TNCC Notes for Written Exam
What is kinematics?
: Answer--A branch of mechanics (energy transfer)
that refers to motion and does not consider the
concepts of force and mass of the object or body.
What is Newton's First Law?
: Answer--A body at rest will remain at rest. A body
in motion will remain in motion until acted on by
an outside force.
What is the Law of Conservation of Energy?
: Answer--Energy can neither be created nor
destroyed. It only changed from one form to
another.
What is Newton's Second Law?
: Answer--Force equals mass multiplied by
acceleration of deceleration.
What is kinetic energy (KE)?
: Answer--KE equals 1/2 the mass (M) multiplied by
the velocity squared.
What is the Mnemonic for the Initial Assessment?
:Answer--A = Airway with simultaneous cervical
spine protection
B = Breathing
,C = Circulation
D = Disability (neurologic status)
E = Expose/Environmental controls (remove clothing and
keep the patient warm)
What is the Mnemonic for the Secondary Assessment?
: Answer--F = Full set of VS/Focused adjuncts (includes
cardiac monitor, urinary catheter, and gastric
tube)/Family presence
G = Give comfort measures (verbal reassurance, touch,
and pharmacologic and nonpharmacologic management
of pain).
H = Hx and Head-to-toe assessment
I = Inspect posterior surfaces
Where do you listen to auscultate breath sounds?
: Answer--Auscultate the lungs bilaterally at the second
intercostal space midclavicular line and at the fifth
intercostal space at the anterior axillary line.
What are the late signs of breathing compromise?
: Answer--- Tracheal deviation
- JVD
What are signs of ineffective breathing?
: Answer--- AMS
- Cyanosis, especially around the mouth
,- Asymmetric expansion of chest wall
- Paradoxical movement of the chest wall during
inspiration and expiration
- Use of accessory muscles or abdominal muscles or both
or diaphragmatic breathing
- Sucking chest wounds
- Absent or diminished breath sounds
- Administer O2 via NRB or assist ventilations with a bag-
mask device, as indicated
- Anticipate definitive airway management to support
ventilation.
Upon initial assessment, what type of oxygen should be
used for a pt breathing effectively?
: Answer--A tight-fitting nonrebreather mask at 12-15 lpm.
What intervention should be done if a pt presents with
effective circulation?
: Answer---Insert 2 large caliber IV's
- Administer warmed isotonic crystalloid solution at an
appropriate rate
What are signs of ineffective circulation?
: Answer--- Tachycardia
- AMS
- Uncontrolled external bleeding
, - Pale, cool, moist skin
- Distended or abnormally flattened external jugular veins
- Distant heart sounds
What are the interventions for Effective/Ineffective
Circulation?
: Answer--- Control any uncontrolled external bleeding by:
- Applying direct pressure over bleeding site
- Elevating bleeding extremity
- Applying pressure over arterial pressure points
- Using tourniquet (last resort).
- Cannulate 2 large-caliber IV's and initiate infusions of an
isotonic crystalloid solution
- Use warmed solution
- Use pressure bags to increase speed of IVF infusion
- Use blood administration tubing for possible
administration of blood
- Use rapid infusion device based on protocol
- Use NS 0.9% in same tubing as blood product
- IV = surgical cut-down, central line, or both.
- Blood sample to determine ABO and Rh group
- IO in sternum, legs, arms or pelvis
What is kinematics?
: Answer--A branch of mechanics (energy transfer)
that refers to motion and does not consider the
concepts of force and mass of the object or body.
What is Newton's First Law?
: Answer--A body at rest will remain at rest. A body
in motion will remain in motion until acted on by
an outside force.
What is the Law of Conservation of Energy?
: Answer--Energy can neither be created nor
destroyed. It only changed from one form to
another.
What is Newton's Second Law?
: Answer--Force equals mass multiplied by
acceleration of deceleration.
What is kinetic energy (KE)?
: Answer--KE equals 1/2 the mass (M) multiplied by
the velocity squared.
What is the Mnemonic for the Initial Assessment?
:Answer--A = Airway with simultaneous cervical
spine protection
B = Breathing
,C = Circulation
D = Disability (neurologic status)
E = Expose/Environmental controls (remove clothing and
keep the patient warm)
What is the Mnemonic for the Secondary Assessment?
: Answer--F = Full set of VS/Focused adjuncts (includes
cardiac monitor, urinary catheter, and gastric
tube)/Family presence
G = Give comfort measures (verbal reassurance, touch,
and pharmacologic and nonpharmacologic management
of pain).
H = Hx and Head-to-toe assessment
I = Inspect posterior surfaces
Where do you listen to auscultate breath sounds?
: Answer--Auscultate the lungs bilaterally at the second
intercostal space midclavicular line and at the fifth
intercostal space at the anterior axillary line.
What are the late signs of breathing compromise?
: Answer--- Tracheal deviation
- JVD
What are signs of ineffective breathing?
: Answer--- AMS
- Cyanosis, especially around the mouth
,- Asymmetric expansion of chest wall
- Paradoxical movement of the chest wall during
inspiration and expiration
- Use of accessory muscles or abdominal muscles or both
or diaphragmatic breathing
- Sucking chest wounds
- Absent or diminished breath sounds
- Administer O2 via NRB or assist ventilations with a bag-
mask device, as indicated
- Anticipate definitive airway management to support
ventilation.
Upon initial assessment, what type of oxygen should be
used for a pt breathing effectively?
: Answer--A tight-fitting nonrebreather mask at 12-15 lpm.
What intervention should be done if a pt presents with
effective circulation?
: Answer---Insert 2 large caliber IV's
- Administer warmed isotonic crystalloid solution at an
appropriate rate
What are signs of ineffective circulation?
: Answer--- Tachycardia
- AMS
- Uncontrolled external bleeding
, - Pale, cool, moist skin
- Distended or abnormally flattened external jugular veins
- Distant heart sounds
What are the interventions for Effective/Ineffective
Circulation?
: Answer--- Control any uncontrolled external bleeding by:
- Applying direct pressure over bleeding site
- Elevating bleeding extremity
- Applying pressure over arterial pressure points
- Using tourniquet (last resort).
- Cannulate 2 large-caliber IV's and initiate infusions of an
isotonic crystalloid solution
- Use warmed solution
- Use pressure bags to increase speed of IVF infusion
- Use blood administration tubing for possible
administration of blood
- Use rapid infusion device based on protocol
- Use NS 0.9% in same tubing as blood product
- IV = surgical cut-down, central line, or both.
- Blood sample to determine ABO and Rh group
- IO in sternum, legs, arms or pelvis
