CASE STUDY:

Mrs. Amelia Middleton is a 68 year old retired receptionist who is bought in by ambulance to the
emergency department (ED) of her local hospital. Her son Paul is with her. Paul had called the
ambulance service earlier stating that his mother woke this morning complaining of a headache
and is now unable to lift her right arm and has been having difficulty speaking.

On examination Mrs. Middleton has a BP of 200/110, pulse 78 and irregular, respiratory rate 16,
SpO2 98%, Glasgow Coma Scale 12, and Temp 36.8. Her blood sugar level is 4.8mmol/L. She
also has paralysis of the right arm and face and loss of sensation to touch on the right side of her
face and right arm. She appears to understand what is being said to her but cannot respond
verbally. Mrs. Middleton’s history includes depression and lower gastrointestinal bleeding
associated with haemorrhoids. She has no known allergies. Mrs. Middleton is an only child. Her
father died of an anterior myocardial infarction at age 57 and her mother died of breast cancer at
age 72.
Mrs. Middleton currently lives with her son after the recent death of her husband, Geoff. She is in
the process of trying to sell the family home. She has three other children, all of whom live
interstate.
Amelia Middleton’s current medications are:
Sertraline 100mg mane
Rectinol HC topically as required
At the time of arrival Mrs. Middleton had a provisional diagnosis of CVA/stroke.
Mrs. Middleton was ordered a CT scan which was conducted 6 hours after her arrival to ED, the
results excluded the presence of a haemorrhagic stroke but indicated ischaemic stroke.
A 12 lead ECG was also conducted on arrival and Mrs. Middleton was found to be in atrial
fibrillatio

Directions
This assessment task requires  to apply the Clinical Reasoning Cycle (CRC) to the above case
study, using the following questions/instructions to guide and organise response.
answers should be presented in an integrated essay-format (rather than short-answer responses)
and be informed and supported by  reading of current research and literature.
1) What additional data/cues would you gather in regard to this case, and how and why would
this be performed?
2) Draw upon existing knowledge and relevant scholarly literature to process the above
information.
3) Given that the diagnosis of ischaemic stroke has already been confirmed, identify and
explain two other issues/problems for Mrs Middleton that emerge from your analysis of the
data (remember, these do not necessarily have to be other specific diagnoses/conditions,
but could be particular problems that arise due to the stroke).
4) Select one of these issues/problems and establish a clear goal for your care.
5) Discuss your key actions/interventions for achieving this goal, drawing upon appropriate practice literature

AP

Steps for Completing the Assignment

Identify the case study you have chosen on the title page of your assignment, for example, Demonstrating Effective Leadership: Case Study 23 A Speed Bump on Staff.
In the body of your paper, briefly summarize the case study. In your summary, be sure you identify who the leader is, the issue he or she is facing, and what you believe to be the cause of the issue. Remember, the case studies do not present all of the answers or information. You will need to use the information available and draw your own conclusions about the situations.
Please note: If your instructor requires you to submit this assignment to Smarthinking for feedback prior to submitting it in the courseroom, be sure you attach the Smarthinking feedback report along with your assignment.
Evaluate how effective this leader is in the ability to build relationships within the organization. Support your evaluation with references to at least one peer-reviewed journal or resource. Based on your evaluation, explain how likely the leader will be able to build and maintain strong relationships outside his or her organization with other public service leaders.
From the information provided in the case study, evaluate how well the leader manages professional responsibilities and priorities. Use examples to clarify and support your evaluation.
How well does this leader communicate both verbally and in writing? What role does communication have in both creating and resolving the issue?
Determine if the leader was effective in resolving the issue. Did he or she offer a solution that everyone understood? Explain. Support your decision with references to at least one peer-reviewed journal or resource.
If you would like assistance in organizing your assignment, or if you simply have a question about your assignment, please do not hesitate to ask your courseroom instructor or the Teaching Assistants (in the PSL Learner Success Lab) for guidance and suggestions.

Your completed assignment should be approximately 3–4 pages in length, not including the title page and reference page. You do not need an abstract for this assignment. You must include references to at least three different resources (peer-reviewed journals or other scholarly resource, assigned unit readings, et cetera). Be sure that you follow APA guidelines for style and formatting, as well as for citing your resources in the body of your paper and on the Reference page.

Submit this assignment to your instructor as an attachment in the assignment area no later than 11:59 p.m. (CST) Sunday.

Reference
Harari, O. (2002). The leadership secrets of Colin Powell. New York, NY: McGraw-Hill.