Nursing 3450 - CM 2 - FINAL - Summer 2026 ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
exam with correct answers ||\\||\\ ||\\||\\ ||\\||\\
Review components of trauma assessment ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Basics of Trauma ||\\||\\ ||\\||\\
• Preparation
||\\||\\
• Team Assembly and equipment Check
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
• Triage
||\\||\\
• Sort patients by level of acuity
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
• Primary Survey: ABCDEF of trauma, should take 1-2
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
minutes MAX! ||\\||\\
Airway ||\\||\\
Breathing
Circulation
Neurologic deficit ||\\||\\
Exposure of patient ||\\||\\ ||\\||\\
Full set of vitals
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
,Primary Survey ||\\||\\
• Designed to identify injuries that are immediately
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
life threatening and to treat them as they are
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
identified
• Resuscitation
||\\||\\
• Rapid procedures and treatment to treat injuries
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
found in primary survey before completing the||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
secondary survey ||\\||\\
• Secondary Survey
||\\||\\ ||\\||\\
• Full History and Physical Exam to evaluate for other
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
traumatic injuries, FAST (Focused abdominal ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
sonogram for trauma) ||\\||\\ ||\\||\\ ||\\||\\
• Monitoring and Evaluation, Secondary adjuncts
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
• Transfer to Definitive Care
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
• ICU or unit, Operating Room, Another facility
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Appendicitis
A. Appendicitis
||\\||\\
,-Inflammation of the vermiform appendix, most ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
common cause of acute abdominal pain requiring ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
surgery
• Etiology: Appendicitis results from obstruction of
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
the appendiceal lumen, typically by lymphoid
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
hyperplasia (dense collections of lymphocytes, which ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
can grow during infection, and block the lumen of
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
the appendix), but occasionally by a fecalith (mass of
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
dried fecal material), foreign body, or even worms or ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
other parasites. ||\\||\\
• Pathophysiology: The cells lining the appendix
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
secrete mucus. If there is an obstruction, ongoing ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
secretion will fill the lumen of the appendix, leading ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
to distention. ||\\||\\
• Enlargement of the appendix puts pressure on
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
abdominal visceral pain sensors, leading to ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
abdominal pain. ||\\||\\
• Intestinal bacteria, such as E. coli, are trapped
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
behind the obstruction, leading to overgrowth, and ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
infection.
, • As bacterial growth continues, the weakened wall
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
of the appendix can rupture, leaking bacteria into
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
an abscess, or, with complete perforation, into the
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
peritoneal space. ||\\||\\
• Bacteria spilled into the peritoneum can lead to
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
peritonitis, which causes rebound tenderness (pain ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
with removal of pressure) ||\\||\\ ||\\||\\ ||\\||\\
B. Clinical manifestations
||\\||\\ ||\\||\\
• Local abdominal tenderness (referred to umbilicus
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
area)
• "Relief" of pain following rupture
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
• Nausea, vomiting, anorexia after pain starts
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
• Constipation or diarrhea
||\\||\\ ||\\||\\ ||\\||\\
• Low-grade fever
||\\||\\ ||\\||\\
• Right hip pain
||\\||\\ ||\\||\\ ||\\||\\
• Anorexia (loss of appetite)
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
• Increased WBC with left shift
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
exam with correct answers ||\\||\\ ||\\||\\ ||\\||\\
Review components of trauma assessment ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Basics of Trauma ||\\||\\ ||\\||\\
• Preparation
||\\||\\
• Team Assembly and equipment Check
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
• Triage
||\\||\\
• Sort patients by level of acuity
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
• Primary Survey: ABCDEF of trauma, should take 1-2
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
minutes MAX! ||\\||\\
Airway ||\\||\\
Breathing
Circulation
Neurologic deficit ||\\||\\
Exposure of patient ||\\||\\ ||\\||\\
Full set of vitals
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
,Primary Survey ||\\||\\
• Designed to identify injuries that are immediately
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
life threatening and to treat them as they are
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
identified
• Resuscitation
||\\||\\
• Rapid procedures and treatment to treat injuries
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
found in primary survey before completing the||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
secondary survey ||\\||\\
• Secondary Survey
||\\||\\ ||\\||\\
• Full History and Physical Exam to evaluate for other
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
traumatic injuries, FAST (Focused abdominal ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
sonogram for trauma) ||\\||\\ ||\\||\\ ||\\||\\
• Monitoring and Evaluation, Secondary adjuncts
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
• Transfer to Definitive Care
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
• ICU or unit, Operating Room, Another facility
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Appendicitis
A. Appendicitis
||\\||\\
,-Inflammation of the vermiform appendix, most ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
common cause of acute abdominal pain requiring ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
surgery
• Etiology: Appendicitis results from obstruction of
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
the appendiceal lumen, typically by lymphoid
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
hyperplasia (dense collections of lymphocytes, which ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
can grow during infection, and block the lumen of
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
the appendix), but occasionally by a fecalith (mass of
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
dried fecal material), foreign body, or even worms or ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
other parasites. ||\\||\\
• Pathophysiology: The cells lining the appendix
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
secrete mucus. If there is an obstruction, ongoing ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
secretion will fill the lumen of the appendix, leading ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
to distention. ||\\||\\
• Enlargement of the appendix puts pressure on
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
abdominal visceral pain sensors, leading to ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
abdominal pain. ||\\||\\
• Intestinal bacteria, such as E. coli, are trapped
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
behind the obstruction, leading to overgrowth, and ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
infection.
, • As bacterial growth continues, the weakened wall
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
of the appendix can rupture, leaking bacteria into
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
an abscess, or, with complete perforation, into the
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
peritoneal space. ||\\||\\
• Bacteria spilled into the peritoneum can lead to
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
peritonitis, which causes rebound tenderness (pain ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
with removal of pressure) ||\\||\\ ||\\||\\ ||\\||\\
B. Clinical manifestations
||\\||\\ ||\\||\\
• Local abdominal tenderness (referred to umbilicus
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
area)
• "Relief" of pain following rupture
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
• Nausea, vomiting, anorexia after pain starts
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
• Constipation or diarrhea
||\\||\\ ||\\||\\ ||\\||\\
• Low-grade fever
||\\||\\ ||\\||\\
• Right hip pain
||\\||\\ ||\\||\\ ||\\||\\
• Anorexia (loss of appetite)
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
• Increased WBC with left shift
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
