TCRN Exam Review Exam Questions with 100% Correct Answers

Circumfrential burns Correct Answer Full-thickness burns result in the formation of an eschar that is tough and unyielding. Can cause a burn compartment syndrome, and often requires escharotomy Shock Correct Answer Systemic reaction to insult that causes decreased oxygen delivery to the cells 4 Classifications of Shock Correct Answer 1. Hypovolemic 2. Distributive 3. Cardiogenic 4. Obstruction Hypovolemic Shock Correct Answer Low blood volume results in altered perfusion (Ex: Hemorrhage, third spacing) Distributive Shock Correct Answer Severe vasodilation with normal blood volume results in altered perfusion (Ex: Sepsis, anaphylaxis, neurogenic) Cardiogenic Shock Correct Answer Altered cardiac function results in reduced perfusion (Ex: Blunt chest injury, CHF) Obstructive Shock Correct Answer Blockage in the system causes altered perfusion (Ex: PE, high PEEP, tension pneumothorax) Alpha Receptors Correct Answer Activated by sympathetic nervous system, causing: Vasoconstriction Glycogenolysis Diaphoresis Glycogenolysis Correct Answer Breakdown of glucose stores in the liver to provide increased circulating glucose, stimulated by Alpha receptors Beta 1 Receptors Correct Answer *Think: 1 heart Cause increased heart rate and contractility Beta 2 receptors Correct Answer *Think: 2 lungs Cause bronchodilation and increased respiratory rate RAAS System Correct Answer Increases resorption of sodium and water in the kidneys to increase vascular volume, decreasing urine output 3 hr. Sepsis Bundle Correct Answer Lactic level Blood cultures before antibiotics Broad spectrum antibiotics 30 ml/kg fluid bolus for hypotension 6 hr. Sepsis Bundle Correct Answer Repeat lactic Start pressors if fluid bolus ineffective Gain central access for pressors Symptoms of Early Shock Correct Answer Normotensive with NARROWING pulse pressure Tachycardia Weak and thready pulse Tachypnea with DEEP respirations Normal lactic Cool and clammy Anxiety, impending doom Decreased urine output Symptoms of Late Shock Correct Answer Hypotension Tachycardia Tachypnea with shallow respirations Elevated lactic Cool, clammy, and mottled skin Confusion, decreased LOC SUPER decreased to no urine output Stages of Shock Correct Answer 1. Early (Compensatory) 2. Late (Decompensated) 3. Irreversible Irreversible Shock Symptoms Correct Answer MODS Severe acidosis Obtunded Cardiac arrest Trauma Triad of Death Correct Answer Hypothermia Acidosis Coagulopathy Symptoms of Hypothermia Correct Answer Decreased cardiac output and HR (reduced perfusion) Vasoconstriction