A & P
MOI
Assessment
Nursing
Specific Injuries
100
The largest solid organ in the abdomen.
What is the liver located in the right upper quadrant at the level of the 6th to 10th ribs along the right costal margin under the diaphragm.
100
Injuries to this organ are often associated with other injuries due to it's anatomical location it can be crushed between the anterior abdominal wall and the spinal column.
What is the pancreas. Fewer than 10% of pt's who sustain a pancreatic injury will have a single-system injury. Often associated with a duodenal injury.
100
Injuries to the abdomen and pelvic organs and vasculature can cause this. It is important to rapidly identify and control this.
What is HEMORRHAGE. Controlling hemorrhage in order to save the patient's life. Several liters of blood are needed to affect abdominal girth, and distention may be a late sign of uncontrolled internal bleedng.
100
This sign may take several hours before presentation.
What is ecchymosis.
100
This injury occurs in approx 20% of pt's with penetrating MOI to abdomen. The patient may have bloody drainage from the NGT/OGT.
What is a gastric injury. This injury requires operative intervention. A significant force is rquired to rupture the stomach so consider concurrent injuries.
200
This abdominal organ is highly vascular and filters 1.7 Liters of blood per minute and holds 13% of the body's blood supply.
What is the liver. It's size, location and vasculature make it the most frequently injured abdominal organ. Bleeding may be contained by the capsule encasing the liver leading to a hematoma and the capsule may be lacerated.
200
Tearing or shearing from sudden acceleration or deceleration can cause stress on fixed sites in the abdomen relusting in injury. The organs most susceptible to this injury in the abdomen are?
What is the small bowel, large bowel, ureters, urethera and esophagus and aorta.
200
This can influence the nurse's ability to accurate asess the abdomen.
What is PAIN. Pain, rigid abdomen and guarding can be signs of peritonal irriation. Referred pain- KEHR's sign pain radiating to left shoulder, testicular pain may be a duodenal injury.
200
This may develop symptoms 24 hours after intial injury.
What is perioneal signs.
200
This injury can occur from blunt or penetrating injuries. Blunt force energy may cause it to rupture or be torn from fixed points or avulsed from abdominal wall.
What is the Large bowel. This injury requires operative intervention where the bowel will be repaired and may have a diveting colostomy which may be closed within a few weeks.
300
This organ is not necessary for life, but without it the patient is at risk for leukocytosis.
What is the spleen. After a splenectomy, patient's are encouraged to get the flu shot, meningococcal and pneumococcal vaccines.
300
This type of fracture can result from compression forces d/t crush, collision and falls. This type of fractures can causing tearing of interanl iliac artery and uncontrolled hemorrhage.
What is a pelvic ring fracture.
300
Bruising around teh umbiicus or in the right upper quadrant.
What is Cullen's sign and associated with liver injury.
300
To monitor for additional injuries or worsening injuries. This is a priority nursing responsiblity.
What is serial abdomial examinations to assess for injuries. Trending of labs, pain assessment and monitoring vital signs watching for s/s of shock.
300
This injury may be treated non-operatively with complete blowel rest, nutritional support, serial labs, exams and CT scans.
What is a pancreatic injury.
400
This abdominal organ has MINIMAL elasticity and flexibility.
What is the spleen.
400
Pentrating trauma as a relut of a GSW can create what in thr body from the damaging velocity of the missile.
What is cavitation effect or bullet fragmentation. GSW's may cause additional injuries based on their trajectory.
400
A focused ultrasound examining all 4 abdominal quadrants looking for uncontolled internal hemorrhage is done in the initial resuscitation phase.
What is a FAST exam. However, if pt continues to exhibit s/s of bleeding the first FAST may not have revealed the blood loss.
400
This injury may take up to 24 hours to show s/s after a penetrating injury.
What is a retroperitoneal colon injury which will require surgical exploration.
400
This injury may be treated non-operatively if hemodynamically stable, stable Hct and Hgb's and graded I or II. These pt's will have serial abdominal exams adn H/H labs. Operatively they will be managed when unable to stabilize.
What is a splenic injury. Grade III= greater than 50% surface area hematome and expanding or active bleeding. Grade IV= laceration involving hilar vessels Grade V = completely shattered spleen.
500
This MOI for an adult 12-20 feet or 2-3 times the height of a child is associated with increased injury severity.
What is Falls. The higher they fall. More likely to have abdominal injuries.
500
LFT's, Coags, H/H and amylase.
What is What is useful lab tests for evaluting abdominal injury. Amylase is not a test ordered for the initial resusciation, but may be ordered later while evaluating the pancreas.
500
Injury to this organ is graded between Grade I-VI minor to severe. Non-operative management is teh standard for hemodynamically stable pt's who sustain blunt injury and may be oberseved but are a high risk for failure of non-op treatement and require frequent abdominal assessments. If unstable then treated operatively and with fluid/blood resuscitation.
What is a liver injury.
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