TNCC 8th Edition COMPLETE QUESTIONS WITH ANSWERS REVISION EXAM QUESTIONS GRADED A+

Describe the characteristics of hypovolemic shock Hypovolemia is caused by a decrease in the amount of circulating volume usually caused by massive bleeding, but also can be from vomiting and diarrhea. Characteristics include low blood pressure and preload, increase heart rate respiratory rate and afterload, with contractility unchanged. Signs include obvious bleeding, weak peripheral pulses, pale cool and moist skin, distended abdomen, pelvic fracture, or bruise swollen and deformed extremities especially long bones. What is the recommended fluid bolus for a trauma? 500 ML's of warmed isotonic crystalloid. Ongoing fluid boluses of 500 ML's should be given judiciously with constant reassessments after administration. What is the minimum permissive hypertension and a trauma patient? A systolic of greater than or equal to 90 MMHG What is the minimum permissive oxygenation level of a trauma patient? Greater than or equal to 94% What is Cullen's sign and its significance? Cullens sign is periumbilical bruising and is indicative of intraperitoneal bleeding Define Cushing's triad Bradycardia, progressive hypertension (widening pulse pressure), and decreased respiratory effort What are the early signs of increased Intracranial pressure headache, vomiting, behavioral changes that begin with restlessness and may progress to confusion, drowsiness, or impaired judgment What are the late signs of Increased intracranial pressure dilated, non-reactive pupil(s); abnormal motor posturing (flexion, extension, flaccidity); Cushing's triad, Unresponsive to per verbal and painful stimuli, bradycardia and decreased respiratory effort What are the symptoms of a subdural hematoma? Decreased LOC, nausea vomiting headache and ipsilateral pupillary changes What is a trademark symptom of an epidural hematoma Loss of consciousness then awake and alert then loss of consciousness Define the characteristics of neurogenic shock Distributive shock with a T6 or higher injury results and vasodilation, bradycardia, flushed warm dry skin. Risk for temperature instability. Nursing interventions include maintaining warmth and spinal stabilization. Define the characteristics of spinal shock Transient loss of function can include loss of reflexes and muscle tone below the level of industry with possible vascular response. Describe the four types of spinal cord injury Central cord injury results in greater weakness distally, anterior injury includes motor loss or weakness below the cord level of injury yet sensory is intact, Brown-Sequard (hemicord) is weak on one side with sensory deficit on opposite side, posterior cord syndrome although rare is when the patient is unable to use sense vibration in proprioception Describe one fat embolism syndrome is most likely to occur in its characteristics With longform fractures. Tachycardia, Thrombocytopenia, and petechiae rash. What is the Munro-Kellie doctrine? Within the skull 80% his brain, 10% is blood, and 10% is CSF. Any increase of any of the products results in increased intracranial pressure. What are the treatment goals for a TBI? O2 saturation or equal to 95%, systolic blood pressure or equal to 100 MMHG, ICP 15 MMHG, CPP or equal to 60 MMHG, normal glycemia, hemoglobin or equal to 7 g/DL, sodium 135-145, osmotic diuretics, anti-emetics, sedatives, anticonvulsants, head of bed at 30°, and neck at midline