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A comprehensive overview of the trauma nursing core course (tncc), covering a wide range of topics related to trauma assessment and management. It delves into the assessment findings, interventions, and key concepts for various types of traumatic injuries, including mild to severe traumatic brain injury, diffuse axonal injury, spinal cord injuries, pancreatic injuries, hyphema, neurogenic shock, and more. The document also discusses the biomechanics of trauma, imaging studies, and critical care management principles. This extensive resource would be highly valuable for healthcare professionals, particularly nurses, who specialize in trauma care, as it offers detailed insights and evidence-based practices to enhance their knowledge and skills in this crucial field.
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B. It allows you to open the airway with little or no movement of the head and cervical spine. C. Other techniques and interventions don't work as well. D. It can relieve a variety of anatomic airway obstructions in patients who are breathing spontaneously. - ansQuestion 1: B Manual maneuvers like the trauma jaw thrust or chin lift are always the first airway maneuver you should make when treating a trauma patient. In patients with suspected head, neck, orfacial trauma, the cervical spine is maintained in a neutral in-line position.The trauma jaw thrust maneuver allows you to open the airway with little or no movement of the head and cervical spine.
A. "Oh yes, that's a great idea!" B. "Yes, but we have to immobilize him first" C. "Take a blood pressure first to see if he needs an IV." D. "No, keep the pressure and let's get out of here!" - ansQuestion 2: D This patient is likely in decompensated shock with internal bleeding, so rapid transport is the next priority. You should maintain pressure on the wound, because having massive external bleeding start up again is the last thing you want in this situation.
A. Preferences B. Phases C. Principles D. Transport - ansQuestion 3: C The science of medicine provides the principles of medical care. Simply stated, principles define the duties required of the prehospital care practitioner in optimizing patient survival and outcome.
C. Obtain the patient's medical records and resuscitate to his normal blood pressure reading. D. Carefully administer IV fluids to raise the patient's systolic blood pressure to between 80 and 90 mm Hg. - ansQuestion 3: D Abdominal trauma represents one of the key situations in which a balanced resuscitation is indicated. Aggressive administration of IV fluid may elevate the patient's blood pressure to levels that will disrupt any clot that has formed and result in recurrence of bleeding that had ceased because of blood clotting and hypotension. Prehospital care practitioners must achieve a delicate balance: maintain a blood pressure that provides perfusion to vital organs without restoring blood pressure to elevated or even normal ranges, which may reinitiate bleeding sites in the abdomen or pelvis. In the absence of TBI, the target systolic blood pressure is 80 to 90 mm Hg (mean arterial pressure of 60 to 65 mmHg).
Early mechanical ventilation via bag mask device or advanced airway measures should be considered in geriatric trauma patients because of their greatly limited physiologic reserve.
In a compensated state, CSF and blood volume decrease, while heart rate and blood pressure are still within normal range. _________ therapy is now suggested for fluid resuscitation to replace patient losses, including administering PRBCs, plasma, and platelets. - ansCOMPONENT THERAPY ch. 5, p. 45 __________, which can occur in resuscitation, is a common IATROGENIC cause of INCREASED intrathoracic pressure resulting in COMPRESSION of the heart and DECREASED cardiac output. - ansHYPERVENTILATION ch. 7, p. 74 55% of spinal injuries occur to which part of spine? - anscervical ch. 13, p. 179 A rapid, thready pulse may indicate (a. _______), and an irregular pulse may warn of potential (b. _______). - ansa. HYPOVOLEMIA b. CARDIAC DYSFUNCTION ch. 5, p. 45 ABGs provide values of oxygen, CO2 and base excess, which are... - ansReflective endpoint measurements of the effectiveness of cellular perfusion, adequacy of ventilation, and the success of the resuscitation. An abnormal base deficit may indicate poor perfusion and tissue hypoxia, which results in the generation of hydrogen ions and metabolic acidosis. ch. 5, p. 46 Activation of the SYMPATHETIC NERVOUS SYSTEM causes the ADRENAL glands to release TWO catecholamines - EPINEPHRINE and NOREPINEPHRINE. These cause... - ans- HIGH levels of EPINEPHRINE cause smooth muscle relaxation in the airways and causes arteriole smooth muscle contractility (potentiating inotrophic effect). EPI also INCREASES heart rate (positive chronotrophic effect), peripheral vasocontriction, and glycogenolysis (breakdown of glycogen stores in liver into glucose for cellular use)
As ICP rises, CPP ________, resulting in cerebral ischemia, hypoxemia, and lethal secondary insult. - ansDECREASES Ch. 9, p. 109 As shock progresses, primary goal of the body is to maintain perfusion to vital organs. Sympathetic stimulation has little effect on the cerebral and coronary vessels since they are capable of autoregulation. Cerebral autoregulation maintains a constant... - anscerebral vascular blood flow as long as the MAP is maintained between 50-150... when autoregulation in the brain fails, perfusion becomes dependent solely on pressure. ch. 7, p. 78 Assess pupils for... - ansEquality, shape, and reactivity (PERRL) ch. 5, p. 45 Assessment findings for MILD, MODERATE, and SEVERE TRAUMATIC BRAIN INJURY INCLUDE: - ansMILD
Beck's Triad- HYPOTENSION, MUFFLED HEART SOUNDS, DISTENDED NECK VEINS
Define biomechanics - ansThe general study of forces and their effects p. 25 Define kinematics - ansThe study of energy transfer as it applies to identifying actual or intentional injuries p. 25 Define mechanism of injury (MOI) - ansHow external energy forces in the environment are transferred to the body p. 25 Define trauma - ans- Trauma is injury to living tissue caused by extrinsic agent