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Module HCT 341 Cardio-Respiratory Care: Theory to Practice

Assessment type: Written assignment

Weighting: 100% of module assessment

Assignment word count: 4000 words

Assignment Submission date: Wednesday 19th May 2021 by 12:30 pm

Assignment Resubmission date for September 2020 cohort (if failed 1st attempt): August 2nd 2021 by 12:30 pm

Assignment Resubmission date for January 2021 cohort (if failed 1st attempt): March 28th 2022 by 12:30 pm

There is a choice of4patient scenarios on which to base your written assignment.

Where do I find the information about the patient scenario?

The 4 patient scenarios are presented viaonline audio-visual video recordings.

The pathologies involved are:

Asthmas, cystic fibrosis, myocardial infarction and heart failure

Theweblinks for each the patient scenarioscan be found on page 4 – 7 of this document and alsoin the Assessment folder of HCT 341 module at this link:

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Each of the 4 patient scenarioshas several short video clips of the patient talking about their condition. This typically includes information about:diagnosis, clinical features, living with the condition, treatment and treatment burden. Although not all videos directly relate to clinical features and their management, some clips may be useful for understanding the whole person (attitudes, beliefs, motivations and goals)

and how thecondition affects the individual. This may influence your thoughts on how appropriate any given treatment or management may be for that individual.

How do I structure myAssignment?

This is a suggested basic outline of the Assignment; more details can be found in the Assignment presentation lecture and document supporting the understanding of the Level 7 assignment Rubric – found in the Assessment folder of the module 341:


  • Choose 1 patient scenarioto base your assignment on (from the 4 options given via the patient scenario links). Watch and/or read the patient’s story paying close attention to the clinical features they describe (signs and symptoms) and any attitudes, beliefs and thoughts about the management of their condition. Also note personal details such as age and gender.
  • Assignment introduction. This section should briefly introduce the patient-condition that has been chosen, for example asthma. It should include a definition of the condition with its incidence/prevalence, aetiology, burden on patient (e.g.influence of the condition on quality of life, morbidity, mortality rates) and health care system (e.g. cost to health care system). Reference to how typical the patient in the scenario is to the condition could be made, for example, is the age, gender and ethnicity of the person characteristic of the condition? The introduction should also tell the reader what the assignment will include – this need only be two or three sentences. The whole introduction should be no more than half a side of A4 paper.
  • From thechosen patient scenario, choose one clinical feature highlighted in the audio-videorecording / written scriptto focus on in your assignment, for example, breathlessnessin asthma or chest painin myocardial infarction.
  • Explore the normal anatomy and physiology of the structures involved in your chosen clinical feature, for example, normal airway wall structure, in and function, of most relevant airways, when considering breathlessness in asthma. To prepare for this section, it is helpful first look at the pathophysiology underpinning the clinical feature to ensure that you focus only on the most relevant normal structures and their function.
  • Then explore how the pathophysiology underpinning your chosen clinical feature affects the normal structure and function. For example, how does abnormal airway wall smooth muscle contraction happen and how might it contribute to breathlessness in asthma.
  • Brieflyconsider the current management options for treating your chosen clinical feature. This could beaccording to national guidelines and evidence based/best practice. This maybe different to the management approach mentioned in the video/case scenario. This section should only be 1-2 paragraphs.
  • The above sections should make up approximately one half of the assignment.
  • Next focus on the effectiveness of one management approach, justifying the reason for your choice,using research evidence. This will involve using a Search strategy to explore the literature base underpinning your chosen management approach. The research articles captured by this search should then be critically analysed in the context of the assignment question and the patient in the video. This involves considering the strengths and weaknesses of each study with particular attention to any biases which may have influenced the findings. An evaluation of the research findings for each study in relation to the specific patient scenario should then be made, for example, would the management approach suit the age, gender, attitudes, and beliefs of the patient in the scenario. Also, explain how the given management approach treats the clinical features. e. how does the treatment alter the pathophysiology?
  • Small summaries should be made throughout the critical analysis but also a summary of the research findings from all the studies should be made before moving to the final conclusion. This should highlight to what extent the chosen management approach is likely to be effective in the patient scenario with justification (in your opinion). It should also consider implications or recommendations for professional practice and recommendations for further study.
  • The final conclusion should bring together all the main ideas/concepts that the work has raised. It should ‘answer’ the assignment remit and should not just be a list of points covered in the main text.
  1. Asthma case scenario


Above is a screen shot of the web page for Asthma patient scenario. There are several short video clips from Peter – all of which can be viewed by clicking on the white play arrow.The video can then be enlarged by clicking on the expand icon bottom right of the video.

Brief overview of asthma case scenario – Peter

Name: PeterAge: 62

Gender: Male.

Ethnicity/nationality: White British

Social history: married. 2 adult children. Retired IT professional. Enjoys hill walking and skiing when tolerated, AsthmaUK volunteer speaker, seems motivated and knowledgeable about his condition

Medical history: asthma diagnosis age 45 following a prolonged chest infection poorly responsive to antibiotics. Controlled with relievers for 4/5 years but gradual deterioration.Severity: Variable – from mild to ‘quite debilitating’. Mild for 9 months of year – very little trouble with symptoms. Gradually worsening with age but more confident in self-management and control over past 2.5 years. Occasional chest infection with antibiotic management. Also has Rhinitis.

Clinical features: Variable – cough (affects sleep sometimes), chest tightness, wheeze, breathlessness (sometimes only limits hill walking, sometimes limits conversation or stairs) and +/- sputum production dependent on chest infection.

Aggravating factors: cold viruses, respiratory infections, hill walking, skiing, exercise, lying flat.

Management: several courses of antibiotics for respiratory infections, ‘reliever’ inhaler. No hospitalisation. Symbicort and Singilair inhalers several times a day and steroids when needed. Uses peak expiratory flow to help monitor asthma.

  • Cystic Fibrosis case scenario


Name: Sophie

Gender: Female

Age: 19

Ethnicity/nationality: White British

Social history: Second year university student. Lives in shared accommodation with other female students. Tries to do daily exercise – jogging, netball or cycling.Busy social life, manages studies well though does find balancing study, social, sporting and CF quite challenging. Difficulty finding time to cook for herself leading to losing weight and energy but now improved. Some difficulty adapting to not being able to drink alcohol – but this has given her pain similar to acute pancreatitis which she has previously had. Some apprehension about moving from paediatric to adult care, but the transition has been smooth. Sophie was fully self-managing her condition before coming to university. Believes that health care professionals should adopt a patient-centred approach when considering new management strategies.

Medical history: Diagnosed with Cystic Fibrosis at 8 years old. Controlled with medication, nebulisers and exercise. Expectorates mucus, especially with exercise. Sometimes experiences chest tightness and breathlessness, particularly if she has lapsed on her physiotherapy. Episodes of haemoptysis following prolonged exercise but also during normal activity treated with bronchial artery embolization.

Management: nebulisers, multiple CF medications – creon etc ’50 tablets a day’, ‘chest physiotherapy’ (one-hour self-physiotherapy/day plus sport; increased cough and chest tightness if omitted)

  • Heart failure case scenario


Name: Vivienne

Gender: Female.

Age: 61

Ethnicity/nationality: White British

Social history: Retired deputy matron in a children’s home; two adult daughters, grandchildren (who she previously helped with; her daughter has had to change to part-time working as a result), divorced. Daughters help when they can.

Previously unable to do household activities, stairs, personal care but has improved with attendance of well-being class which involves advice and exercise. Some anxiety – has been told it is a terminal condition but with no time-factor given.

Medical history: diagnosed with heart failure 1 year ago. Awoke feeling breathless and admitted to A & E (on 3 occasions); initial misdiagnosis with a panic attack.

Further episodes of orthopnoea and reduced exercise tolerance (over short distances on the level) and breathlessness. Often feels extreme fatigue and palpitations. Anxiety and weight gain since diagnosis. 

Management: ICD (Implantable Cardioverter Defibrillator) which took several months to show benefits but now feels ‘90%’ better but has ‘bad’ days.

Multiple cardiac medications at maximal safe dosage.

  • Myocardial Infarction case scenario


Gender: Female

Age: 53

Ethnicity/nationality: white British

Social history: Book-keeper, returned to work part-time following MI. Two adult children – one in university – main carer following MI.Son had difficulty accepting the diagnosis and resulting disability. Divorced. Some anxiety following MI, fear of re-infarct and living alone.

Medical history: Heart attack age 53 in hospital for 6 days. Declined thrombolysis due to possible risk at perception that MI was mild. Current medication ramipril, simvastatin, aspirin, metoprolol, GTN. Subsequent angioplasty and stent. Found Reiki useful to aid sleep and anxiety since the MI.Clinical features: pains down both arms, nausea and vomiting, weakness during MI – reduced exercise toleranceduring activities of daily living in the days/weeks followingthe MI.

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