Medications
What intravascular solution is most commonly used for patients who have sustained burns? (adult)
Lactated Ringers
A trauma pt presents with snoring respirations. What nursing intervention should be performed next?
Jaw thrust --> OPA
A pt presents with chest pain and SOB after an MVC. EKG shows sinus tach with ischemic changes, labs show an elevated trop. The trauma nurse is highly suspicious of what injury?
Blunt cardiac injury
An older adult presents to the ED with c/o dizziness, headache, and nausea. The pt was involved in an MVC 10 days ago. There was no LOC, a hematoma is noted to the forehead, the pt states they were seen in the ED after the event. What is most likely the cause of their symptoms?
Post-concussive syndrome
You are caring for a pt who was shot multiple times in the chest and abdomen. They are unresponsive with snoring, shallow respirations, absent radial pulses, weak and rapid carotid pulse, and cool/diaphoretic skin. What management strategy should the nurse anticipate?
MTP
True or False:
The trauma nurse knows that administration of bicarb is necessary for pts on active MTP with acidosis.
False (NO BICARB!)
Which of the following is expected when assessing a pt with a chest tube?
A) tubing is clamped for transport
B) fluctuation in the water seal
C) output of 250 mL/hr for the last 3 hrs
B) fluctuation in the water seal
Trauma pts that present with chest or back pain that may be described as "ripping" or "tearing," hoarseness, dyspnea, vagal complaints, signs of hemorrhagic shock may have injury to what?
Great Vessel Injuries
A pt is diagnosed with a T12 SCI following a 20-foot fall. Which finding is consistent with spinal shock?
A) loss of reflexes
B) Bradycardia
C) widened pulse pressure
A) loss of reflexes
Brusing around the umbilicus (Cullen's sign) is likely a symptom of which abdominal organ injury?
Liver or Pancreas
An adult weighing 75kg sustained partial and full thickness burns to 32% of their body 2 hours prior to arrival. IVF resuscitation was calculated to be 400 mL/hr. The urine output over the last hour was 15mL. What intervention should the nurse anticipate?
increase isotonic crystalloid infusion rate
A pt arrives with a large sucking chest wound after being stabbed. A 3-sided dressing is applied. The pt is now anxious, restless, cyanotic, hypotensive, and in severe respiratory distress. What is the priority nursing intervention for this pt?
Dressing removal
An adult pt that was assaulted presents with SOB, BP 88/50 mm HG, HR 130 bpm, cyanosis, and muffled heart tones. What procedure can the trauma nurse anticipate?
Pericardiocentesis
A pt with a complete SCI who is in neurogenic shock will demonstrate hypotension and which other clinical signs?
A) tachycardia and poikilothermia
B) bradycardia and absent motor fcn below the level of injury
C) tachycardia and respiratory depression
B) bradycardia and absent motor fcn below the level of injury
Bruising around the flanks (Grey-Turner's sign) is likely a symptom of which abdominal organ injury?
kidneys
This medication may be used to decrease elevations in ICP AND is SAFE to use for hypovolemic patients
Hypertonic Saline (3% saline solution)
A pt presents to the ED after a high speed MVC. She presents with diminished breath sounds on the L side, hypotension, and R sided tracheal deviation. What is the priority nursing intervention?
needle decompression
With this injury leakage of contents may cause mediastinitis and rupture into the pleural space causing respiratory difficulties and chest infections
Blunt esophageal rupture
A pt is being treated for a high-speed car vs tree collision 3 hours ago. The pt has been unconscious with decorticate posturing and a temp of 104F since arrival. Which brain injury is most likely associated with these symptoms?
Diffuse Axonal Injury
Removal of this abdominal organ will lead to the pt being immunocompromised FOR LIFE
Spleen/ splenectomy
An adult trauma pt has received 1L of fluids, 6 units PRBC, 6 units FFP, and 1 unit of platelets. Re-assessment includes: BP 100/60, HR 115 w/ intermittent ventricular bigeminy, & muscle tremors. What can the RN anticipate administering?
Calcium gluconate
What medical intervention is MANDATORY after needle decompression?
chest tube insertion/ tube thoracostomy
A driver involved in a high speed MVC arrives to the ED, the airbags failed to deploy. The pt presents with chest pain and ecchymosis to chest wall. He is tachycardic and hypotensive with no evidence of uncontrolled bleeding, and PVCs noted to the monitor. What class of medication is appropriate for this pt?
Inotropic medications
What assessment finding is most concerning for a pt with a C6 anterior spinal cord injury?
A) distension of bladder
B) inability to move legs
C) increasing work of breathing
C) increasing work of breathing
A pt is brought to the ED following an MVC. He is c/o LUQ pain and L shoulder pain. This presentation is most consistent with an injury to which organ?
Spleen