Trauma Nursing Core Course (TNCC)- 9th edition Questions and Answers, Exams of Nursing

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edition Questions and Answers

Why is alertness included in the airway assessment? - correct answer ✅✅ Including this helps evaluate the patient's ability to protect their own airway What pneumonic is used to assess a patient level of alertness? - correct answer ✅✅ A: Alert V: Responds to verbal stimuli P: Responds to pain U: Unresponsive Why is AVPU beneficial to use at the beginning of the initial patient assessment? - correct answer ✅✅ Will help determine appropriate airway intervention In a patient who is unable to open their mouth or unresponsive, how do we assess the airway? - correct answer ✅✅ Jaw- thrust maneuver is performed to open airway and mouth to assess for obstruction What inspecting the airway, what are we inspecting for? - correct answer ✅✅ Vocalization Tongue Obstruction Loose or missing teeth Foreign objects Fluids (blood, vomit, secretions) Edema

edition Questions and Answers

Burns/ evidence of inhalation injury If an airway is patent, what is the goal? - correct answer ✅✅ Focusing efforts at maintaining and supporting a patent airway (Pt may be allowed to assume position that facilitates better air exchange so long as no CSI is suspected) Can an oropharyngeal airway be used in someone with a gag reflex? - correct answer ✅✅ No How do you assess breathing? - correct answer ✅✅ Expose the patient's chest and inspect for the following: Spontaneous breathing Symmetrical chest rise and fall Depth, pattern and rate of resps Work of breathing (accessory muscles, pursed lip, diaphragmatic breathing) Skin colour Contusions, abrasions, deformities Open pneumothorax JVD Signs of inhalation injuries

edition Questions and Answers

Sign of inhalation injuries - correct answer ✅✅ Singed nasal hairs Carbonaceous sputum Hoarse voice How to assess for proper placement of a definitive airway ( steps) - correct answer ✅✅ 1. Attach CO2 detector (assess for presence of CO2 after 5-6 breaths)

2. Adequate rise/fall of chest with assisted ventilation
3. Auscultate for gurgling over epigastrium and presence of bilateral breath sounds. Wha is a result of inadequate oxygenation? - correct answer ✅✅ Hypoxemia Resulting in anaerobic metabolism and acidosis ETCO2 level indicating effective ventilation - correct answer ✅✅ 35-45 mm (Greater than 50 signifies depressed ventilation What is a definitive airway? - correct answer ✅✅ Tube securely placed in the trachea with cuff inflated. List some conditions or situations that would require definitely secured airway - correct answer ✅✅ Apnea

edition Questions and Answers

GCS of 8 or less Severe maxillofacial fractures Evidence of inhalation injury Laryngeal or tracheal injury or neck hematoma High risk of aspiration and patient unable to protect airway Compromised or ineffective ventilation Anticipation of deterioration of neurological status