TNCC NOTES FOR WRITTEN EXAM LATEST 2023-2024 |TEST
BANK|100% COMPLETE verified pass
PLACEMENT WITH PROOF
- Each attempt NOT to exceed 30 seconds, max of 3 attempts. Ventilate pt 30-60 seconds between
attempts.
- After intubation, inflate the cuff
- Confirm tube placement w/exhaled CO2 detector.
POSTINTUBATION MANAGEMENT:
- Secure ET tube
- Set ventilator settings
- Obtain Chest x-ray
- Continue to medicate
- Recheck VS and pulse oxtimetry
What are the S/S of a basilar skull fx? - ans- H/A
- Altered LOC
- Periorbital ecchymosis (raccoon eyes), mastoid ecchymosis (Battle's sign), or blood behind tympanic
membrane (hemotympanum)
- Facial nerve (VII) palsy
- CSF rhinorrhea or otorrhea
What are the S/S of a depressed skull fx? - ans- H/A
- Possible decreased LOC
- Possible open fx
- Palpable depression of skull over the fx site
What are the S/S of a linear skull fx? - ans- H/A
- Possible decreased LOC
What are the S/S of a pneumothorax? - ans- Dyspnea, tachypnea
- Tachycardia
- Hyerresonance (increased echo produced by percussion over the lung field) on the injured side
- Decreased or absent breath sounds on the injured side
- Chest pain
- Open, sucking wound on inspiration (open pneumothorax)
What are the S/S of a tension pneumothorax? - ans- Severe respiratory distress
- Markedly diminished or absent breath sounds on affected side
- hypotension
- Distended neck, head and upper extremity veins-may not be clinically appreciated if significant blood
loss present
- Tracheal deviation - shift toward uninjured side (LATE sign)
- Cyanosis (LATE sign)
What are the S/S of flail chest? - ans- Dyspnea
- Chest wall pain
- Paradoxical chest wall movement - the flail segment moves in during inspiration and out during
expiration.
What are the S/S of Hemothorax? - ans- Dyspnea, tachypnea
- Chest pain
- Signs of shock
- Decreased breath sounds on injured side
- Dullness to percussion on the injured side
,TNCC NOTES FOR WRITTEN EXAM LATEST 2023-2024 |TEST
BANK|100% COMPLETE verified pass
What are the S/S of orbital fracture (orbital blowout fracture)? - ans- Diplopia (double vision)
- Loss of vision
- Altered extraocular eye movements
- Enophthalmos (displacement of the eye backward into the socket)
- Subconjunctival hemorrhage or ecchymosis of the eyelid
- Infraorbital pain or loss of sensation
- Orbital bony deformity
What are the S/S of pericardial tamponade? - ansA collection of blood in pericardial sac. As blood
accumulates, it exerts pressure on the heart, inhibiting or compromising ventricular filling.
- Hyotension
- Tachycardia or PEA
- Dyspnea
- Cyanosis
- Beck's Triad (hypotension, distended neck veins + muffled heart sounds)
- Progressive decreased voltage of conduction complexes on ECG
What are the S/S of pulmonary contusion? - ans- Dyspnea
- Ineffective cough
- Hemoptysis
- Hypoxia
- Chest pain
- Chest wall contusion or abrasions
What are the signs and symptoms of postconcussive syndrome? - ans- Persistent H/A
- Dizziness
- Nausea
- Memory impairment
- Attention deficit
- Irritability
- Insomnia
- Impaired judgement
- Loss of libido
- Anxiety
- Depression
What are the two types of herniation that occurs with ICP? - ans1. Uncal herniation
2. Central or transtentorial herniation
What are you looking for when auscultating lung sounds? - ansAbsence of BS:
- Pneumothorax
- Hemothorax
- Airway Obstruction
Diminished BS:
- Splinting or shallow BS may be a result of pain
What are you looking for when palpating the chest wall, clavicles and neck? - ans- Tenderness
- Swelling
- subcutaneous emphysema
- step-off deformities
= These may indicate: esophageal, pleural, tracheal or bronchial injuries.
Palpate trachea above suprasternal notch. Tracheal deviation may indicate a tension pneumothorax or
massive hemothorax.
, TNCC NOTES FOR WRITTEN EXAM LATEST 2023-2024 |TEST
BANK|100% COMPLETE verified pass
What are you looking for when percussing the chest? - ansDullness:
- hemothorax
Hyperresonance
- Pneumothorax
What could a flail chest be associated with? - ans- Ineffective ventilation
- Pulmonary contusion
- Lacerated lung parenchyma
What happens to a ruptured diaphragm? - ansPotentially life-threatening, results from forces that
penetrate the body. Left hemidiaphragm is more susceptible to injury because the right side is protected
by the liver.
- Herniation of abdominal contents
- Respiratory compromise b/c impaired lung capacity + displacement of normal tissue.
- Mediastinal structures may shift to opposite side of injury
What intervention should be done if a pt presents with effective circulation? - ans- Insert 2 large caliber
IV's
- Administer warmed isotonic crystalloid solution at an appropriate rate
What is a cerebral contusion and its S/S? - ansA common focal brain injury in which brain tissue is bruised
and damaged in a local area. Mainly located in frontal and temporal lobes. May cause hemorrhage,
infarction, necrosis and edema. Max effects of bleeding & edema peak 18-36 post injury.
S/S:
- Alteration in LOC
- Behavior, motor or speech deficits
- Abnormal motor posturing
- Signs of increased ICP
What is a Combitube? - ansA dual-lumen, dual-cuff airway that can be placed blindly into the esophagus to
establish an airway. If inadvertently placed into trachea, it can be used as a temporary ET tube. There are
only two sizes: small adult and larger adult.
What is a concussion and its signs and symptoms? - ansA temporary change in neurologic function that
may occur as a result of minor head trauma.
S/S:
- Transient LOC
- H/A
- Confusion and disorientation
- Dizziness
- N/V
- Loss of memory
- Difficulty with concentration
- Irritability
- Fatigue
What is a flail chest? - ansA fracture of two or more sites on two or more adjacent ribs, or when rib
fractures produce a free-floating sternum.
Flail segments may not be clinically evident in the first several hours after injury b/c of muscle spasms
that cause splinting. After positive pressure intiated, paradoxical chest wall movement ceases.
BANK|100% COMPLETE verified pass
PLACEMENT WITH PROOF
- Each attempt NOT to exceed 30 seconds, max of 3 attempts. Ventilate pt 30-60 seconds between
attempts.
- After intubation, inflate the cuff
- Confirm tube placement w/exhaled CO2 detector.
POSTINTUBATION MANAGEMENT:
- Secure ET tube
- Set ventilator settings
- Obtain Chest x-ray
- Continue to medicate
- Recheck VS and pulse oxtimetry
What are the S/S of a basilar skull fx? - ans- H/A
- Altered LOC
- Periorbital ecchymosis (raccoon eyes), mastoid ecchymosis (Battle's sign), or blood behind tympanic
membrane (hemotympanum)
- Facial nerve (VII) palsy
- CSF rhinorrhea or otorrhea
What are the S/S of a depressed skull fx? - ans- H/A
- Possible decreased LOC
- Possible open fx
- Palpable depression of skull over the fx site
What are the S/S of a linear skull fx? - ans- H/A
- Possible decreased LOC
What are the S/S of a pneumothorax? - ans- Dyspnea, tachypnea
- Tachycardia
- Hyerresonance (increased echo produced by percussion over the lung field) on the injured side
- Decreased or absent breath sounds on the injured side
- Chest pain
- Open, sucking wound on inspiration (open pneumothorax)
What are the S/S of a tension pneumothorax? - ans- Severe respiratory distress
- Markedly diminished or absent breath sounds on affected side
- hypotension
- Distended neck, head and upper extremity veins-may not be clinically appreciated if significant blood
loss present
- Tracheal deviation - shift toward uninjured side (LATE sign)
- Cyanosis (LATE sign)
What are the S/S of flail chest? - ans- Dyspnea
- Chest wall pain
- Paradoxical chest wall movement - the flail segment moves in during inspiration and out during
expiration.
What are the S/S of Hemothorax? - ans- Dyspnea, tachypnea
- Chest pain
- Signs of shock
- Decreased breath sounds on injured side
- Dullness to percussion on the injured side
,TNCC NOTES FOR WRITTEN EXAM LATEST 2023-2024 |TEST
BANK|100% COMPLETE verified pass
What are the S/S of orbital fracture (orbital blowout fracture)? - ans- Diplopia (double vision)
- Loss of vision
- Altered extraocular eye movements
- Enophthalmos (displacement of the eye backward into the socket)
- Subconjunctival hemorrhage or ecchymosis of the eyelid
- Infraorbital pain or loss of sensation
- Orbital bony deformity
What are the S/S of pericardial tamponade? - ansA collection of blood in pericardial sac. As blood
accumulates, it exerts pressure on the heart, inhibiting or compromising ventricular filling.
- Hyotension
- Tachycardia or PEA
- Dyspnea
- Cyanosis
- Beck's Triad (hypotension, distended neck veins + muffled heart sounds)
- Progressive decreased voltage of conduction complexes on ECG
What are the S/S of pulmonary contusion? - ans- Dyspnea
- Ineffective cough
- Hemoptysis
- Hypoxia
- Chest pain
- Chest wall contusion or abrasions
What are the signs and symptoms of postconcussive syndrome? - ans- Persistent H/A
- Dizziness
- Nausea
- Memory impairment
- Attention deficit
- Irritability
- Insomnia
- Impaired judgement
- Loss of libido
- Anxiety
- Depression
What are the two types of herniation that occurs with ICP? - ans1. Uncal herniation
2. Central or transtentorial herniation
What are you looking for when auscultating lung sounds? - ansAbsence of BS:
- Pneumothorax
- Hemothorax
- Airway Obstruction
Diminished BS:
- Splinting or shallow BS may be a result of pain
What are you looking for when palpating the chest wall, clavicles and neck? - ans- Tenderness
- Swelling
- subcutaneous emphysema
- step-off deformities
= These may indicate: esophageal, pleural, tracheal or bronchial injuries.
Palpate trachea above suprasternal notch. Tracheal deviation may indicate a tension pneumothorax or
massive hemothorax.
, TNCC NOTES FOR WRITTEN EXAM LATEST 2023-2024 |TEST
BANK|100% COMPLETE verified pass
What are you looking for when percussing the chest? - ansDullness:
- hemothorax
Hyperresonance
- Pneumothorax
What could a flail chest be associated with? - ans- Ineffective ventilation
- Pulmonary contusion
- Lacerated lung parenchyma
What happens to a ruptured diaphragm? - ansPotentially life-threatening, results from forces that
penetrate the body. Left hemidiaphragm is more susceptible to injury because the right side is protected
by the liver.
- Herniation of abdominal contents
- Respiratory compromise b/c impaired lung capacity + displacement of normal tissue.
- Mediastinal structures may shift to opposite side of injury
What intervention should be done if a pt presents with effective circulation? - ans- Insert 2 large caliber
IV's
- Administer warmed isotonic crystalloid solution at an appropriate rate
What is a cerebral contusion and its S/S? - ansA common focal brain injury in which brain tissue is bruised
and damaged in a local area. Mainly located in frontal and temporal lobes. May cause hemorrhage,
infarction, necrosis and edema. Max effects of bleeding & edema peak 18-36 post injury.
S/S:
- Alteration in LOC
- Behavior, motor or speech deficits
- Abnormal motor posturing
- Signs of increased ICP
What is a Combitube? - ansA dual-lumen, dual-cuff airway that can be placed blindly into the esophagus to
establish an airway. If inadvertently placed into trachea, it can be used as a temporary ET tube. There are
only two sizes: small adult and larger adult.
What is a concussion and its signs and symptoms? - ansA temporary change in neurologic function that
may occur as a result of minor head trauma.
S/S:
- Transient LOC
- H/A
- Confusion and disorientation
- Dizziness
- N/V
- Loss of memory
- Difficulty with concentration
- Irritability
- Fatigue
What is a flail chest? - ansA fracture of two or more sites on two or more adjacent ribs, or when rib
fractures produce a free-floating sternum.
Flail segments may not be clinically evident in the first several hours after injury b/c of muscle spasms
that cause splinting. After positive pressure intiated, paradoxical chest wall movement ceases.
