TNCC 8th Edition
According to newtons law which of these two force is greater: size or force? - correct
answer-Neither. For each force there is an equal and opposite reaction.
Define Cushing's triad - correct answer-Bradycardia, progressive hypertension (widening
pulse pressure), and decreased respiratory effort
Define the characteristics of neurogenic shock - correct answer-Distributive shock with a T6
or higher injury results and vasodilation, bradycardia, flushed warm dry skin. Risk for
temperature instability. Nursing interventions include maintaining warmth and spinal
stabilization.
Define the characteristics of spinal shock - correct answer-Transient loss of function can
include loss of reflexes and muscle tone below the level of industry with possible vascular
response.
Describe one fat embolism syndrome is most likely to occur in its characteristics - correct
answer-With longform fractures. Tachycardia, Thrombocytopenia, and petechiae rash.
Describe the characteristics of cardiogenic shock - correct answer-Cardiogenic shock results
from pump failure in the presence of adequate intravascular volume. Lack of cardiac output
and an organ perfusion occurs secondary to a decrease in myocardial contractility and or
valvular insufficiency. This can happen with blunt cardiac trauma or an MI. Symptoms can
include low blood pressure increase heart rate and respiratory rate chest pain shortness of
breath dysrhythmias increase troponin and pale cool moist skin
Describe the characteristics of distributive shock. - correct answer-Distributive shock occurs
as a result of Mel distribution of an adequate circulating blood volume with the loss of
vascular tone or increased permeability. This can occur with spinal cord injuries, sepsis, or
anaphylaxis. Symptoms include low blood pressure heart rate respiratory rate preload and
afterload, spinal tenderness, difficulty breathing, warm pink and dry skin with a cool core
temperature.
Describe the characteristics of hypovolemic shock - correct answer-Hypovolemia is caused
by a decrease in the amount of circulating volume usually caused by massive bleeding, but
also can be from vomiting and diarrhea. Characteristics include low blood pressure and
preload, increase heart rate respiratory rate and afterload, with contractility unchanged.
Signs include obvious bleeding, weak peripheral pulses, pale cool and moist skin, distended
abdomen, pelvic fracture, or bruise swollen and deformed extremities especially long bones.
Describe the characteristics of obstructive shock - correct answer-Obstructive shock is it
mechanical problem that results from hypoperfusion of the tissue due to an obstruction in
either the vasculature or the heart resulting in decreased cardiac output. Some causes
include a tension pneumothorax, cardiac tamponade, or venous air embolism on the right
, side of the heart during systole in the pulmonary artery.Signs include anxiety, muffled heart
sounds, JVD, hypertension, chest pain, difficulty breathing, or pulses paradoxes.
Describe the four types of spinal cord injury - correct answer-Central cord injury results in
greater weakness distally, anterior injury includes motor loss or weakness below the cord
level of injury yet sensory is intact, Brown-Sequard (hemicord) is weak on one side with
sensory deficit on opposite side, posterior cord syndrome although rare is when the patient
is unable to use sense vibration in proprioception
Describe the measurement of an NPA - correct answer-Measure from the tip of the patient's
nose to the tip of the patients earlobe.
Differentiate between the three impacts of motor vehicle impact sequence. - correct
answer-The first impact occurs when the vehicle collided with another object. The second
impact occurs after the initial impact when the occupant continues to move in the original
direction of travel until they collide with the interior of the vehicle or meet resistance. The
third impact occurs when internal structures collide within the body cavity.
Measurement of an OPA - correct answer-Place the proximal end or flange of the airway
adjunct at the corner of the mouth to the tip of the mandibular angle.
Name the three ways to confirm ETT placement - correct answer-Placement of a CO2
monitoring device, Assessing for equal chest rise and fall, and listening at the epigastrium
and four lung fields for equal breath sounds.
True or false: NPAs and OPAs are definitive airways. - correct answer-False. When placing
one of these? One should consider the potential need for a definitive airway.
What are contributing factors to injuries related to blunt traumas? - correct answer-The point
of impact on the patient's body, the type of surface that is hit, the tissues ability to resist
(bone versus soft tissue, air-filled versus solid organs), and the trajectory of force.
What are the early signs of increased Intracranial pressure - correct answer-headache,
vomiting, behavioral changes that begin with restlessness and may progress to confusion,
drowsiness, or impaired judgment
What are the four types of shock? - correct answer-Hypovolemic, Cardiogenic, Obstructive,
& Distributive
What are the four types of trauma related injuries? - correct answer-Blunt, penetrating,
thermal, or blast.
What are the greatest risks for transport? - correct answer-Loss of airway patency, displaced
obstructive tubes lines or catheters, dislodge splinting devices, need to replace or reinforce
dressings, deterioration in patient status change in vital signs or level of consciousness,
injury to the patient and/or team members
