Case Study:

Brian (88 years old) is a resident at a high dependency aged care facility (nursing home). He has developed infectious conjunctivitis in his right eye. On examination,
his eye was found to be red and swollen with a purulent and sticky discharge. His vision was unaffected; however he did complain that his eye was painful. The doctor
prescribed gentamicin eye drops which were to be administered to both eyes.
Using the supplied template, answer the following questions:
Q1. Background of the case study (Total: 5 marks)
1.1 What is infectious conjunctivitis? (1 mark)
1.2 Of the four micro-organisms listed below, justify which one is more likely to be the cause of Brian’s eye infection. Indicate why the other micro-organisms from
the list are less likely to cause the infection. (4 marks)
• Legionella pneumophila
• Plasmodium ovale
• Adenovirus
• Escherichia coli

Q2. Mechanism of action and adverse reactions (Total: 5 marks)
2.1 Describe the mechanism of action of gentamicin (4 marks)
2.2 Name two possible adverse reactions to this drug (1 mark)
Q3. Mediators of signs and symptoms (Total: 10 marks).
3.1-3.3 Identify and discuss the various chemical and cellular mediators which are responsible for any three signs or symptoms of Brian’s condition (10 marks).
Q4. Infection control issues (Total 5 marks)
4.1-4.2 Identify and discuss two infection control issues associated with high dependency aged care facilities that can contribute to the spread of conjunctivitis (5
marks).
Q5. Transmission of infection (Total: 5 marks)
5.1 Mary who resides in the room next door was diagnosed with the same eye infection 4 days later. Describe how the organism could have been transmitted from Brian’s
eye to Mary’s eye (describe the chain of infection that could have occurred form Brian’s eye to Mary’s eye) (5 marks).
Q6. Breaking the chain of infection (Total: 5 marks)
6.1 Describe two procedures nurses will need to undertake to prevent the infection from Brian’s eye being transmitted to another individual. Clearly explain how each
procedure will effectively break the chain of infection (5 marks).
Q7. Presentation: 5 marks. See template

Resources

• The following eight resources must be used and cited in this case study. Additional references may be used if required. Some of these can be accessed online
as indicated. Others may be placed on closed reserve in the library.
References:
Boland, M. (Director), Santall, J. (Presenter), & Video Education Australasia. (2011). Infection control in healthcare [Videorecording]. Bendigo, Australia: VEA.
Available online (https://www.youtube.com/watch?v=5Z_N1jPhFtc)
Boustcha, E., & Nicolle, L. E. (1995). Conjunctivitis in a long-term care facility. Infection Control and Hospital Epidemiology, 16(4), 210-216. Available online
Bullock, S., & Manias, E. (2014). Fundamentals of pharmacology (7th ed.). Frenchs Forest, Australia: Pearson Australia.
Craft, J., Gordon, C., Heuther, S., McCance, K., Brashers, V., & Rote, N. (2015). Understanding pathophysiology 2. Chatswood, Australia: Elsevier. Available online
(2011 edition)
Lee, G., & Bishop, P. (2013). Microbiology and infection control for health professionals (5th ed.). Frenchs Forest, Australia: Pearson.
Lehne, R. A., Moore, L., Crosby, L., & Hamilton, D. (2013). Pharmacology for nursing care (8th ed.). St. Louis, Mo: Saunders/Elsevier. Available online
Marieb, E.N., & Hoehn, K. (2014). Human anatomy & physiology (9th ed.). Boston, MA: Pearson.
Porth, C. M., & Matfin, G. (2009). Pathophysiology: Concepts of altered health states (8th ed.). Philadelphia, PA: Lippincott Williams & Wilkins AND/OR Grossman, S.
C., & Porth, C. M. (2014). Porth’s pathophysiology: Concepts of altered health states (9th ed.). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.
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