Shock Shock Shock
Becky had a blunt chest trauma and now is positive for Beck's Triad.... 1) what are the components of Beck's Triad? 2) What type of shock is she in?
What is 1) Beck's Triad: Tachycardia, elevated JVD, muffled heart sounds 2) CARDIOGENIC if cardiac contusion, otherwise, OBSTRUCTIVE
During what stage of the primary survey are pupils/GCS assessed?
D (4th) disability
The most important lab in trauma survey.
What is TYPE AND SCREEN?
When screening for abuse, the nurse knows that a risk factor found in a caregiver, that increases the risk of abuse is:
What is substance abuse?
The number of people involved in assessing cervical spine stability.
What is TWO?
Tina is in respiratory distress, SQ emphysema, absent RT lung sounds 1) potential dx? 2) potential tx?
What is OBSTRUCTIVE shock in the setting of tension pneumothorax... which can lead to cardiogenic shock.
TX with 2nd ICS, midclavicular line needle decompression, EMERGENCY!
Assessing wounds, placing lines, binders, and tourniquet falls under what part of a primary survey?
What is CIRCULATION
The nurse knows that intentional burns in the pediatric patient are frequently associated with?
What is TOILET TRAINING?
Children of abusive brain injuries frequently present with retinal hemorrhages, changes in level of consciousness and ________________:
What are subdural hemorrhages?
Anne drives into a shallow swimming pool and hits her head first; Alan is trying to recreate a Jackass stunt by jumping off a tower onto a skateboard, and misses, landing hard on his feet. Both are examples of:
What is AXIAL loading (which causes injury to vertebral column)
Susie is hypotensive (80/40) and her HR is 75 at the scene. DX?
What is NEUROGENIC SHOCK
Using the alphabet, tell me the PRIMARY and SECONDARY letters:
What is : Primary: ABCDE Secondary: FGHI
Name the components of the Trauma Triad of death.
What is 1) hypothermia 2) acidosis 3) coagulopathy
A child is brought to the ED with facial bruising and swelling after being physically assaulted at school. As part of the initial assessment, the physician asks the child to bite down on a tongue depressor. The nurse knows that physician is most likely testing for what type of injury?
What is malocclusion? Checking for maxillary and/or mandibular fractures.
An example of a deceleration injury, this process and injury occurs when the brain goes back and forth against the skull
What is SHEARING, diffuse axonal injury
Name the types of shock in trauma
What is 1) HYPOVOLEMIC (ex. blood loss)
2) CARDIOGENIC (ex. blunt cardiac contusion)
3) NEUROGENIC (ex. spinal cord injury)
4) OBSTRUCTIVE (ex. tension pneumothorax)
When performing an initial assessment on a traumatically injured child, assessing for motor deficits related to a spinal cord injury is done as which part of the survey?
What is SECONDARY SURVEY?
When ventilating a patient with a known head injury, the nurse should strive for a PaCO2 of?
What is between 35 and 40 mm Hg?
Goal: low normal level, to prevent vasodilation and additional volume to the cranium which can increase ICP.
Name one risk factor, found in an infant, that can increase the risk for abuse.
What is PREMATURITY?
A 2 year old child's brain begins herniating following a fall from a second story window. Herniation often causes vital signs known as Cushing's triad. Define this triad.
What is bradycardia, bradypnea, and hypertension with a widened pulse pressure?
Pulses tend to be "full" and "bounding" in which forms of shock?
What is NEUROGENIC and SEPTIC shock?
When do you do a full head to toe assessment in trauma
What is SECONDARY SURVEY
What organs/processes are you concerned about with each finding: 1) Starred windshield? 2)Bent steering wheel?
What is 1) head injury 2) sternum, heart
A child is brought to the ED with burns. What location is most indicative of burns caused by abuse?
What is burns isolated to areas of the body normally covered by clothing.
Intentional burns more likely have clearly demarcated edges.
Why are toddlers are at a higher risk for both head and increased intracranial pressure than school-aged children.
What is their body:head ratio?
Larger head makes them more susceptible to head injuries and resultant increased ICP.