NRS312 Essential Nursing Care: Managing the Deteriorating Patient (16)


This subject will expand on the knowledge and skills developed in Essential Nursing Care: Acute Care, with a focus on the provision of safe, evidence-based nursing care to children and adults experiencing acute serious or life-threatening illness. Using a case-based approach, students will explore the pathophysiology, recognition and collaborative management of cardiovascular, respiratory, neurological, mental health and paediatric emergencies and their associated complications. During weekly clinical simulation laboratory sessions and workplace learning, students will have the opportunity to further develop their assessment skills as they perform comprehensive assessment of the relevant body systems (for distance education students this will involve a 4 day residential school). Students will also develop clinical skills relevant to the management of the seriously ill adult or child including venepuncture, intravenous cannulation, administration of blood products and management of central venous access devices.

+ Subject Availability Modes and Location

Session 1
InternalAlbury-Wodonga Campus
InternalBathurst Campus
InternalDubbo Campus
InternalWagga Wagga Campus
Distance*Bathurst Campus
*This subject offering contains a residential school. Please view following information for further details.
Continuing students should consult the SAL for current offering details: NRS312
Where differences exist between the Handbook and the SAL, the SAL should be taken as containing the correct subject offering details.

Subject information

Duration Grading System School:
One session HD/FLSchool of Nursing, Midwifery and Indigenous Health

Enrolment restrictions

Only available to students enrolled in the Bachelor of Nursing course.
NRS223 or NRS293

Learning Outcomes

Upon successful completion of this subject, students should:
  • be able to collect, interpret and document subjective and objective data in the seriously ill or deteriorating person (aligns with Nursing and Midwifery Board of Australia National Competency Standards for the Registered Nurse: 1.1, 1.2, 2.5, 4.1, 5.1, 5.2, 5.3, 7.4, 8.1, 8.2).
  • be able to demonstrate a broad knowledge which links the underlying pathophysiology of serious cardiac, respiratory and neurological presentations to their clinical manifestations (NMBA 2.6, 3.1, 3.4, 4.1, 7.4).
  • be able to apply theoretical knowledge, critical thinking and the use of best evidence to contribute to the planning and implementation of appropriate nursing interventions for the person experiencing a serious or life-threatening illness (NMBA 1.2, 2.5, 2.6, 3.1, 3.2, 3.3, 3.4, 4.1, 6.1, 6.2, 6.4, 7.1, 7.2, 7.4, 7.7, 7.8, 8.1, 8.2, 10.3).
  • be able to apply theoretical knowledge to safely perform selected procedural skills including venepuncture, intravenous cannulation, administration of blood products and management of central venous access devices, required for the care of patients experiencing serious or life-threatening illness (NMBA 1.2, 2.5, 7.1, 7.2, 7.4).
  • be able to analyse the legal and ethical considerations associated with the management of the deteriorating patient (NMBA 1.1, 2.1, 2.2, 2.3, 2.4, 2.5, 7.4, 7.5, 7.6, 9.3, 9.5).
  • be able to communicate effectively with individuals, groups and members of the interdisciplinary team in the acute care environment (NMBA 1.2, 2.3, 2.4, 2.5, 5.1, 5.2, 5.3, 6.1, 6.2, 6.3, 7.4, 7.5, 7.6, 7.7, 9.1, 9.2, 9.3, 9.4, 10.2, 10.4)


The subject will cover the following topics:
  • Module 1: Recognition of the Deteriorating Patient/Advanced Life Support. Recognising the deteriorating infant/child. Recognising the deteriorating adult. Cardiac and respiratory arrests pathophysiology. Cardiac monitoring recognition of lethal rhythms, basic ECG interpretation. Principles of Advanced Life Support (ALS) defibrillation and medications. ALS algorithms for adults and children. Basic Principles of Triage. Learning. Outcomes: 1-4, 6.
  • Module 2: Legal and Ethical Issues in Acute Health Deterioration. Withdrawal of treatment. Patient comfort analgesia, provision of basic nursing care, supporting the family. Organ donation. Family presence during resuscitation. Mental Health Emergencies. Learning Outcomes: 5, 6.
  • Module 3: Circulatory Deterioration. Shock overview pathophysiology, stages types with focus on hypovolaemic, cardiogenic and anaphylactic shock. Central venous access and arterial lines. Management of shock fluid resuscitation, vasoactive medications, advanced medication calculations. Venepuncture and introduction to IV cannulation. Administration of blood products. Learning Outcomes: 1-4, 6.
  • Module 4: Respiratory Deterioration. Respiratory trauma, pneumothorax, flail chest. Advanced oxygen therapy and management of chest drains. Respiratory failure. Airway management. Introduction to mechanical ventilation. Learning Outcomes: 1-4, 6.
  • Module 5: Neurological Deterioration. Comprehensive assessment of the neurological system. Stroke, pathophysiology, clinical manifestations, immediate management. Traumatic brain injury and raised intracranial pressure- pathophysiology, clinical manifestations and management. Epilepsy, immediate treatment. Delirium. Brain Death. Learning Outcomes: 1-4, 6.
  • Module 6: Renal and Diabetic Emergencies. Renal Assessment. Pathophysiology of Acute Kidney Injury (AKI) and complications. Collaborative management of AKI and complications, pharmacological, introduction to continuous renal replacement therapy, nursing considerations. DKA, assessment and management. Learning Outcomes: 1-4, 6.
  • Module 7: Severe Burn Injury & Sepsis. Severe burn injury, pathophysiology and complications. Assessment of burn injury, burn size and depth. Immediate management of burn injury, first aid, criteria for referral, fluid resuscitation, airway management, initial wound management. Sepsis, pathophysiology and complications. Immediate management of sepsis, fluid resuscitation, vasoactive medications. Learning Outcomes: 1-4, 6.
  • Module 8: Mental Health Deterioration. Self-harm and suicidal ideation. Acute intoxication, overdose, withdrawal. Aggressive behaviour and threats of violence. Acute psychosis. Acute anxiety. Learning Outcomes: 1-4, 6.

Residential School

This subject contains a compulsory 4 day residential school. This will include tutorials and assessment of students through Clinical Skills Labs/Simulation. Development of physical skills through simulation is essential in the development of nursing skills related to managing a deteriorating patient.

Work Place Learning

This subject contains a Compulsory Workplace Learning component of 20 days duration. Students will attend a workplace learning component focussing on the acute setting. This subject contains a Compulsory Workplace Learning component of 20 days duration. Students will attend a workplace learning component focussing on the acute setting.

Specialised Resources

Distance Education students will be required to travel to a residential school.


The information contained in the 2016 CSU Handbook was accurate at the date of publication: 06 September 2016. The University reserves the right to vary the information at any time without notice.