ATCN Exam Review QUESTIONS WITH COMPLETE VERIFIED SOLUTIONS 2024/2025, Exams of Health sciences

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ATCN Exam Review QUESTIONS WITH COMPLETE VERIFIED SOLUTIONS 2024/2025 The approach to trauma care typically begins with what? notification that a trauma patient is arriving When preparing to receive a trauma patient, what should you keep in mind? safe practice, safe care What does "Safe practice" mean when receiving trauma patients? take into consideration the protection of the team (universal precautions/PPE/preparing equipment prior to patient arrival) What does "Safe care" mean when receiving trauma patients? that the patient is going to the right hospital, in the right time, for the right care Trauma primary survey for "A"? airway and alertness with simultaneous cervical spinal stabilization Trauma primary survey for "B"? breathing and ventilation Trauma primary survey for "C"? circulation and hemorrhage control Trauma primary survey for "D"? disability (neurological status: AVPU/GCS) Trauma primary survey for "E"? exposure and environmental control Trauma primary survey for "F"? full set of vital signs and family presence Trauma primary survey for "G"? get resuscitation adjuncts (LMNOP) Which resuscitation adjunct under the "G" primary assessment is this? -"L" laboratory studies (ABG's/Type and cross) Which resuscitation adjunct under the "G" primary assessment is this? -"M" monitor for continuous cardiac rhythm and rate assessment Which resuscitation adjunct under the "G" primary assessment is this? -"N" naso/orogastric tube consideration Which resuscitation adjunct under the "G" primary assessment is this? -"O" oxygenation and ventilation analysis (pulse oximetry/ETCO2/capnography) Which resuscitation adjunct under the "G" primary assessment is this? -"P" pain assessment and management Trauma primary survey for "H"? history and head to toe assessment Trauma primary survey for "I"? inspect posterior surfaces 1.chest pain 2.air hunger 3.respiratory distress 4.tachycardia 5.hypotension 6.tracheal deviation away from injury 7.unilateral absence of breath sounds 8.elevated hemithorax w/out respiratory movement 9.neck vein distention 10.cyanosis (late sign) 10 Signs and sx of tension pneumothorax 1. Becks Triad= increased venous pressure(distended neck veins), decreased arterial pressure(hypotension), muffled heart tones 2. PEA 3. JVD &/or Kussmauls sign 4. Use FAST to dx Signs and sx of cardiac tamponade Careful assessment of the pt's breath sounds is paramount to differentiate the two tension pneumothorax can often be confused with cardiac tamponade, how do you differentiate? 1. Needle decompression- large bore needle 2nd intercostal space midclavicular line 2. chest tube 4 or 5th intercostal space mid axillary Tx of tension pneumothorax -Acidosis - Hypothermia - Coagulopathy (blood can't clot resulting in continued bleeding) triad of death The best way to restore cellular and organ perfusion in hemorrhagic shock is to adequate urinary output Which of the following would provide the nurse with the best indication of the effectiveness of fluid resuscitation in the burn patient direct pressure to area of EXTERNAL active bleeding Initial management of external life-threatening hemorrhagic shock includes: decrease elevated intracranial pressure In the acutely neurological deteriorating patient For the head trauma patient with cerebral edema, hyperventilation should only be used cautiously for limited periods of time to: altered level of consciousness nausea and vomiting headache restlessness, change in speech NOT: Dilated or non-reactive pupil In the head injured patient all of the following are considered early signs and symptoms of increased ICP tachycardia and hypotension Symptoms of compression of the vena cava in the pregnant trauma patient include: intubation of the patient assessment of the arterial blood gasses the need for chest tube placement The intervention that the nurse must anticipate in a patient who has sustained a severe crush injury to the chest and is SOB include: forceful manual compression and pelvic rock of the pelvis to determine instability For pelvic fractures NEVER place an occlusive dressing over the wound (taped on three sides) For an open bubbling chest wound tearing of a bridging vein between the cerebral cortex and a draining venous sinus Most common underlying cause of a subdural hematoma? 1. Respiratory distress 2. Asymmetry of breath sounds 3. Deviation of trachea to the opposite side of the defect 4. Marked decreased in cardiac output 5. Hypotension 6. Muffled heart sounds signs of tension pneumothorax the neck muscles are strong What is NOT an anatomical difference of children? burns that destroy the entire thickness of the skin -dark leathery appearance -mottled, or wax like appearance -painless -dry surface third degree burns muffled heart sounds distended neck veins hypotension S/S of cardiac tamponade (Beck's triad) retrograde urethrogram Radiographic procedure to r/o urethral injury Patient with RR of 10 blood or vomit in the oral cavity cervical spine injury Potential indications for nasal intubation infusion of IV crystalloid fluids judicious use of vasopressors close monitoring of the patient's BP and pulse anticipate invasive hemodynamic monitoring Treatment of neurological shock -remove damp clothing -warm fluids orally if pt can drink -placing the injured extremity in warm circulating water at 40 C Management of Frostbite - Administer IV fluids -Administer Sodium Bicarb -Close monitoring of renal perfusion/health (rhabdo) -Close monitoring of compartment syndrome The management of a crush injury infusion of warm fluids peripheral IV access short, large caliber IV catheters infusion rates of 20 ml/kg Initial fluid resuscitation may include: pain with passive stretch of the muscle swelling of the affected extremity paresthesias and loss of function pain out of proportion to the injury S/S of compartment syndrome -assess pulses, color, temperature, and sensation o the extremity distal to the injury before and after splinting -stabilize the joint proximal and distal to the fracture site The basic principles of applying splints to extremity fractures include A- Allergies M-Medications currently used P-Past illnesses or Pregnancy? L-Last meal E- Eevents/Environment r/t injury Secondary Survey Late sign of compartment syndrome Loss of pulses in injured limbs L-Look externally E-Evaluate (3-3-2) for oral cavity spacing M-Mallampti score O-Obstruction of airway N-Neck mobility LEMON for intubation 1- No difficulty 2- No difficulty but less of an opening 3- Moderate difficulty, only base of uvula visible 4- Severe difficulty, only hard palate visible Mallampti Scores patients with cardiac arrest C02 detector reading may be inaccurate in coagulation abnormalities Patients with TBI's are particularly prone to type A New universal plasma type? devices capable of warming and rapid infusion Fluid and blood should be administered through