SSM TCAR Exam Questions
Reviewed And Revised With
Correct Answers
<Updated!!>
1) What is permissive hypotension? - ANSWER Keeping SBP
80-90
>Aggressvie fluid resuscitation disrupts new clots, dilutes blood,
promotes coagulopathies, and aggravates endothelial leakage
NOT APPRORIATE FOR TBI
2) What are the 2 types of bleeding in a trauma patient? -
ANSWER Mechanical & Coagulopathic
Mechanical requires surgery to fix hole
Coagulopathic- later in ICU,
TIC-trauma induced coagulopathy
3) What are the suggested lab studies for someone in Trauma
induced cogulaopthy? - ANSWER Thromboelastography
(TEG)
,Rotational Thromobelastometry (ROTEM)
both testes provide real-time visual representation of clot
formation and clot lysis
4) Why is autotransfused blood better than banked blood? -
ANSWER It is fresher, warmer, releases O2 better, and costs
less
5) Banked blood causes what electrolyte abnormalities? -
ANSWER Elevated K-released from old or damaged blood
cells
Decreased Ca-citrate in blood binds with calcium so the ionized
Ca level is low
6) What nursing assessment would make you suspet low
calcium? - ANSWER Carpal spasm (Trousseau Sign) while
checking BP
7) What does SBP estimate for you? - ANSWER SBP= CO--
they go up & down together
It is an indication of volume (preload) and contractility
,8) What does DBP estimate for you? - ANSWER DBP is a
measure of vascular resistance-afterload
DBP reflects vasoconstriction due to sympathetic compensation
9) What is pulse pressure? - ANSWER The relationship
between CO & the body's compensatory vasoconstrictive
response
Pulse Pressure= SBP-DBP
Minimal acceptable number is 30-40 or
25% of SBP
10) What is MAP, and how is it calculated? - ANSWER It is
the organ & tissue perfusion pressure, the pressure the organs
actually receive.
Normal is >65.
SBP+DBPx2/3
11) What is shock index? - ANSWER The relationship
between SBP & heart rate required to maintain it (tachycardic
compensation). HR divided by SBP,
normal is 0.5-0.7
, 12) What are markers of tissue ischemia? - ANSWER
Lactate, pH, base deficit
13) What are markers of hemostasis? - ANSWER Clotting
factors and H&H
14) What do patients need who drop their BP after opiod
administration? - ANSWER They need volume
15) What system is at greatest risk following initial
stabilization? - ANSWER Pulmonary
16) What are hypotonic fluids? - ANSWER Fluids that
distribute throughout the body. Beneficial for dehydrated
patients who need maintenance fluids.
17) What are isotonic fluids? - ANSWER Fluids that fill the
vascular space, for those that need circulating volume
replacement. 3/4 of this fluid quickly moves to interstitial
spaces
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