NURS427 Assignment Brief 

NURS427 Long-term Conditions: Pathophysiology and Management / NĀHI 427 Mate Mauroa – Mātai Tukumate- Whaiaroaro me te Whakahaere Assignment 

Aims

To increase understanding of a population to enable planning and implementation of culturally appropriate programmes of health care for individuals with long-term conditions; this includes supporting individuals and populations to reduce their risk of developing long term illness.         

Students will develop extensive knowledge of pathophysiological processes associated with selected acute, long-term and common conditions and the associated alterations in function. This paper aims to integrate knowledge of pathophysiology with risk factors and evidenced based interventions for common long-term conditions.

To increase nursing knowledge of long term, and common conditions for the delivery of optimal patient-centred health care including a focus on self-management and lifestyle interventions. This includes assisting those with new diagnoses to manage their condition and prevent acute exacerbations, and complications in the context of networks of support.

Learning Outcomes

1. Critically appraise aetiology, epidemiology, pathophysiology and clinical manifestations of long-term health conditions with respect to gender, age, ethnicity, chronicity, multi-morbidity and apply this knowledge in practice to ensure optimal patient outcomes.
2. Critically appraise clinical manifestations of pathophysiology states and common conditions to inform clinical reasoning and decision making in clinical practice.
3. Show evidence of supporting individuals with long-term health conditions to achieve and maintain optimum health throughout their illness trajectory.
4. Critically analyse factors which contribute to risk with chronic disease and multi-morbidity to promote management strategies for health and wellbeing.
5. Accurately inform and assist individuals to reduce their risk through integrated care planning and education.
6. Critique and develop the role for nurses in long-term condition management and how the Registered Nurse role relates to other team members.            

Content

Continuum of long-term conditions

Population health and individual health

Acute exacerbation of long-term conditions

The patient with multi-morbidity

Pathophysiology of selected acute and common long-term health conditions  

Risk factors and determinants for chronic health conditions 

• Ageing
• Health inequities for Māori and Pacific people
• Biological risk factors (obesity, hypertension)
• Behavioural or lifestyle risks factors (alcohol, tobacco use, diet)

Pathophysiology of some common long-term health conditions

• Endocrine (Obesity, diabetes type I and II)
• Respiratory (Chronic obstructive pulmonary disease, asthma, sleep disorders)
• Genitourinary (Acute and chronic kidney disease)
• Cardiovascular (Myocardial infarction, heart failure, stroke)
• Musculoskeletal (Arthritis, osteoarthritis, rheumatoid arthritis)
• Neurological (Dementia, Parkinsons disease, chronic pain)
• Gastrointestinal (Inflammatory bowel disease, Hepatitis C)
• Mental health (Mood disorders, depression)
• Infection and immunity (Sepsis, HIV)
• Cancer (Hallmarks of a cancer cell, bowel, lung, prostate)
• Haematological (Clotting disorders, anaemias)
• Integumentary (Skin cancer, dermatitis) 

Long-term health condition management 

Long-term condition management and evaluation frameworks

Patient engagement and self-management

Advanced care planning  Health literacy

Clinical care – Evidence based guidelines for both acute/newly diagnosed and longterm conditions including:

• Diabetes
• Cardiovascular disease
• Chronic respiratory disease
• Depression and anxiety
• Living with pain

Monitoring and evaluating effectiveness of risk reduction and management of patients with long term and common conditions through audit and other measures

Context of care

• Current infrastructure; funding, systems, and/or organisational
• Service delivery, models of integrated care, and supports
• Interdisciplinary teamwork and collaborative relationships
• Regulatory context: Medicines list for Designated RN Prescribing

ATTENDANCE

Contact Hours 

46 hours

Students are expected to attend all teaching sessions unless prevented by exceptional circumstances. If you are unable to attend please notify the Paper Convenor prior to the commencement of the study block.

Self-Directed Learning   

312 hours

A range of activities will make up the self-directed learning hours including class preparation, general reading and assessment preparation.

Note: A 30-point single semester paper requires approximately 20 hours of study per week.

Total course hours – 360 hours

RESEARCHREADY

Every student enrolled with the Department of Nursing is required to complete the following via the links on Moodle: 

• ResearchReady – modules 2, 3 & 4
• ritical Skills for Postgraduate Studies – 2 modules

ResearchReady is a set of modules designed to orient you to resources and services available through the Health Sciences Library and to develop skills in accessing, evaluating and using information for your assignments and professional practice. As a health professional you will be required to demonstrate skills in finding, evaluating and using information effectively.

There are four ResearchReady modules in total.  NB: Only modules 2, 3, 4 are required to be completed.

Module 4 covers how to use information in an ethical way by learning about academic integrity and citing and referencing when writing assignments.  By the end of this module, you should be able to:

• distinguish between forms of academic integrity and academic misconduct
• understand the importance of citing and referencing sources you use
• know the citation style for your paper
• identify how to use in-text citations and references in your assignments.

Critical Skills for Postgraduate Studies comprises two modules addressing essential postgraduate study skills, and critical thinking and critical writing.

It is expected that all modules will be completed by the fourth week of enrolment.

Useful link:

Canterbury Medical Library:  https://www.otago.ac.nz/christchurch/library

Module 1 of ResearchReady is optional and includes information about the Dunedin campus library.  For Christchurch-based students, see the link above for Canterbury Medical Library.

RESOURCES

For information on access to resources refer to the Distance Learning Information and Support: https://www.otago.ac.nz/distance/current

ONLINE LEARNING SYSTEM

Moodle is used in this paper to provide a richer learning environment. The online environment provides a place to communicate and work with lecturers and other students, to access course resources, and to discuss questions raised during the course.

You will need to use the online environment to access course material, undertake learning activities, and submit assignments via Turnitin.

eReserve is an electronic platform in which resources such as research articles, book chapters and pdf documents are linked directly to the source. The purpose of this is to ensure the copyright of materials is maintained. You will find a link to eReserve in Moodle.

NB: Moodle is best accessed by using Chrome or Firefox internet browsers. 

Students are strongly advised to check Moodle at least twice a week for new course related announcements.

THE USE OF GENERATIVE ARTIFICIAL INTELLIGENCE (AI) SOFTWARE

The University’s policy recommends the inclusion of paper-specific guidelines. Unless specifically required for part of an assessment, students in this paper should not use generative artificial intelligence software (AI) such as Chat GPT for content generation due to the potential for biases, factual errors, lack of originality, and the risk of breaching Academic Integrity standards.  The use of AI, when used appropriately, ethically, critically and responsibly and with permission, can assist in various aspects of the learning process. For example:

• The use of Grammarly for grammar checking may be permitted but must be acknowledged appropriately. See examples below for in-text and reference list citation examples.
• The citation requirements also apply to images created using AI.

The outputs sourced from generative AI must be considered the same as any other work that is generated by another person and acknowledged accordingly. This statement is in line with the University of Otago Use of Generative-Artificial Intelligences and Autonomous Content Generation in Learning and Teaching policy and Academic Integrity Policy.

Example:

This research paper was reviewed and edited for grammar and style using Grammarly’s GenAI tool (Grammarly, 2023).

Grammarly (2023). Grammarly (Oct 16 version) [Large language model].

https://app.grammarly.com/

If you have any questions about AI use and application, please discuss with your Paper Convenor.

TEXTBOOKS/ESSENTIAL READINGS

The two required textbooks for this paper are:

Chang, E. & Johnson, A. (2021). Living with chronic illness and disability:   Principles for nursing practice (4^th ed.). Elsevier

Craft, J. A., Gordon, C. J., Huether, S. E., McCance, K. L., & Brashers, V. L. (Eds.)   (2023). Understanding pathophysiology Australia and New Zealand Edition (4th ed.). Elsevier. ISBN (print) 9780729543910; ISBN (Electronic) 9780729597739.

NB – The 3^rd and 2^nd editions of Craft et al. are also appropriate.

Recommended textbook.

Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P. (2021). Bates’ guide   to physical examination and history taking (13th edition). Lippincott Williams & Wilkins.

This textbook is available as an electronic version textbook, in the University of Otago Library.

See Course Documents in Moodle for a full list of readings.

NURS427 ASSESSMENT

Patient Consent and Confidentiality

Presentation of any casework must include a statement confirming consent was given for the use of de-identified clinical information for the purposes of education. A pseudonym must be used and stated as such within the assignment.  All other potentially identifying patient information must be anonymised or removed.

Please refer to the Master of Health Sciences Programme and Master of Advanced Nursing Practice Assessment Policy, Procedures and Guidelines for further information.

To pass the paper students must:

• achieve a pass grade of 50% in each assessment.

Resits – A pass mark (usually 50%) must be attained for each piece of assessment in papers.  In the case of failure in a piece of assessment, a resit may be offered on one occasion only within each paper.  For resits, an upper limit of C- grade will be imposed for that assessment.

Penalty for exceeding word limit

Students must adhere to the assignment word count. Appendices and reference lists are excluded from the word count although in-text references are included. The policy allows for 10% over the word limit. Beyond this limit, a mark deduction of 1% is imposed for 2% of text more than the word limit. Accordingly, mark deductions accumulate for every further 2% of text.

Appeals

Grievance and appeal mechanisms – refer to Master of Health Sciences Programme and Master of Advanced Nursing Practice Assessment Policy, Procedures and Guidelines.

Assignment Submission

Students are strongly encouraged to save and retain a copy of all their assignment work – in more than one location. In the rare event of loss or damage after submission, the copy enables re-submission without distress to, or further work by, the student affected. Refer to Master of Health Sciences Programme and Master of Advanced Nursing Practice Assessment Policy and Procedures document for information regarding extensions and late submissions.

Turnitin

Submission of assignments to Turnitin to check for plagiarism is required for this paper. You may submit a draft of your assignment to gain a plagiarism check of your work before final submission.

To submit your draft for a plagiarism check: Click on the link to draft assignment submissions in the assignment section in Moodle. Choose the correct tab for your assignment and then click on the cloud icon to upload your draft. Once submitted you need to wait until it comes back with a percentage. Click on the percentage to view your report in Turnitin. Then check and amend your assignment if necessary.

To submit your final copy: Click on the assignment you wish to submit in Moodle and upload your assignment at the bottom of the page with the button that says “add submission”. Wait until a percentage appears and then click on this to see your report.

Requirements related to the use of Turnitin regarding each piece of assessment will be discussed at the first study block.

Policy for return of assessments

Students submitting their work for examining should receive their work back, with feedback as soon as possible and no later than 15 working days after the day the work was handed in or due, whichever is the later.             

NURS427 Assignment One

 Collaborative Care Plan (for a patient with a long-term condition)

Submission Date:         Thursday 2 April 2026

Submission Details:  via Moodle before 5.00pm

Word Limit:                     3000

Assignment Weighting: 30%

This assessment meets learning outcomes:  1, 2, 3, 4, 5, 6

Turnitin check required:            Yes

Purpose

The aim of this assignment is to develop and demonstrate your skills in writing a patient case and planning collaborative comprehensive care for patients while considering the wider picture of long-term conditions.

Note: Ethics

Informed consent: You will need to gain the informed consent (verbal is sufficient) of the patient and where applicable, their family/whānau. Consent includes acknowledgement that the information will be used in an assignment. You are not to conduct research. Do not audio record any interviews. Use pseudonyms in any written notes and de-identify all other potentially identifying information.

Process

1. Present a patient profile of someone who has experienced a long-term condition: Include a comprehensive assessment of the patient’s history and their current health status.
2. Discuss the pathophysiology of the condition. If another acute or long-term condition(s) exists, mention it in your assessment but only focus on one long-term condition.
3. Formulate a collaborative care plan which displays; interdisciplinary collaborations, strategies to address the patient’s long-term condition, their overall wellbeing and if appropriate, the needs of their family/whānau.
4. In the above care plan, include education considerations that closely align with self-management principles.
5. Evaluate the effectiveness of the care plan by referring to an appropriate framework.

• Relevant literature about evidence-based practice and clinical guidelines are to be integrated throughout the assignment.
• To align with the collaborative care plan, please cite either the:

o Standards of Competence for Registered Nurses (2025) (Nursing Council of

New Zealand) or the  o Competencies for RN Prescribers – If you are working towards this scope of practice.

Please note, in the event you do not have access to a suitable patient, there is the option to use a patient profile provided by the Department. 

Grading of Assignment 1 – Collaborative Care Plan

NURS427 Assignment Two

Collaborative Clinical Case Study (in a patient with  co-morbidities)

Submission Date:          Friday 8 May 2026

Submission Details:         via Moodle before 5.00pm            

Word Limit:                         4000 words

Assignment Weighting: 40%

This assessment meets learning outcomes:  1, 2, 3, 4, 5, 6

Turnitin check required: Yes

Purpose

The purpose of this collaborative clinical case study is to demonstrate an ability to integrate learning about; anatomy, physiology, pathophysiology, diagnostic reasoning, and treatment options including pharmacological and nonpharmacological interventions in the care of a patient who is experiencing more than one long-term condition. The patient may have an exacerbation of a previously recorded long-term condition, or a separate acute presentation such as sepsis, or an acute kidney injury, for example, or an additional LTC.   Demonstrate your understanding of how these additional acute presentations or co-morbidities impact the patient and their wider family/whānau.

Note. You must choose a different patient and condition from the case selected for Assignment One.

Your collaborative clinical case study should provide a clear rationale in relation to:

• Comprehensive assessment of patient’s history and current health status
• Pathophysiology of the presenting conditions
• Present your understanding of the interactive effect of the condition(s), and/or the exacerbation of one as an acute presentation, for the patient and their family/whānau
• Where applicable, differential diagnoses (prioritised with rationale)
• Diagnostic tests and interpretation of assessments
• Treatment options for differential diagnoses, interventions and monitoring
• Current evidenced-based references that underpin treatment interventions; both non-pharmacological and pharmacological
• Collaboration with other healthcare professionals, including the patient and their family/whānau
• Evaluating the effectiveness of treatment(s)
• Relevant literature about evidence-based practice and clinical guidelines are to be integrated throughout the assignment
• To align with the collaborative care plan, please cite either the:

o Standards of Competence for Registered Nurses (NCNZ,2025) OR the  o Competencies for RN Prescribers – if you are working towards this scope of practice. Professional role and legal responsibilities, including reference to the list of medicines for registered nurse prescribers as specified by the Director-General of Health under the Medicines Act 1981. This list can be found here  https://gazette.govt.nz/notice/id/2022-go969.

A clear record of decision-making is required at each stage of the process. The student will demonstrate the linkage and integration between the patient’s medical history, evidence supporting diagnoses and clinical decisions.

Expectations include:

• evidence that the patient’s physiological condition and co-morbidities are considered
• analysis of the intended therapeutic effects and outcome of the interventions.

Discuss professional implications and reflections of advanced practice in this clinical case study.

Please note: if you do not have access to a suitable patient, there is the option to use a patient profile provided by the Department.

Grading of Assignment 2 – Collaborative Clinical Case Study

NURS427 Assessment Three

Pathophysiology Examination

Assessment Date: Tuesday 26 May 2026, 09.30–11.30am

Assignment Weighting: 30%

This assessment meets learning outcomes:  1 & 2

Duration:  2 hours

• This examination will comprise multi-choice questions on the topics of common long-term health conditions covered in the paper.
• The exam will be conducted in person with sittings in Christchurch and Dunedin.
• The pass mark for the examination is 50%.

If required, a 2-hour re-sit examination will be held on Wednesday 17 June 2026 at 09.30am.

University of Otago grade scale

The university of Otago uses the following scale to convert numerical marks into grades: