RNSG 2432 Enhanced Concepts of Adult Health

Module 15: Nursing Care of the Individual Experiencing Trauma/Shock: Emergency/Critical Care Nursing

Module Objectives:

Utilizing critical thinking and the nursing process, the student will:

1. Compare and contrast risk factors associated with trauma and shock.

2. Analyze the etiology and pathophysiology for the following disorders:

3. Analyze the signs and symptoms and complications of the following disorders:

  • . Trauma
    1) Types of trauma
    2) Effects of traumatic injury
  • . Shock
    1) Stages of shock
    2) Effect of shock on body systems
    3) Types of shock inc cardiogenic, obstructive, hypovolemic, distributive (septic, neurogenic and anaphylactic

4. Integrate the diagnostic tests with the etiology, pathophysiology, and signs and symptoms for the following disorders:

  • . Trauma
    1) Blood type and cross
    2) BAC
    3) UDS
    4) Pregnancy test
    5) CT/MRI
    6) Other
  • . Shock
    1) Cardiac and hemodynamic monitoring
    2) Frequent vital signs
    3) Urine output

5. . Formulate relevant prioritized nursing diagnosis that address physical, psychosocial, and learning needs.

  • . Trauma
    1) Ineffective airway
    2) Risk for infection
    3) Impaired physical mobility
    4) Spiritual distress
    5) Risk for post-trauma syndrome
  • . Shock
    1) Decreased cardiac output
    2) Altered tissue perfusion
    3) Anxiety

6. Formulate client and family centered goals that assist toward health promotion, maintenance, and/or restoration.

7. Prioritize and evaluate nursing interventions related to:

  • . Drug therapy:
    1) Trauma

    (1) Volume expanders
    (2) Inotropes
    (3) Vasopressors
    (4) Opiods
    2) Shock

    (1) Fluid replacement
    (2) Positive inotropes
    (3) Vasodilators (mainly cardiogenic)
    (4) Vasoconstrictors (mainly distributive)
    (5)Vasoconstrictors (mainly distributive).
  • Diet therapy
    1) Hypermetabolic states
  • Surgical/Medical interventions:
    1) Trauma
    (1) Rapid head-to-toe assessment
    (2) Spinal immobilization
    (3) Oxygen therapy, airway maintenance
    (4) Other
    2) Shock
    (1) IAPB
    (2) VAD
    (3) Positioning of patient
    (4) Airway maintenance
    (5) Other
  • . Patient teaching; therapeutic communication
  • . Consider human and material resources, including delegation
  • . Referrals
  • . Other:
    1) Forensic considerations
    2) Organ donations

8. Evaluate and revise goals and modify the nursing care plan specific to the individual experiencing trauma and shock.

9. Integrate associated issues and trends into nursing practice:

  • . Legal
  • . Ethical considerations

10. Analyze emergency rooms and critical care units, and the nurses' role in each area.

Learning Activities:

Review module objectives.


  • Read LeMone p. 136-164; review p. 876-878 (hemodynamic monitoring)
  • PSD Software: Critical Care:Cardiovascular: Ms. Jane Doe with cardiac arrest
  • PSD Software: Critical Care:Gastrointestinal: George White with stab wound
  • Read: Notes: Trauma/Shock
  • Complete: Learning Guide: Trauma/Shock (*T&F answers in Mod 15 Discussion Board)
  • Access Class Lab #5; complete required readings
  • Define the vocabulary terms on the Student CD-Rom accompanying text, chap 6

Interactive exercises:

Case study/critical thinking activities:

  • Shock Tutorial (Select Shock and complete the following units: Introduction, What is Shock and Key Points. Also explore the other units for an in-depth understanding of pathophysiology of shock)
  • Case Study: MR with Trauma/Shock (seminar or on your own)
  • Nursing care Plan: A Client with Multiple Injuries, text p.149; complete Critical Thinking questions and evaluate responses.
  • Nursing care Plan: A Client with Septic Shock, text p. 163; complete Critical Thinking questions and evaluate responses.
  • Evolve Case Studies: Access Medical Surgical case studies and complete Peripheral Vascular Disease with Amputation (good for review) (See BB announcements page if difficulty in using case studies)

Web sites (opt):

Review module objectives and check for knowledge gaps.

Required: Complete the module quizzes:

  • Blackboard: Critical Care/Trauma/Shock/Emergency