1. What are the main components of the ABCDE bundle and how do they improve patient outcomes in the ICU? (5 marks) Answer: The ABCDE bundle consists of: - Awakening and Breathing Coordination: This involves daily interruption of sedation and spontaneous breathing trials to reduce mechanical ventilation duration and complications. - Delirium monitoring and management: This involves routine assessment of delirium using a validated tool and prevention and treatment of delirium using non-pharmacological and pharmacological strategies. - Early mobility and exercise: This involves early mobilization of patients who are mechanically ventilated or at risk of ICU-acquired weakness to improve physical function and quality of life. The ABCDE bundle improves patient outcomes by reducing the incidence and duration of delirium, mechanical ventilation, ICU stay, hospital stay, mortality, and long-term cognitive impairment. It also enhances patient comfort, safety, and satisfaction. Rationale: This question tests the students' knowledge of the evidence-based practice of the ABCDE bundle and its benefits for critically ill patients. 2. What are the indications, contraindications, complications, and nursing care for a patient undergoing therapeutic hypothermia after cardiac arrest? (10 marks) Answer: Therapeutic hypothermia, also known as targeted temperature management, is a technique that lowers the body temperature to 32-36°C for 24-48 hours after cardiac arrest to reduce brain injury and improve neurological outcomes. The indications for therapeutic hypothermia are: - Out-of-hospital cardiac arrest with return of spontaneous circulation (ROSC) and an initial shockable rhythm (ventricular fibrillation or pulseless ventricular tachycardia) - In-hospital cardiac arrest with ROSC and any initial rhythm - Post-cardiac arrest syndrome with coma or unresponsiveness The contraindications for therapeutic hypothermia are: - Active bleeding or coagulopathy - Severe infection or sepsis - Pregnancy - Pre-existing hypothermia or temperature <30>