Critical Care Unit After An Accident
CC is a previously healthy 27-year-old man admitted to the critical care unit after an accident in which he was hit by a car and dragged along the pavement for nearly 100 feet. He suffered a frontal contusion, fractured clavicle and ribs, and extensive abrasions on his arms, legs, side, back, and buttocks. On admission, he was tachycardic, hypotensive, unresponsive, and ventilating poorly. He was placed on a mechanical ventilator and given IV fluids for the treatment of his shock. CC responded well to fluids, with an increase in blood pressure and an improvement in urine output.
1. Based on his case history and responsiveness to fluid therapy, what type of shock was CC experiencing?
2. What other clinical findings would be helpful in confirming the type of shock? Why?
3. Because of his many open wounds and invasive lines, CC is at risk for sepsis and septic shock. What clinical findings would suggest that this complication has developed?
4. What is the link between sepsis and multiple organ dysfunction syndrome (MODS)?
Review Appendix A, Sections I–V in Finkelman (2012, pp. 510–515).
- Select one of the sections and share how your chief nurse executive demonstrates expertise in these competencies. Your comments should be about the “highest nursing leader” in your organization. Typically this is the leader who represents nurses and nursing to the governing board.
- In your own words, explain the differences between a transactional nursing leader and a transformational nursing leader. What one is more like your Nurse Executive?
- Describe how the Nurse Executive “leads the charge” for transformational leadership in an organization where you work or have done prelicensure clinical experiences.
Finkelman, A. (2012). Leadership and management for nurses: Core competencies for quality care (2nd ed.). Boston, MA: Pearson.
- Chapter 15: Evidence-based Practice and Management
- Appendix A: Nurse Executive Competencies (pp. 510–515)
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