Essential Nursing Care: Managing the Deteriorating Patient

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Abstract

This subject will expand on the knowledge and skills developed in Essential Nursing Care: Acute Care, with a focus on the provision of safe, evidence-based nursing care to children and adults experiencing acute serious or life-threatening illness. Using a case-based approach, students will explore the pathophysiology, recognition and collaborative management of cardiovascular, respiratory, neurological, mental health and paediatric emergencies and their associated complications. During weekly clinical simulation laboratory sessions and workplace learning, students will have the opportunity to further develop their assessment skills as they perform comprehensive assessment of the relevant body systems (for distance education students this will involve a 4 day intensive). Students will also develop clinical skills relevant to the management of the seriously ill adult or child including venepuncture, intravenous cannulation, administration of blood products and management of central venous access devices.

Syllabus

This subject will cover the following topics: Module 1Learning Outcomes: 1-4, 6 Recognition of the Deteriorating Patient/Advanced Life Support;Recognising the deteriorating infant/child;Recognising the deteriorating adult;Cardiac and respiratory arrests pathophysiology;Cardiac monitoring recognition of lethal rhythms, basic ECG interpretation;Principles of Advanced Life Support (ALS) defibrillation and medications;ALS algorithms for adults and children; … For more content click the Read More button below. Module 2Learning Outcomes: 5, 6 Legal and Ethical Issues in Acute Health Deterioration;Withdrawal of treatment;Patient comfort analgesia, provision of basic nursing care, supporting the family;Organ donation;Family presence during resuscitation; andMental Health Emergencies. Module 3Learning Outcomes: 1-4, 6 Circulatory Deterioration;Shock overview pathophysiology, stages types with focus on hypovolaemic, cardiogenic and anaphylactic shock;Central venous access and arterial lines;Management of shock fluid resuscitation, vasoactive medications, advanced medication calculations;Venepuncture and introduction to IV cannulation; andAdministration of blood products. Module 4: Learning Outcomes: 1-4, 6 Respiratory Deterioration;Respiratory trauma, pneumothorax, flail chest;Advanced oxygen therapy and management of chest drains;Respiratory failure;Airway management; andIntroduction to mechanical ventilation. Module 5Learning Outcomes: 1-4, 6 Neurological Deterioration;Comprehensive assessment of the neurological system;Stroke, pathophysiology, clinical manifestations, immediate management;Traumatic brain injury and raised intracranial pressure- pathophysiology, clinical manifestations and management;Epilepsy, immediate treatment;Delirium; andBrain Death. Module 6Learning Outcomes: 1-4, 6 Renal and Diabetic Emergencies;Renal Assessment;Pathophysiology of Acute Kidney Injury (AKI) and complications;Collaborative management of AKI and complications, pharmacological, introduction to continuous renal replacement therapy, nursing considerations; andDKA, assessment and management. Module 7Learning Outcomes: 1-4, 6 Severe Burn Injury & Sepsis;Severe burn injury, pathophysiology and complications;Assessment of burn injury, burn size and depth;Immediate management of burn injury, first aid, criteria for referral, fluid resuscitation, airway management, initial wound management;Sepsis, pathophysiology and complications; andImmediate management of sepsis, fluid resuscitation, vasoactive medications. Module 8Learning Outcomes: 1-4, 6 Mental Health Deterioration;Self-harm and suicidal ideation;Acute intoxication, overdose, withdrawal;Aggressive behaviour and threats of violence;Acute psychosis; andAcute anxiety.

This subject will cover the following topics:

Module 1
Learning Outcomes: 1-4, 6

Recognition of the Deteriorating Patient/Advanced Life Support;
Recognising the deteriorating infant/child;
Recognising the deteriorating adult;
Cardiac and respiratory arrests pathophysiology;
Cardiac monitoring recognition of lethal rhythms, basic ECG interpretation;
Principles of Advanced Life Support (ALS) defibrillation and medications;
ALS algorithms for adults and children; and
Basic Principles of Triage.

Module 2
Learning Outcomes: 5, 6

Legal and Ethical Issues in Acute Health Deterioration;
Withdrawal of treatment;
Patient comfort analgesia, provision of basic nursing care, supporting the family;
Organ donation;
Family presence during resuscitation; and
Mental Health Emergencies.

Module 3
Learning Outcomes: 1-4, 6

Circulatory Deterioration;
Shock overview pathophysiology, stages types with focus on hypovolaemic, cardiogenic and anaphylactic shock;
Central venous access and arterial lines;
Management of shock fluid resuscitation, vasoactive medications, advanced medication calculations;
Venepuncture and introduction to IV cannulation; and
Administration of blood products.

Module 4:
Learning Outcomes: 1-4, 6

Respiratory Deterioration;
Respiratory trauma, pneumothorax, flail chest;
Advanced oxygen therapy and management of chest drains;
Respiratory failure;
Airway management; and
Introduction to mechanical ventilation.

Module 5
Learning Outcomes: 1-4, 6

Neurological Deterioration;
Comprehensive assessment of the neurological system;
Stroke, pathophysiology, clinical manifestations, immediate management;
Traumatic brain injury and raised intracranial pressure- pathophysiology, clinical manifestations and management;
Epilepsy, immediate treatment;
Delirium; and
Brain Death.

Module 6
Learning Outcomes: 1-4, 6

Renal and Diabetic Emergencies;
Renal Assessment;
Pathophysiology of Acute Kidney Injury (AKI) and complications;
Collaborative management of AKI and complications, pharmacological, introduction to continuous renal replacement therapy, nursing considerations; and
DKA, assessment and management.

Module 7
Learning Outcomes: 1-4, 6

Severe Burn Injury & Sepsis;
Severe burn injury, pathophysiology and complications;
Assessment of burn injury, burn size and depth;
Immediate management of burn injury, first aid, criteria for referral, fluid resuscitation, airway management, initial wound management;
Sepsis, pathophysiology and complications; and
Immediate management of sepsis, fluid resuscitation, vasoactive medications.

Module 8
Learning Outcomes: 1-4, 6

Mental Health Deterioration;
Self-harm and suicidal ideation;
Acute intoxication, overdose, withdrawal;
Aggressive behaviour and threats of violence;
Acute psychosis; and
Acute anxiety.

Enrolment restrictions

Only available to students enrolled in the Bachelor of Nursing course and Bachelor of Nursing - Graduate Diploma of Clinical Practice (Paramedic).

Pre-requisite

Work integrated learning

Placement Duration 140 hours Details Students will attend a workplace learning component focussing on the acute setting. 20 days (approx 140hrs)

Learning activities

Intensive

Learning resources

Additional resources required by students

Students attending compulsory intensive schools on Charles Sturt campuses will incur costs associated with travel, accommodation and required resources.

Students attending compulsory work integrated learning will incur costs associated with travel, accommodation and required resources.