TNNCS
According to newtons law which of these two force is greater: size or force? -
ansNeither. For each force there is an equal and opposite reaction.
Define Cushing's triad - ansBradycardia, progressive hypertension (widening pulse
pressure), and decreased respiratory effort
Define the characteristics of neurogenic shock - ansDistributive 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 - ansTransient 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 -
ansWith longform fractures. Tachycardia, Thrombocytopenia, and petechiae rash.
Describe the characteristics of cardiogenic shock - ansCardiogenic 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. - ansDistributive 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 - ansHypovolemia 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 - ansObstructive 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.
, TNNCS
Describe the four types of spinal cord injury - ansCentral 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 - ansMeasure 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. - ansThe 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 - ansPlace 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 - ansPlacement 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. - ansFalse. 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? - ansThe 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 - ansheadache, vomiting,
behavioral changes that begin with restlessness and may progress to confusion,
drowsiness, or impaired judgment
What are the four types of shock? - ansHypovolemic, Cardiogenic, Obstructive, &
Distributive
What are the four types of trauma related injuries? - ansBlunt, penetrating, thermal, or
blast.
What are the greatest risks for transport? - ansLoss 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
