TNCC COMPREHENSIVE ACTUAL QUESTIONS AND
ANSWERS FIRM A+
✔✔Flail chest - ✔✔Paradoxical chest wall movement
✔✔can be caused by blunt trauma. air escapes from injured lung to pleural space and
negative intrapleural pressure is lost causing partial or collapsed lung - ✔✔Simple
Pneumothorax
✔✔1. Dyspnea
2. Tachycardia
3. Decreased or absent breath sounds on the injured side
4. CP - ✔✔Simple Pneumo assessment:
✔✔Tx is based on size, presence of sx, and stability. For those are aysmpomatic and
stable. Observation with or without oxygen. Larger pneumo who are unstable or likely to
deteriorate a chest tube is placed. - ✔✔Simple pneumo interventions:
✔✔can result from penetrating wound through chest wall causing air to be trapped in to
the intrapleural place. Might hear "sucking"
Tx: nonporous dressing tapes on 3 sided, then Chest tube and would closure surgical
repair. - ✔✔Open Pneumo:
✔✔Air cannot escape intrapleural space.. can begin to compress heart. pt will have
sever resp distress, hypotension, JVD. - ✔✔Tension pneumo
✔✔A 14 gauge needle that is inserted into the 2nd intercostal space in the midclavicular
line on the affected side over the top of the rib to avoid neuromuscular bundle that runs
under the rib.
Prepare for chest tube placement. - ✔✔Tension pneumo intervention
✔✔Caused by blood in the intrapleural space/ May also occur from lac to live or spleen
combined with injury to the diaphragm.
Ensure two large bore IVS are placed.
Prepare for thoracentesis and chest tube insertion. If open thoracotomy is done chest
tube is deferred. - ✔✔Hemothorax:
✔✔1. Hypotension
2. JVD
3. Muffled heart sounds - ✔✔Becks Triad:
, ✔✔Needle pericardiocentesis, but it is a temp solution. Requires surgical evaluation.
(Ultrasound guided) - ✔✔Cardiac Tamponade Intervention:
✔✔Aortic Dissection - ✔✔Unequal extremity pulse strength possibility of..
✔✔1. pain - hallmark sign, early sign
2. pressure - early sign
3. pallor, pules, paresthesia, paralysis - late sign - ✔✔Six P's of compartment
syndrome:
✔✔Pediatric Assessment Triangle
1. General appearance - muscle tone, interactiveness, consoloability, poor or gaze,
speech or cry
2. Work of breathing - inadequate or excessive, accessory muscle use, retractions,
tripod position, abnormal upper airway sounds
3. Circulation of the skin - color, mottling or central or peripheral cyanosis, diaphoresis -
✔✔PAT
✔✔brachial pulse - ✔✔Under age of 1 where do you find a pulse
✔✔1. Preparation and Triage
2. Primary Survery (ABCDE) with resuscitation adjuncts (F,G)
3. Reevaluation (consideration of transfer)
4. Secondary Survey (HI) with reevaluation adjuncts
5. Reevaluation and post resuscitation care
6. Definitive care of transfer to an appropriate trauma nurse - ✔✔Initial Assessment
✔✔1. A- airway and Alertness with simultaneous cervical spinal stabilization
2. B- breathing and Ventilation
3. circulation and control of hemorrhage
4. D - disability (neurologic status)
5. F - full set of vitals and Family presence
6. G - Get resuscitation adjuncts
L- Lab results (arterial gases, blood type and crossmatch)
M- monitor for continuous cardiac rhythm and rate assessment
N- naso or orogastric tube consideration
O- oxygenation and ventilation analysis: Pulse oxygemetry and end-tidal caron dioxide
(ETC02) monitoring and capnopgraphy
H- History and head to toe assessment
I- Inspect posterior surfaces - ✔✔ABCDEFGHI
✔✔Before the arrival of the pt - ✔✔When should PPE be placed:
ANSWERS FIRM A+
✔✔Flail chest - ✔✔Paradoxical chest wall movement
✔✔can be caused by blunt trauma. air escapes from injured lung to pleural space and
negative intrapleural pressure is lost causing partial or collapsed lung - ✔✔Simple
Pneumothorax
✔✔1. Dyspnea
2. Tachycardia
3. Decreased or absent breath sounds on the injured side
4. CP - ✔✔Simple Pneumo assessment:
✔✔Tx is based on size, presence of sx, and stability. For those are aysmpomatic and
stable. Observation with or without oxygen. Larger pneumo who are unstable or likely to
deteriorate a chest tube is placed. - ✔✔Simple pneumo interventions:
✔✔can result from penetrating wound through chest wall causing air to be trapped in to
the intrapleural place. Might hear "sucking"
Tx: nonporous dressing tapes on 3 sided, then Chest tube and would closure surgical
repair. - ✔✔Open Pneumo:
✔✔Air cannot escape intrapleural space.. can begin to compress heart. pt will have
sever resp distress, hypotension, JVD. - ✔✔Tension pneumo
✔✔A 14 gauge needle that is inserted into the 2nd intercostal space in the midclavicular
line on the affected side over the top of the rib to avoid neuromuscular bundle that runs
under the rib.
Prepare for chest tube placement. - ✔✔Tension pneumo intervention
✔✔Caused by blood in the intrapleural space/ May also occur from lac to live or spleen
combined with injury to the diaphragm.
Ensure two large bore IVS are placed.
Prepare for thoracentesis and chest tube insertion. If open thoracotomy is done chest
tube is deferred. - ✔✔Hemothorax:
✔✔1. Hypotension
2. JVD
3. Muffled heart sounds - ✔✔Becks Triad:
, ✔✔Needle pericardiocentesis, but it is a temp solution. Requires surgical evaluation.
(Ultrasound guided) - ✔✔Cardiac Tamponade Intervention:
✔✔Aortic Dissection - ✔✔Unequal extremity pulse strength possibility of..
✔✔1. pain - hallmark sign, early sign
2. pressure - early sign
3. pallor, pules, paresthesia, paralysis - late sign - ✔✔Six P's of compartment
syndrome:
✔✔Pediatric Assessment Triangle
1. General appearance - muscle tone, interactiveness, consoloability, poor or gaze,
speech or cry
2. Work of breathing - inadequate or excessive, accessory muscle use, retractions,
tripod position, abnormal upper airway sounds
3. Circulation of the skin - color, mottling or central or peripheral cyanosis, diaphoresis -
✔✔PAT
✔✔brachial pulse - ✔✔Under age of 1 where do you find a pulse
✔✔1. Preparation and Triage
2. Primary Survery (ABCDE) with resuscitation adjuncts (F,G)
3. Reevaluation (consideration of transfer)
4. Secondary Survey (HI) with reevaluation adjuncts
5. Reevaluation and post resuscitation care
6. Definitive care of transfer to an appropriate trauma nurse - ✔✔Initial Assessment
✔✔1. A- airway and Alertness with simultaneous cervical spinal stabilization
2. B- breathing and Ventilation
3. circulation and control of hemorrhage
4. D - disability (neurologic status)
5. F - full set of vitals and Family presence
6. G - Get resuscitation adjuncts
L- Lab results (arterial gases, blood type and crossmatch)
M- monitor for continuous cardiac rhythm and rate assessment
N- naso or orogastric tube consideration
O- oxygenation and ventilation analysis: Pulse oxygemetry and end-tidal caron dioxide
(ETC02) monitoring and capnopgraphy
H- History and head to toe assessment
I- Inspect posterior surfaces - ✔✔ABCDEFGHI
✔✔Before the arrival of the pt - ✔✔When should PPE be placed:
