Question 1

Tom and Jerry met with an accident while riding a motorcycle. Tom was riding the motorcycle while Jerry was pillion riding. Jerry gets flung off and hits the pavement injuring his neck. They both sustained spinal trauma. In ICU, Tom is diagnosed with the transaction of the spinal cord at L2, while Jerry is diagnosed with the transaction of the spinal cord at C4. Both are conscious and have no head injury. Jerry is on a ventilator using a tracheostomy tube while Tom has no difficulty in breathing. As an ICU nurse, you need to explain to Tom and Jerry about the injury and why they have different symptoms.

Based on your understanding of anatomy and physiology, explain the difference in the presenting symptoms of Tom and Jerry.

Question 2

David is a police officer and is involved in controlling a gang fight. During the encounter, a gangster stabbed David in the back using a broken bottle. The piece of the bottle used was very sharp and pointed. In the hospital, the investigation showed that the glass piece has severed the hemisection of the spinal cord (half of the spinal cord) on the left side at T8. Being the nurse in charge of the patient, you need to explain to David’s wife about the injury and the effect the injury will have on his legs.

Based on your understanding of anatomy and physiology, explain the various pathways that may have severed. Relate this information to the symptoms David will show.

Question 3

Baby M, born with a large head, was diagnosed with hydrocephalus during the antenatal check-up. On birth, you notice a large head, and eyes sunken downwards. Over the next few hours, the baby is not feeding adequately and has poor muscle tone. As a ward nurse, you need to explain to the parents of Baby M about the disease. You have learned that hydrocephalus is due to excessive cerebrospinal fluid in the ventricles. Describe the production, circulation, and reabsorption of cerebrospinal fluid. Describe the functions of cerebrospinal fluid. Based on your understanding of the physiology, explain the symptoms of Baby M.

Question 4

Mr. T and Mr. B are mahjong buddies, admitted to neuro-ICU with ischemic stroke. Hypothetically they have different arteries blocked due to embolism. Mr. T who is righthanded has a left middle cerebral artery affected. Mr. B who is also right-handed has the right anterior cerebral artery affected. As an ICU nurse you need to explain to the relatives of Mr. T and Mr. B about the disease and why they have different symptoms. Based on your understanding of anatomy and physiology, assuming there is no collateral circulation, explain the difference in the presenting symptoms in Mr. T and Mr. B.

Question 5

Asim is diagnosed with open-angle glaucoma at the age of 48. You have learned during the nursing course that patients with glaucoma have increased intraocular pressure. Treatment and regular follow-ups help to slow the disease. Asim is a typical noncompliant patient who does not turn up for follow-up appointments. Being the nurse in charge of the patient, you need to explain to Asim the progress of the disease and why regular follow-ups are important.

Based on your understanding of the anatomy of the eye, including chambers of the eye, retina, fovea, and optic nerve, explain to Asim what effects the increased intraocular pressure will have on his vision.

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