NURS07042-26455 – Emergency and Critical Care Nursing
| University | Technological University of the Shannon (TUS) |
| Subject | NURS07042-26455 - Emergency and Critical Care Nursing |
Summer Examinations 2023/2024
Section A
Question 1
Q 1. Describe the key steps involved in conducting a thorough trauma assessment, encompassing both primary and secondary surveys.
[100 Marks]
OR
Question 2
Q.2. Describe the fundamental principles of triage and the key considerations involved in prioritizing patient care.
[100 Marks]
Section B
Question 3
Mr Sanchez has been admitted to the critical care unit with severe burn injuries following a house fire. Following initial assessment, it is established that he weighs approximately 80 kgs and has sustained partial-thickness burns. The burn covers his entire chest, abdomen, back, and back of one leg. He has large blisters on his chest and the back of his knees. His right lower arm is also extensively burned.
Q 3(a)
Explain how burns are classified and explain some of the tools (methods) used to estimate the percentage of total body surface area (TBSA) burned. You may include diagrams to aid your answer.
[25 Marks]
Q 3(b)
Discuss how the trauma of the burn injuries may lead to multi-systemic alterations in body function that may affect the patient in the long and short term. Provide a clear rationale for your answers by explaining how alterations in these systems may manifest clinically.
[35 Marks]
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Q 3(c)
Describe the assessment, management, and ongoing care of Mr Sanchez while in the critical care unit?
[40 Marks]
[TOTAL MARKS: 100]
OR
Question 4
While working as a registered nurse in the critical care unit, you have been asked to care for Mrs O Brien, who was recently transferred to the unit and has required invasive ventilation.
Q 4(a)
Explain the main types of ventilation and some of the main reasons that patients might require ventilation.
[25 Marks]
Q 4(b)
Explain the main risks associated with endotracheal intubation.
[25 Marks]
Q 4(c)
Outline and explain your role and responsibilities as a nurse in the care and management of patients who are invasively ventilated.
[50 Marks]
[TOTAL MARKS: 100]
Section C
Question 5
Q 5 Describe the steps in a model of communication that can be used to facilitate delivering bad news to a patient.
[100 Marks]
OR
Question 6
Q 6 Describe the ISBAR communication tool and how it can be used to ensure good communication between health professionals in healthcare environments.
[100 Marks]
Summer Examinations 2022/2023
Section A: Critical Care Nursing
Question1
Q 1(a)
You have been asked to care for a patient who requires invasive ventilation in the Critical Care Unit. Explain the main types of ventilation and some of the main reasons that patients might require ventilation.
[25 Marks]
Q 1(b)
Explain the main risks associated with tracheostomy and endotracheal intubation.
[25 Marks]
Q 1(c)
Outline and explain your role and responsibilities as a nurse in the care and management of patients who are invasively ventilated.
[50 Marks]
[TOTAL MARKS: 100]
OR
Question 2
Q 2(a)
A 38-year-old gentleman has had an anaphylactic reaction following administration of an Intravenous (IV) medication while being cared for in the Critical Care Unit. Explain what an anaphylactic reaction is and what are some potential causes/triggers of anaphylaxis?
[10 Marks]
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Q 2(b)
With reference to underlying pathophysiology, explain the common signs and symptoms and main risks for patients with anaphylaxis?
[30 Marks]
Q 2(c)
Using an ABCDE approach, explain the nursing approach to the care and management of this patient, including the primary and secondary medications used.
[60 Marks]
[TOTAL MARKS: 100]
Section B: Emergency Care Nursing
Question 3
“Emergency department overcrowding stems from fewer emergency departments being available for a greater number of patients seeking care……. Patients in the emergency department are triaged on arrival to determine the acuity of their complaint” (Stanfield & Burlington, 2015: 396).
Q 3(a)
Define triage and explain the principles of triage within the Emergency Department.
[20 Marks]
Q 3(b)
With reference to the Manchester Triage System, describe how the triage process supports a comprehensive patient assessment in the Emergency Department.
[60 Marks]
Q 3(c)
Discuss the role of the nurse in assessing a patient in triage and the ongoing reassessment & monitoring.
[20 Marks]
OR
Question 4
A 72-year-old gentleman, John Browne, has been admitted to the Emergency Department following a road traffic accident. He arrives at the department on a spinal board with a cervical spine collar in situ. Handover from the paramedics indicates no loss of consciousness; however, he may have possibly sustained a fractured femur.
Q 4(a)
With reference to a recognised communication tool used by the paramedic team, describe the key elements of the handover from the paramedics used to support the patient’s initial assessment.
[10 Marks]
Q 4(b)
Discuss the assessment and management of this patient in the Emergency Department.
[70 Marks]
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Q 4(c)
Discuss the rationale for a systematic approach to the assessment of the trauma patient in the Emergency Department.
[20 Marks]
[TOTAL MARKS: 100]
Section C: Applied Psychology
Question 5
Outline how models of grief and loss can be useful to the nurse in emergency or critical care environments, using at least one model to support your answer.
[100 Marks]
OR
Question 6
Q 6(a)
Discuss the importance of effective communication in emergency and critical care environments.
[60 Marks]
Q 6(b)
Describe one communication model that can facilitate effective communication with staff or service users.
[40 Marks]
[TOTAL MARKS: 100]
