TCAR UPDATED TEST PAPER QUESTIONS AND
ANSWERS SET A+
✔✔complication of postrenal failure - ✔✔includes bladder rupture
✔✔treatment of postrenal failure - ✔✔it is an outflow "plumbing" problem
so fluids okay, nephron is functioning
*so you need to fix the plumbing w/stents or a cathetr
✔✔what type of renal failure needs stents or a catheter - ✔✔postrenal failure = fix the
plumbing with stents or a catheter
✔✔giving IVF bolus to postrenal fialure - ✔✔bolus w/IVF for low urine but can't get it
out. if the urine wall leaks, the urien will lieak into retroperitoneal or peritoneal cavity
✔✔Q to ask in compartment syndrome - ✔✔pain out of proportion to the injury
✔✔where is pressure in compartment syndrome - ✔✔limb-threatening high pressure in
a fascial compartment that threatens tissue perfusion - muscle cell necrosis
*fascial compartment (fascia isn't elastic)
*edema or hemorrhage when compartment pressure is over venous pressure
✔✔how do burns cause compartment syndrome - ✔✔can also be far too tight or skin in
circumferential burns
✔✔late s/s of compartment syndrome - ✔✔pulseness & pallor
✔✔benchmark for causing pulselessness in compartment syndrome - ✔✔pressure
needs to be > arterial pressure in compartment syndrome to cause pulselessness
✔✔crude way to measure pulselessness as a s/s of compartment syndrome - ✔✔pulse
ox can be a crude perfusion monitor. before & after affected limb
-especially if cast doesn't let you measure the pulse but you do have exposed toes
,-we aren't interested in SpO2 b/c should be similar. we are interested in the waveform
good limb = good pleth
affected limb = dampended pleth
✔✔crude way to evalute for compartment syndrome if casted but toes or fingers are
exposed - ✔✔pulse ox
not interested in SpO2; we want to see the pleth
good limb = good pleth
affected limb = dampended pleth
✔✔normal compartmetn pressure - ✔✔0 - 5 mm hg
✔✔compartment pressure that indicates ischemia - ✔✔>20 -30 mm hg
if they suspect compartmetn syndrome, the person might go straight to OR rather than
measure pressure
✔✔what part of the tissue oxygenation cascade does muscle compartment syndrome
affect - ✔✔tissue oxygen utilization problem b/c limited blood flow
tissue hypoxia to necrosis
✔✔what happens when the OR does the fasciotomy - ✔✔the compartment opens super
wide on its own. wound margins can spread 1ft apart if very high pressure
✔✔orthostatic hypotension - ✔✔
✔✔intractable pain - ✔✔
✔✔invarably - ✔✔
✔✔Dakin's solution - ✔✔
✔✔hydrogen peroxide - ✔✔
✔✔concept of Ankle-Brachial Index - ✔✔based on teh concept that when supine, SOB
in arm and leg should be the same
✔✔when does an Ankle-Brachial Index indicate a perfusion problem - ✔✔do when teh
patient is laying down. >10% means a perfusion problem
✔✔objective RN data that can indicate potential compartment syndrome - ✔✔poor pleth
on SpO2 of injuried extremity
ABI
intractable pain
**objective date to support compartment syndrome
, ✔✔tips for what you should use to clean a wound - ✔✔"if you wouldn't put it in your eye,
don't put it in a wound"
-tap water, commercial wound cleansers
✔✔indication for ankle brachial indedx - ✔✔
✔✔how does a negative pressure wound vac worl - ✔✔
✔✔Exparel - ✔✔long acting (>72hr) locla anesthestic added to the site during surgery
✔✔72hr long local anesthetic added to the surgical site - ✔✔Exparel
✔✔bone infection - ✔✔osteomyelitis
✔✔open bone fracture - ✔✔compound
✔✔interventions for open bone fracture - ✔✔tetanus
ABX within 1 hr
✔✔VTE - ✔✔venous thromboembolism
✔✔indication for inferior vena cava implant - ✔✔if at an increased risk for clot
-severe TBI, SCI w/paralysis, comoplex pelvis fracture, multiple long bone fractures
-doesn't prevent clot formation but doe prevent PE
-some can be removed later
✔✔what does diffuse axonal injury represent - ✔✔suggests deliberate trauma -
probably not an accident
✔✔pathology of diffuse axonal injury - ✔✔axons are disrupted at the time of injury or in
the following hours "disconnecting from the brain"
**immediate LOC**
* effect is similiar to yanking out a computer cord. it immediately turns off and doesn't
turn back on
* torn axons dont' regenerate and don't come back
*no putting the brian back together and it cain't recover
*cause of vegetative state in TBI
✔✔cause of vegetative state in TBI - ✔✔diffuse axonal injury
immediate LOC like you yanked out the computer cord. it immediately turns off and
does not turn back on
ANSWERS SET A+
✔✔complication of postrenal failure - ✔✔includes bladder rupture
✔✔treatment of postrenal failure - ✔✔it is an outflow "plumbing" problem
so fluids okay, nephron is functioning
*so you need to fix the plumbing w/stents or a cathetr
✔✔what type of renal failure needs stents or a catheter - ✔✔postrenal failure = fix the
plumbing with stents or a catheter
✔✔giving IVF bolus to postrenal fialure - ✔✔bolus w/IVF for low urine but can't get it
out. if the urine wall leaks, the urien will lieak into retroperitoneal or peritoneal cavity
✔✔Q to ask in compartment syndrome - ✔✔pain out of proportion to the injury
✔✔where is pressure in compartment syndrome - ✔✔limb-threatening high pressure in
a fascial compartment that threatens tissue perfusion - muscle cell necrosis
*fascial compartment (fascia isn't elastic)
*edema or hemorrhage when compartment pressure is over venous pressure
✔✔how do burns cause compartment syndrome - ✔✔can also be far too tight or skin in
circumferential burns
✔✔late s/s of compartment syndrome - ✔✔pulseness & pallor
✔✔benchmark for causing pulselessness in compartment syndrome - ✔✔pressure
needs to be > arterial pressure in compartment syndrome to cause pulselessness
✔✔crude way to measure pulselessness as a s/s of compartment syndrome - ✔✔pulse
ox can be a crude perfusion monitor. before & after affected limb
-especially if cast doesn't let you measure the pulse but you do have exposed toes
,-we aren't interested in SpO2 b/c should be similar. we are interested in the waveform
good limb = good pleth
affected limb = dampended pleth
✔✔crude way to evalute for compartment syndrome if casted but toes or fingers are
exposed - ✔✔pulse ox
not interested in SpO2; we want to see the pleth
good limb = good pleth
affected limb = dampended pleth
✔✔normal compartmetn pressure - ✔✔0 - 5 mm hg
✔✔compartment pressure that indicates ischemia - ✔✔>20 -30 mm hg
if they suspect compartmetn syndrome, the person might go straight to OR rather than
measure pressure
✔✔what part of the tissue oxygenation cascade does muscle compartment syndrome
affect - ✔✔tissue oxygen utilization problem b/c limited blood flow
tissue hypoxia to necrosis
✔✔what happens when the OR does the fasciotomy - ✔✔the compartment opens super
wide on its own. wound margins can spread 1ft apart if very high pressure
✔✔orthostatic hypotension - ✔✔
✔✔intractable pain - ✔✔
✔✔invarably - ✔✔
✔✔Dakin's solution - ✔✔
✔✔hydrogen peroxide - ✔✔
✔✔concept of Ankle-Brachial Index - ✔✔based on teh concept that when supine, SOB
in arm and leg should be the same
✔✔when does an Ankle-Brachial Index indicate a perfusion problem - ✔✔do when teh
patient is laying down. >10% means a perfusion problem
✔✔objective RN data that can indicate potential compartment syndrome - ✔✔poor pleth
on SpO2 of injuried extremity
ABI
intractable pain
**objective date to support compartment syndrome
, ✔✔tips for what you should use to clean a wound - ✔✔"if you wouldn't put it in your eye,
don't put it in a wound"
-tap water, commercial wound cleansers
✔✔indication for ankle brachial indedx - ✔✔
✔✔how does a negative pressure wound vac worl - ✔✔
✔✔Exparel - ✔✔long acting (>72hr) locla anesthestic added to the site during surgery
✔✔72hr long local anesthetic added to the surgical site - ✔✔Exparel
✔✔bone infection - ✔✔osteomyelitis
✔✔open bone fracture - ✔✔compound
✔✔interventions for open bone fracture - ✔✔tetanus
ABX within 1 hr
✔✔VTE - ✔✔venous thromboembolism
✔✔indication for inferior vena cava implant - ✔✔if at an increased risk for clot
-severe TBI, SCI w/paralysis, comoplex pelvis fracture, multiple long bone fractures
-doesn't prevent clot formation but doe prevent PE
-some can be removed later
✔✔what does diffuse axonal injury represent - ✔✔suggests deliberate trauma -
probably not an accident
✔✔pathology of diffuse axonal injury - ✔✔axons are disrupted at the time of injury or in
the following hours "disconnecting from the brain"
**immediate LOC**
* effect is similiar to yanking out a computer cord. it immediately turns off and doesn't
turn back on
* torn axons dont' regenerate and don't come back
*no putting the brian back together and it cain't recover
*cause of vegetative state in TBI
✔✔cause of vegetative state in TBI - ✔✔diffuse axonal injury
immediate LOC like you yanked out the computer cord. it immediately turns off and
does not turn back on
