1. What are the main components of the ABCDE assessment and why is it important in acute care settings?
(5 marks)
Answer: The ABCDE assessment stands for Airway, Breathing, Circulation, Disability and Exposure. It is a
systematic and structured approach to assess and manage critically ill patients. It helps to identify and
prioritize life-threatening conditions and guide appropriate interventions.
2. What are the common causes and signs of septic shock and how would you manage a patient with this
condition? (10 marks)
Answer: Septic shock is a type of distributive shock caused by a severe infection that triggers a systemic
inflammatory response. The common causes are bacterial, viral or fungal infections, especially in patients
with compromised immune systems or chronic diseases. The signs of septic shock include hypotension,
tachycardia, tachypnea, altered mental status, oliguria, fever or hypothermia, and elevated lactate levels. The
management of septic shock involves fluid resuscitation, vasopressors, antibiotics, source control, oxygen
therapy, and supportive care.
3. What are the indications and contraindications for non-invasive ventilation (NIV) and what are the
potential complications and nursing interventions associated with it? (10 marks)
Answer: NIV is a form of mechanical ventilation that delivers positive pressure to the airway without using
an invasive airway device. The indications for NIV include acute respiratory failure due to COPD
exacerbation, cardiogenic pulmonary edema, asthma, pneumonia, or neuromuscular disorders. The
contraindications for NIV include respiratory arrest, hemodynamic instability, facial trauma or surgery,
upper airway obstruction, inability to protect airway or clear secretions, or intolerance to the mask or device.
The potential complications of NIV include skin breakdown, aspiration, gastric distension, pneumothorax,
or hypotension. The nursing interventions for NIV include monitoring vital signs, oxygen saturation,
respiratory rate and effort, level of consciousness, and comfort; ensuring proper mask fit and seal; adjusting
settings as prescribed; providing oral care and humidification; and educating the patient and family about
the benefits and risks of NIV.
4. What are the types and causes of acute kidney injury (AKI) and how would you assess and monitor a
patient with this condition? (10 marks)
Answer: AKI is a sudden decline in kidney function that results in impaired fluid and electrolyte balance,
acid-base balance, and waste elimination. The types of AKI are prerenal (caused by reduced blood flow to
the kidneys), intrarenal (caused by damage to the kidney tissue), and postrenal (caused by obstruction to the
urine flow). The causes of AKI vary depending on the type, but some common ones are hypovolemia,
hypotension, sepsis, nephrotoxic drugs, glomerulonephritis, renal calculi, benign prostatic hyperplasia, or
tumors. The assessment and monitoring of a patient with AKI include measuring urine output, serum
creatinine, blood urea nitrogen (BUN), electrolytes, pH, blood gases, fluid balance, weight, blood pressure,
edema, and signs of uremia (such as nausea, vomiting, fatigue, pruritus,
or confusion).
Category | NR & NUR Exams |
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