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2024 TNCC test prepa, TNCC Notes for Written Exam, TNCC Notes for Written Exam, TNCC Prep, TNCC EXAM, TNCC 8th Edition Gra
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a. obtain labs, type and cross b. infuse warm isotonic fluids c. consider balanced resuscitation d. use rapid infusion device - ANSC Interventions: apply splint and elevate above the level of the heart - ANSa 37 y/o F has a deformity of the L wrist after a fall. She is reluctant to move her hand due to pain. Which of the following is the most appropriate intervention? ask pt to pen his or her mouth - ANSWhile assessing airway the patient is alert and responds to verbal stimuli you should.. bardycardia and absent motor function below the level of injury - ANSA pt with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and which other clinical signs? Before the arrival of the pt - ANSWhen should PPE be placed: Biomechanics - ANSIs the general study of forces and their effects. bowel - ANSWhich of the following injuries is LEAST likely to be promptly identified? brachial pulse - ANSUnder age of 1 where do you find a pulse Breathing: To assess breathing expose the chest:
Ensure two large bore IVS are placed. Prepare for thoracentesis and chest tube insertion. If open thoracotomy is done chest tube is deferred. - ANSHemothorax: Circulation and Control of Hemorrhage Inspect first for any uncontrolled bleeding Skin color palpate for central pulses - carotid and femoral - rate, rhythm, and strength Skin temp: cool, diaphoretic, or warm and dry - ANSC Colorimetric CO2 detectors provide info about the presence or absence of CO2. A chemically treated indicator strip changes color revealing the presence or absence of exhaled CO2 - ANSQualitative compensated - ANSA trauma pt is restless and repeatedly asking "where am i?" VS upon arrival: BP 110/60, HR96, RR 24. Her skin is cool and dry. Current VS are BP 104/84, HR 108, RR 28. The pt is demonstrating s/sx of which stage of shock? Complete - ANSEMS brings a pt from MVC. VS: BP 90/49, HR 48, RR 12, temp 97.2F (36.2 C). The pt exhibits urinary incontinence and priapism. These assessment findings are most consistent with which of the following types of spinal cord injury? D displaced tube O obstructed or kinked P pneumothorax E equipment failure , such as becoming detached from the equipment or loss of capnopgrahy - ANSDOPE Define central or transtentorial herniation. - ANSA downward movement of the cerebral hemispheres with herniation of the diencephalon and midbrain through the elongated gap of the tentorium. Define central or transtentorial herniation. - ANSA downward movement of the cerebral hemispheres with herniation of the diencephalon and midbrain through the elongated gap of the tentorium. Define Cushing's triad - ANSBradycardia, progressive hypertension (widening pulse pressure), and decreased respiratory effort Define Hemothorax. - ANSAccumulation of blood in the pleural space. Define Hemothorax. - ANSAccumulation of blood in the pleural space. Define Minor Head Trauma. - ANSGCS 13- Define Minor Head Trauma. - ANSGCS 13- Define Moderate Head Trauma - ANSPostresuscitative state with GCS 9-13. Define Moderate Head Trauma - ANSPostresuscitative state with GCS 9-13. Define Pneumothorax. - ANSResults when an injury to lung leads to accumulation of air in pleural space w/subsequent loss of negative intrapleural pressure. Partial or total collapse of lung may ensue.
defusings - ANSAll of these are considered a critical communication point in trauma care EXCEPT which of the following? Describe common patterns and severity of injuries in the bariatric trauma patient. - ANS Describe effects of common medications in relation to the older adult trauma patient. - ANS Describe one fat embolism syndrome is most likely to occur in its characteristics - ANSWith longform fractures. Tachycardia, Thrombocytopenia, and petechiae rash. Describe specific injuries associated with interpersonal violence and abuse. - ANS Describe steps to maintain the forensic chain of custody. - ANS Describe techniques to improve the intubation process for the bariatric trauma patient. - ANS Describe the 3 types of external forces of energy transfer in the context of trauma. - ANSDeceleration: Force from a sudden stop in the body's motion Acceleration: Force from a sudden onset in the body's motion Compression: Force from being crushed between objects Describe the 3 types of Internal forces of energy transfer in the context of trauma. - ANSCompression: The ability of the tissue to resist crush injury or force Tension: The ability to resist being pulled apart when stretched Shear: The ability to resist a force applied parallel to the tissue Describe the activities and associated factors related to low-energy trauma in the older adult. - ANS 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. Describe the fluid resuscitation of an older adult patient related to fluid overload, when to administer red blood cells, and the use of anticoagulant medication. - ANS 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. Describe the pathophysiologic changes of the systems of the bariatric patient and the effects on trauma resuscitation efforts. - ANS Describe the three impacts in the motor vehicle impact sequence - ANS1. First Impact: Vehicle hits another object
Epi stimulates receptors in heart to increase force of cardiac contraction (positive inotropy) and increase HR (positive chronotropy) to improve cardiac output, BP and tissue perfusion. Shock stimulates hypothalamus to release corticotropin-releasing hormone that stimulates pituitary to release ACTH that stimulates adrenal gland to release cortisol. Effect of cortisol release is elevation in blood sugar and increased insulin resistance and gluconeogenesis, hepatic process to produce more sugar. Cortisol also causes renal retention of water and sodium, a compensatory mechanism to conserve body water. Explain Cardiogenic Shock. - ANSSyndrome that results from ineffective perfusion caused by ineffective perfusion caused by inadequate contractility of cardiac muscle. Some causes:
As shock progresses, glycogenolysis is activated by epi to break down glycogen into glucose. In a compensatory response to shock, hepatic vessels constrict to redirect blood flow to other vital areas. Explain Hepatic Response. - ANSLiver can store excess glucose as glycogen. As shock progresses, glycogenolysis is activated by epi to break down glycogen into glucose. In a compensatory response to shock, hepatic vessels constrict to redirect blood flow to other vital areas. Explain Hypovolemic Shock. - ANSMost common to affect a trauma pt cause by hypovolemia.. Hypovolemia, a decrease in amount of circulating blood volume, may result from significant loss of whole blood because of hemorrhage or from loss of semipermeable integrity of cellular membrane leading to leakage of plasma and protein from intravascular space to the interstitial space (as in a burn). Some causes:
N - naso or oro gastric tubes O Oxygen and ETC02 monitors P - pain assessment and management - ANSG globe rupture - ANSA 35 y/o M presents with facial trauma after being struck in the face with a baseball. A teardrop-shaped left pupil is noted on exam. What type of injury is suspected? H,I - ANSSecondary Survery hemoglobin does not readily release O2 for use by the tissues - ANSWhat is the effect of hypothermia on the oxyhemoglobin dissociation curve? History and Head to toe MIST - prehospital report MOI Injuries sustained S s/s in the field T treatment in the field if patients family present get a better hx on them - ANSH How do you assess Mnemonic "D"? - ANSDISABILITY A = Alert V = Verbal P = Pain U = Unresponsive
How would you assess a pt with a cranial injury? - ANS(Initial assessment) INSPECTION: