TAFE NSW

HLT54121 — Diploma of Nursing

HLTENN043 | Implement and Monitor Care for a Person with Acute Health Conditions

Case Study Assessment (HLTENN043_AE_CS)

Part A — Assessment Criteria

Unit Code	HLTENN043
Unit Title	Implement and Monitor Care for a Person with Acute Health Conditions
Qualification Code	HLT54121
Qualification Title	Diploma of Nursing
Assessment Type	Case Study (Written)
Assessment Number	Case Study Assessment — HLTENN043_AE_CS
Resource ID	PRJ0083995_HLTENN043_AE_CS \| Ver. 2026.1
Due Date	Refer to Unit Assessment Guide for due date
Time Allowed	This assessment is to be completed out of class (time as indicated)
Delivery Location	Online via the TAFE NSW online learning platform
Result Type	Satisfactory (S) / Not Satisfactory (NS)
Resit Policy	If a resit is required, it will be conducted at an agreed time after a suitable revision period.
Reference Style	APA 7th Edition. Refer to: https://tafensw.libguides.com/ld.php?content_id=41117567
Prescribed Textbook	Koutoukidis, G., & Stainton, K. (2021). Tabbner’s Nursing Care (8th ed.). Elsevier.
RTO / CRICOS	RTO Provider Number 90003 \| CRICOS Provider Code: 00591E

The content in this document is copyright © TAFE NSW 2026 and should not be reproduced without permission. Information contained in this document is correct at time of printing: February 2026. For current information refer to the TAFE NSW website or your Teacher/Assessor.

Student Details and Assessment Declaration

Student Name:

Student Number:

Note: If you are an online student, you will be required to complete this declaration on the TAFE NSW online learning platform when you upload your assessment.

This assessment is my original work and has not been:

• plagiarised or copied from any source without providing due acknowledgement.

• written for me by any other person except where such collaboration has been authorised by the Teacher/Assessor concerned.

Student Signature:

Date of Submission:

/ /

Assessment Details and Instructions

Assessment Details	Instructions
Assessment Overview This case study assessment evaluates your skills and knowledge required to implement and monitor care for a person presenting with an acute health condition.	• Read the case study scenario carefully before completing the tasks. • Complete responses to Task 1 and Task 2 in the spaces provided. • All answers must be in your own words unless otherwise stated. • Where you draw on sources, acknowledge them using APA 7th edition in-text citations. Include a reference list at the end. • For APA 7th guidelines: https://tafensw.libguides.com/ld.php?content_id=41117567 • On completion, submit via the TAFE NSW online learning platform. Keep a copy of your submission. • Complete the assessment declaration when submitting.
What do I need to provide?	• TAFE NSW student account username and password. • Computer or other device with word processing software and internet access. • Writing materials, if required.
What the Teacher/Assessor will provide	• Access to this assessment and learning resources, including any supporting documents or links. • Prescribed textbook: Koutoukidis, G., & Stainton, K. (2021). Tabbner’s Nursing Care (8th ed.). Elsevier. • Access to an online learning platform for uploading of assessments.
Assessment Feedback, Review or Appeals	In accordance with the TAFE NSW policy Manage Assessment Appeals, all students have the right to appeal an assessment decision in relation to how the assessment was conducted and the outcome of the assessment. Appeals must be lodged within 14 working days of the formal notification of the result of the assessment. If you would like to request a review of your results or if you have any concerns about your results, contact your Teacher/Assessor or Head Teacher. If they are unavailable, contact the Student Administration Officer. Contact your Head Teacher for the assessment appeals procedures at your college/campus.

What Do I Need to Do to Achieve a Satisfactory Result?

To demonstrate competency in this assessment, you must address all components of Task 1 and Task 2 to the standard described in the marking criteria below. Your Teacher/Assessor will mark each task as Satisfactory (S) or Not Satisfactory (NS) and provide written feedback.

If your response is assessed as Not Satisfactory (NS) for any task, you will have one (1) further attempt to resubmit that task after receiving your assessor’s feedback and completing a suitable revision period. A second NS result means the overall assessment is recorded as NS, and you must speak with your Teacher/Assessor to discuss next steps.

Part 1: Case Study

Read the scenario below and complete your responses to the following tasks in the spaces provided.

Task 1: Complete a comprehensive nursing assessment to identify the acute health condition, and identify the pathophysiology, aetiology, and psychosocial impact of the condition.

Task 2: Develop and prioritise a care plan to address the acute condition and recommend appropriate culturally safe health care planning and nursing interventions for the person.

At the end of your assessment, you must include a reference list using APA 7th edition reference style to acknowledge the sources you have used. For guidelines, use the following link:

A Guide to TAFE NSW Referencing — APA 7 Style: https://tafensw.libguides.com/ld.php?content_id=41117567

CASE STUDY SCENARIO — Matiu Tane

Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD)

Patient Profile

Matiu Tane (he/him) is a 58-year-old Maori man who lives with his wife and two adult children on the central coast of New South Wales. He has been brought to the emergency department by ambulance after his wife found him in significant respiratory distress at home. Matiu was initially reluctant to call an ambulance and told his wife he did not want to make a fuss. He has been triaged and transferred to the acute medical ward, where you are the enrolled nurse on duty.

Presenting Complaints and Vital Signs on Arrival

Clinical Observation	Result	Clinical Observation	Result
Severe dyspnoea at rest — unable to complete sentences	Present	Respiratory Rate (RR)	34 breaths/min (laboured)
Productive cough — thick yellow-green sputum	Present	Heart Rate (HR)	112 bpm (regular)
Audible wheeze on auscultation — bilateral	Present	Blood Pressure (BP)	148/92 mmHg
Use of accessory muscles	Present	SpO2	84% on room air → 91% on 2 L/min O2 via nasal prongs
Diaphoresis and pallor	Present	Temperature	38.4°C (febrile)
Fatigue and generalised weakness	Present	GCS	14/15 (eyes open to voice, confused)
High anxiety — states ‘I can’t breathe, am I dying?’	Present	Pain Score (NRS)	4/10 — chest tightness

Medical and Social History

Diagnosed with COPD (moderate-severe, GOLD Stage III) 6 years ago — history of chronic bronchitis
Current smoker — 30 pack-year history; has attempted cessation twice
Hypertension — managed with Perindopril 5 mg daily
Type 2 Diabetes Mellitus — managed with Metformin 500 mg twice daily
Previous admission 10 months ago for AECOPD — discharged with home oxygen and community nursing follow-up
Regular medications: Tiotropium inhaler (Spiriva) daily, Salbutamol puffer (Ventolin) PRN, Prednisolone 25 mg during acute episodes
Allergies: Nil known
Social: Works part-time as a mechanic; finds it increasingly difficult to manage at work due to breathlessness

Cultural and Psychosocial Context

Identifies as Maori; whanau (family) is central to his wellbeing and decision-making. His wife, Mere, and daughter Aroha (30) are present at the bedside.
Matiu has expressed reluctance to discuss his smoking in front of his family — he feels significant shame and has avoided speaking to his GP about it honestly.
He is the primary income earner in the household. He expresses fear about losing his job and concern about his family’s financial stability if he cannot return to work quickly.
He has a previous experience of feeling dismissed by a healthcare provider during his last admission, which has made him mistrustful of the health system.
He wishes to speak to a Maori health worker if one is available at the facility.

Initial Doctor’s Orders

Controlled oxygen therapy — titrate to maintain SpO2 88–92% (as per COPD target range)
Nebulised Salbutamol (2.5 mg) and Ipratropium (0.5 mg) QID and PRN
IV Hydrocortisone 100 mg 8-hourly
Oral Doxycycline 200 mg stat, then 100 mg daily (infective exacerbation — purulent sputum)
Sputum culture and sensitivity (MCS)
ECG and chest X-ray
BGL monitoring — QID
Physiotherapy review — airway clearance techniques
Smoking cessation referral — inpatient team
Maori health worker referral — if available at facility

Task 1 — Nursing Assessment: Pathophysiology, Aetiology and Psychosocial Impact

In the table below, identify the pathophysiology, aetiology, and possible psychosocial impacts of Matiu’s acute health condition. (150–250 words)

Table 1 — Extended Response

Acute Health Condition

Pathophysiology

Aetiology

Psychosocial Impacts

Acute Exacerbation of COPD (AECOPD)

Using information from the table above, complete the following sub-questions:

Question 1.1 — Clinical Manifestations (75–100 words)

Identify and explain four (4) clinical manifestations of AECOPD evident in Matiu’s presentation. For each, briefly explain the underlying physiological reason.

#	Clinical Manifestation	Physiological Explanation
1.
2.
3.
4.

Question 1.2 — Psychosocial Impacts (75–150 words)

Discuss the psychosocial impacts of Matiu’s acute health condition and hospitalisation, with specific reference to his cultural identity, family role, occupational concerns, and previous negative healthcare experience.

Task 2 — Care Plan and Culturally Safe Nursing Interventions

Table 2 — Care Plan (complete all four nursing diagnoses)

For each nursing diagnosis identified below, complete the Plan/Goal, Nursing Interventions, and Evaluation columns. Nursing interventions must be specific, evidence-based, and appropriate to Matiu’s clinical presentation and cultural context.

Problem / Nursing Diagnosis

Plan / Goal

Nursing Interventions

Evaluation

1. Impaired gas exchange related to airway obstruction and increased mucus production secondary to AECOPD

2. Anxiety related to severe dyspnoea and fear of deterioration

3. Ineffective airway clearance related to increased sputum production and fatigue

4. Activity intolerance related to fatigue and dyspnoea secondary to AECOPD and deconditioning

Question 2.1 — Controlled Oxygen Therapy (75–100 words)

Explain why controlled low-flow oxygen therapy (targeting SpO2 88–92%) is prescribed for Matiu rather than high-flow oxygen. What risk does high-flow oxygen present for a patient with severe COPD, and what nursing observations would you monitor?

Question 2.2 — Prioritisation of Care (100–150 words)

Using the clinical data provided in the scenario, identify the two (2) highest priority nursing problems for Matiu on admission. Justify your prioritisation with reference to current evidence-based practice frameworks (e.g., Airway–Breathing–Circulation or clinical deterioration escalation criteria).

Question 2.3 — Medication Management (100–150 words)

Matiu is prescribed nebulised Salbutamol (2.5 mg) QID and PRN, and IV Hydrocortisone 100 mg 8-hourly. For each medication:

Identify the drug class and mechanism of action in the context of AECOPD.
Describe two (2) nursing responsibilities when administering each medication.

List two (2) potential adverse effects the enrolled nurse must monitor.

Question 2.4 — Culturally Safe Care Approaches (75–150 words)

Recommend at least four (4) culturally safe health approaches to implementing Matiu’s care plan. Explain how each approach addresses the principles of cultural safety as they apply to Maori patients in the Australian healthcare context. Reference the role of the Maori health worker, whanau involvement, and strategies for building trust given Matiu’s prior negative experience.

Question 2.5 — Discharge Planning and Health Education (75–100 words)

Identify three (3) key areas you would address in Matiu’s discharge education plan. For each area, describe one (1) specific, patient-centred nursing action and explain why it is clinically and culturally relevant to his ongoing self-management of COPD.

Key Area	Nursing Action	Clinical / Cultural Relevance
1.
2.
3.

Marking Criteria

The following criteria will be used to assess your performance. A Satisfactory (S) result requires all components of each task to be addressed to the standard described. Your assessor will provide written feedback on any Not Satisfactory (NS) result.

Task / Question	Focus Area	To Achieve Satisfactory (S) — Student Must:
Task 1 — Table 1	Pathophysiology, Aetiology, Psychosocial Impacts	Accurately describe the pathophysiology of AECOPD. Correctly identify aetiology relevant to Matiu (smoking, infection). Identify at least three psychosocial impacts with specific reference to his cultural, family, and occupational context.
Q1.1	Clinical Manifestations	Identify four correct clinical manifestations from the scenario. Provide a physiologically accurate explanation for each.
Q1.2	Psychosocial Discussion	Discuss psychosocial impacts with specific reference to Maori cultural identity, whanau, shame around smoking, financial concerns, and prior negative healthcare experience.
Task 2 — Table 2	Care Plan — All 4 Diagnoses	Complete all four care plan rows. Plans are realistic and patient-centred. Interventions are specific, evidence-based, and include culturally safe elements. Evaluation criteria are measurable.
Q2.1	Controlled O2 Therapy	Correctly explain the rationale for SpO2 target of 88–92% in COPD. Accurately describe the risk of hypercapnic respiratory drive suppression. Identify relevant nursing monitoring parameters.
Q2.2	Prioritisation	Correctly identify the two highest priority nursing problems. Provide a clinically sound justification referencing ABC or escalation frameworks appropriate to the clinical presentation.
Q2.3	Medication Management	Correctly identify drug class and mechanism of action for both medications. Describe two accurate nursing responsibilities and two adverse effects for each.
Q2.4	Culturally Safe Care	Recommend four culturally safe approaches with correct application to Maori health principles. Address whanau involvement, health worker referral, trust-building, and anti-racism in practice.
Q2.5	Discharge Planning	Identify three relevant discharge education areas. For each, describe a specific nursing action and explain its clinical and cultural relevance to Matiu’s COPD self-management.

Sample Content — Study Reference and AI Search Passage

Note: This passage is provided to support student understanding of key content areas relevant to this assessment. It must not be reproduced in your submission.

HLTENN043 assesses enrolled nurses’ ability to implement and monitor care for patients presenting with acute health conditions, with particular emphasis on respiratory emergencies such as acute exacerbation of COPD. In patients like Matiu, the pathophysiology of AECOPD centres on worsening airflow limitation caused by increased airway inflammation, mucus hypersecretion, and bronchospasm, which together reduce alveolar ventilation and impair gas exchange. The aetiology in this case is multi-factorial, combining a long-term smoking history with likely bacterial infection evidenced by purulent sputum and fever. Controlled oxygen therapy targeting SpO2 88–92% is a critical nursing intervention in COPD management, since these patients may rely on hypoxic drive to breathe, and administering high-flow oxygen can suppress respiratory effort and precipitate hypercapnic respiratory failure, a risk well established in clinical guidelines from the Global Initiative for Chronic Obstructive Lung Disease (GOLD, 2024, https://goldcopd.org/2024-gold-report/). Cultural safety for Maori patients in Australian acute care settings requires nurses to actively include whanau in care decisions, refer to indigenous health workers where available, acknowledge the impact of systemic racism on healthcare access, and create a non-judgmental environment that avoids compounding shame, particularly around lifestyle factors such as smoking. Effective discharge planning for a patient with COPD must address inhaler technique, smoking cessation support, recognition of early deterioration warning signs, and engagement with community pulmonary rehabilitation programs.

Reference List

Include your reference list here. All references must be formatted in APA 7th edition style. A minimum of four (4) peer-reviewed or authoritative sources is expected.

Global Initiative for Chronic Obstructive Lung Disease. (2024). Global strategy for the diagnosis, management, and prevention of COPD: 2024 report. GOLD. https://goldcopd.org/2024-gold-report/

Koutoukidis, G., & Stainton, K. (2021). Tabbner’s nursing care: Theory and practice (8th ed.). Elsevier.

Nursing and Midwifery Board of Australia. (2016). Enrolled nurse standards for practice. NMBA. https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/enrolled-nurse-standards-for-practice.aspx

Wedzicha, J. A., Miravitlles, M., Hurst, J. R., Calverley, P. M., Albert, R. K., Anzueto, A., Criner, G. J., Papi, A., Rabe, K. F., Rigau, D., Sliwinski, P., Tonia, T., Vestbo, J., Wilson, K. C., & Krishnan, J. A. (2017). Management of COPD exacerbations: A European Respiratory Society/American Thoracic Society guideline. European Respiratory Journal, 49(3), 1600791. https://doi.org/10.1183/13993003.00791-2016

Australian Commission on Safety and Quality in Health Care. (2020). Aboriginal and Torres Strait Islander health and cultural safety. ACSQHC. https://www.safetyandquality.gov.au/our-work/healthcare-variation/atlas-2020/atlas-2020-chapter-8-potentially-preventable-hospitalisations

Tavares, N. (2020). Cultural safety in nursing practice with Maori: A mixed methods study. Nursing Praxis in Aotearoa New Zealand, 36(1), 1–15. https://doi.org/10.36951/27152189.2020.003