COMPLETE EXAM FOR TNCC

COMPLETE EXAM FOR TNCC What is the best measure of the adequacy of cellular perfusion and helps predict the outcome of resuscitation? - CORRECT ANSWER-Base deficit used in conjunction with serum lactate Will hypocapnia cause vasoconstriction or vasodilation, especially in the cerebral vasculature? - CORRECT ANSWER-Vasoconstriction What results from tissue hypo perfusion and oxygen deficit? - CORRECT ANSWERMetabolic acidosis What type of shock results in generalized vasodilation? - CORRECT ANSWERNeurogenic shock Spinal cord injuries at C3-C5 causes loss of what nerves function, resulting in what? - CORRECT ANSWER-Phrenic nerve; paralyzed diaphragm and inability to breath Extremity elevation AT the level of the heart is beneficial for what type of injury? - CORRECT ANSWER-Compartment Syndrome What is a high risk of frostbite? - CORRECT ANSWER-Thrombus formation What two medications can be administered to maintain perfusion after a frostbite injury along with rewarming? - CORRECT ANSWER-Tissue plasminogen activator or non steroidal anti-inflammatory medication (NSAIDS) An rise in diastolic blood pressures is a sign of increasing what? - CORRECT ANSWER-Peripheral resistance What position will benefit the airway and work of breathing for the bariatric patient? - CORRECT ANSWER-Reverse Trendelenburg Which phase of a blast results from flying debris, projectiles, and bomb fragments causing lacerations or penetrating injuries? - CORRECT ANSWER-Secondary Phase What phase of a blast results from any explosion-related illness or injury including hyperglycemia, hypertension, angina, asthma, COPD, or sepsis? - CORRECT ANSWER-Quaternary Phase What phase of a blast results from individuals being thrown by the blast and impacting walls, ground, or any hard object? - CORRECT ANSWER-Tertiary Phase What phase of a blast results from impact of the over and under pressurization wave with body surfaces. Injuries include blast lung, tympanic membrane rupture, abdominal hemorrhage, globe rupture, and mild traumatic brain injury? - CORRECT ANSWERPrimary Phase Signs of what include muscle pain or weakness, dark red or brown urine, general weakness or malaise, and elevated creatinine kinase levels? - CORRECT ANSWERRhabdomyolosis Signs of what include anxiety, pleuritic chest pain, dyspnea, hypoxemia, hemoptysis, cough, orthopnea, adventitious lung sounds, decreased lung sounds, jugular vein distention, or hypotension? - CORRECT ANSWER-Pulmonary Embolus Signs of what include headache, nausea and vomiting, amnesia, behavioral changes, altered level of consciousness? - CORRECT ANSWER-Increased intracranial pressure Signs of what include asymmetric pupillary reactivity, unilateral dilation, widening pulse pressure, abnormal motor posturing, bradycardia, and decreased respiratory effort? - CORRECT ANSWER-Late signs of increased ICP with Herniation Syndrome What is caused by the tear of the bridging veins or middle meningeal artery? - CORRECT ANSWER-Subdural and Epidural Hematoma Affect concentration, memory, sleep, mode, and libido. Causes headaches, dizziness and nausea. - CORRECT ANSWER-Postconcussive Syndrome/ Mild Traumatic Brain Injury Signs and symptoms similar to early signs of increased ICP but do not worsen. - CORRECT ANSWER-Postconcussive Syndrome/ Mild Traumatic Brain Injury Cerebral Perfusion Pressure = ______-______ - CORRECT ANSWER-MAP - ICP What is the range for CO2 to maximize perfusion? - CORRECT ANSWER-35-45 Does hypoventilation cause dilation or constriction? Increase or decrease ICP? - CORRECT ANSWER-Dilation and increase in ICP due to high CO2 Hyperventilation cause dilation or constriction? - CORRECT ANSWER-Constriction d/t low CO2 Pupils with pressure on cranial nerve - CORRECT ANSWER-Fixed and dilated Pupils with opiates vs stimulants - CORRECT ANSWER-small; large Pupils with anticholinergics such as atropine, ipratropium, and scopolamine - CORRECT ANSWER-large Sluggish reaction of pupils is an early sign of what? - CORRECT ANSWER-Increasing ICP Glasgow Coma Score with Mild, Moderate, and Severe TBI - CORRECT ANSWER-Mild = 13-15 Moderate = 9-12 Severe = 3-8 Goal value for ICP - CORRECT ANSWER-<15 Goal value for Cerebral Perfusion Pressure (CPP) - CORRECT ANSWER->60 Le Fort Fracture - CORRECT ANSWER-Fracture of the maxilla What decrease ICP by decreasing cellular edema? - CORRECT ANSWER-Osmotic diuretics (such as 3% saline and mannitol) Becks Triad is a sign of what? And includes what three symptoms? - CORRECT ANSWER-Cardiac Tamponade; 1. Hypotension 2. JVD 3. Muffled heart sounds What is pulsus paradoxus? And what is it a sign of? - CORRECT ANSWER-Drop in blood pressure with inspiration, sign of cardiac tamponade Tachycarida, weak pulses, hypotension, cool periphery, delayed cap refill, anxiety and agitation are signs of what type of shock? Seen with what? - CORRECT ANSWERObstructive Shock; Cardiac Tamponade Persistent blood loss following chest tube insertion is a sign of what? - CORRECT ANSWER-Hemothorax Ipsilateral diminished breath sounds and chest movement is a sign of what? - CORRECT ANSWER-Hemothorax Tearing chest/back pain, unequal blood pressure and pulses are a sign of what? Caused by a high mechanism of injury. - CORRECT ANSWER-Thoracic Aortic Disruption Dysrhythmia, ischemic changes, and persistent unexplained tachycardia are signs of what? - CORRECT ANSWER-Myocardial contusion from Blunt Cardiac Injury