nursing process and current evidence to plan, implement, and monitor person-centred and culturally safe care during the first 24 to 48 hours of admission. Your response should reflect current Australian clinical standards and demonstrate safe delegation and escalation practices.

Assessment Instructions

Task 1: Comprehensive Nursing Assessment (approx. 500–600 words)

Using the case scenario and relevant learning resources:

Identify the person’s actual and potential acute health problems related to stroke. Consider airway, breathing, circulation, disability, exposure, pain, mobility, communication, nutrition, and elimination.
Summarise relevant health history, current observations, and investigation results that support your clinical assessment.
Briefly explain the pathophysiology and aetiology of ischaemic stroke and relate this to the presenting signs and symptoms.
Describe at least two psychosocial impacts of the acute condition for the person and their family or carers.

Your discussion should clearly link assessment findings to underlying neurological changes and demonstrate clinical prioritisation.

Task 2: Develop a Nursing Care Plan and Culturally Safe Approaches (approx. 700–900 words)

Based on your assessment:

Develop and prioritise a nursing care plan addressing the acute stroke and at least three key problems, such as:
- Impaired mobility
- Risk of aspiration
- Pain
- Impaired communication
- Risk of pressure injury
For each identified problem, provide:
- One clear SMART nursing goal or outcome.
- At least two nursing interventions within the EN scope under RN supervision.
- A rationale for each intervention supported by current evidence-based guidelines.
- Assessment criteria describing how you will evaluate whether the goal has been achieved, including what you will monitor, how often, and where documentation will occur.
Describe at least two culturally safe approaches you will use when planning and delivering care. Consider the person’s cultural background, language preferences, spiritual beliefs, and family involvement.

Your care plan must reflect person-centred care principles and demonstrate accountability within delegated practice boundaries.

Task 3: Implementing and Monitoring Care (approx. 300–400 words)

Explain how you will:

Implement prioritised nursing care in collaboration with the Registered Nurse and multidisciplinary team, including physiotherapy, speech pathology, and occupational therapy.
Monitor the person’s response to care by assessing neurological status, vital signs, pain, mobility, nutrition and hydration, elimination patterns, and skin integrity.
Recognise early signs of acute deterioration and escalate concerns promptly using organisational escalation pathways and structured communication tools such as ISBAR.

Your explanation should demonstrate understanding of teamwork, documentation standards, and clinical governance requirements.

Task 4: Documentation and Communication (approx. 200–300 words)

Discuss:

How you will accurately document assessment findings, nursing interventions, and the person’s responses in either paper-based or electronic health records using appropriate terminology and approved abbreviations.
The importance of clear and timely documentation for legal and professional accountability, continuity of care, and quality improvement.
How you would provide a concise ISBAR handover to another nurse at the end of your shift, including identity, situation, background, assessment, and recommendation.

Your discussion should reflect professional standards and patient safety principles.

Submission Requirements

Word processed document with 1.5 line spacing, 12-point font (Arial or Times New Roman), and standard margins.
Use clear headings for each task. Dot points may be used within care plans where appropriate.
Referencing: APA 7th edition. Minimum of five current, credible sources published between 2018 and 2026, including at least one Australian guideline.
Submit via Connect by the due date outlined in the Unit Study Guide.
Marking Criteria (Summary)

Criterion	High Achievement	Satisfactory	Not Yet Satisfactory
Task 1: Assessment	Accurate and comprehensive assessment; strong linkage between clinical data, pathophysiology, and psychosocial impacts.	Key problems identified with basic linkage to pathophysiology; psychosocial impacts correctly described.	Major problems omitted or inaccurately described; limited or no linkage to pathophysiology or psychosocial impact.
Task 2: Care Planning	Prioritised, realistic care plan; goals, interventions, rationales, and evaluation criteria specific and evidence based; culturally safe care clearly articulated.	Care plan mostly appropriate but lacking detail or clear prioritisation; some evidence and cultural safety included.	Care plan unclear, unsafe, or not aligned with EN scope; minimal evidence or cultural consideration.
Task 3: Implementation and Monitoring	Clear explanation of collaborative implementation and monitoring; deterioration recognition and escalation well described.	Implementation and monitoring described with minor gaps; escalation mentioned but limited detail.	Implementation vague or incorrect; escalation processes not addressed.
Task 4: Documentation and Communication	Demonstrates sound understanding of documentation standards and ISBAR; strong links to safety and accountability.	Basic understanding evident; documentation or handover underdeveloped.	Poor understanding of documentation or handover; potential safety risk.
Academic Writing and Referencing	Clear, logical writing; accurate grammar and spelling; consistent APA referencing.	Generally clear writing; minor referencing errors.	Frequent writing errors; referencing incorrect or largely absent.

Effective acute stroke management requires rapid assessment, structured monitoring, and coordinated interdisciplinary intervention to reduce complications and optimise recovery outcomes. National guidelines emphasise early neurological observation, swallow screening, prevention of immobility-related complications, and timely rehabilitation planning as core components of high-quality stroke care (Stroke Foundation, 2021). For the Enrolled Nurse, consistent documentation of limb strength, speech changes, fluid intake, and skin integrity supports early recognition of deterioration and promotes safe escalation to the Registered Nurse. Evidence-based implementation within the first 24 to 48 hours of admission has been associated with reduced mortality, improved functional independence, and shorter hospital stays, reinforcing the importance of systematic and accountable nursing practice in acute neurological settings.

References

Stroke Foundation (2021) Clinical guidelines for stroke management. Melbourne: Stroke Foundation.
Australian Commission on Safety and Quality in Health Care (2021) Acute stroke care clinical care standard. Sydney: ACSQHC.
World Health Organization (2019) WHO guideline: recommendations on stroke rehabilitation. Geneva: WHO.
Winstein, C.J. et al. (2018) ‘Guidelines for adult stroke rehabilitation and recovery’, Archives of Physical Medicine and Rehabilitation, 99(3), pp. 516–569.
Schwamm, L.H. et al. (2021) ‘Advances in acute stroke care: AHA scientific statement’, Stroke, 52(5), pp. 190–204.
Intercollegiate Stroke Working Party (2023) National clinical guideline for stroke. London: Royal College of Physicians.