Emergency & Trauma Care
Priority concern with smoke inhalation, hoarseness, stridor, or facial burns
Airway. Prepare for advanced airway (i.e. intubation)
Primary life-threatening risk during the first 24 hours after major burns.
Hypovolemic shock from fluid loss
Priority intervention for autonomic dysreflexia.
Elevate the head of bed immediately.
This reduces blood pressure quickly while you identify and remove the trigger.
Key goal of nursing care during transitions from acute to rehab settings.
Promote patient and caregiver readiness for increased independence
Primary purpose of a hard cervical collar after suspected spinal trauma.
Prevent spinal movement and secondary injury
Stabilizing the cervical spine limits movement that could worsen a spinal cord injury, especially before full imaging and evaluation are complete.
Step in the trauma survey that includes head-to-toe assessment and patient history.
Secondary survey
Purpose of a fasciotomy (or escharotomy) in a patient with circumferential burns.
To relieve pressure and restore distal perfusion
What distinguishes neurogenic shock from other types of shock?
Loss of sympathetic tone leads to hypotension and bradycardia.
Unlike hypovolemic or septic shock—which cause tachycardia—neurogenic shock disrupts autonomic pathways, resulting in unopposed parasympathetic stimulation below the level of injury. This leads to vasodilation, hypotension, and bradycardia instead of the usual compensatory tachycardia.
Purpose of involving physical and occupational therapy early in burn recovery.
To prevent contractures and promote functional recovery.
This optimizes long-term outcomes
Why patients with high-level SCI require bowel and bladder training.
Loss of autonomic control leads to incontinence or retention
A nurse triages the following 4 patients. Which presentation is most consistent with an “emergent” classification?
A. Sudden confusion and difficulty speaking
B. Migraine with photophobia
C. Minor burn to forearm
D. UTI symptoms with low-grade fever
A. Sudden confusion and difficulty speaking
This could represent a CVA or Profound Hypoglycemia - both of which require immediate intervention
What causes brown, tea-colored urine in a patient with large TBSA burns
Myoglobin released from muscle breakdown (myoglobinuria)
Which assessment finding requires immediate follow-up in a patient with a new halo device?
A. Mild dizziness with movement
B. Numbness in feet and toes
C. Soreness at pin sites
D. New arm and shoulder weakness
D. New arm and shoulder weakness
This may indicate new or worsening cervical spinal cord involvement and needs urgent evaluation.
Primary benefit of teach-back when educating caregivers.
It confirms understanding by requiring the caregiver to demonstrate or explain what they’ve learned
Rationale: Teach-back shifts passive listening into active processing, making errors or confusion more visible.
Which intervention is most important during early rehab for a patient with SCI?
A. Monitoring CBC and BMP
B. Teaching incentive spirometry
C. Initiating passive ROM exercises
D. Reinforcing home medication list
C. Initiating passive ROM exercises
Rationale: Preserving joint mobility early helps prevent contractures and supports long-term independence.
List the five components of the primary trauma survey.
Airway, breathing, circulation, disability, exposure/environmental control
Why are patients with extensive burns at high risk for infection during the acute phase?
Loss of anatomical barrier (Skin) and immunosuppression from systemic inflammatory response
Name five signs or symptoms of autonomic dysreflexia.
Severe hypertension, bradycardia, blurred vision, headache, nasal congestion, facial flushing, diaphoresis above the spinal lesion, apprehension
Rationale: AD presents with a cluster of symptoms from excessive autonomic response to a noxious stimulus—recognizing them early is essential to prevent stroke or seizure.
Most therapeutic way to assess caregiver readiness during discharge planning.
Ask open-ended questions about how they’re feeling or what concerns they have
Open-ended questions invite honest reflection, uncover unspoken concerns, and support emotional readiness—especially important in complex transitions like rehab discharge.
Why is caregiver education essential before discharge in SCI recovery?
Caregivers support complex ADLs, mobility, and complication prevention at home.
Rationale: Involving and educating caregivers reduces readmissions and promotes long-term adaptation.
Why a trauma patient with internal bleeding might initially have normal blood pressure.
Compensatory vasoconstriction (maintains perfusion in early stages of bleeding)
Electrolyte shift responsible for peaked T waves and risk of arrhythmias after major burns.
Hyperkalemia from cellular destruction
Primary assessment when autonomic dysreflexia is suspected.
Check for bladder distention or other noxious stimuli (e.g.impacted bowel)
*refer to Dr. Mike & Dr. Matt Video in Faculty Slide Deck Slide 27
How can nurses support long-term adaptation for patients and families post-SCI?
By coordinating community resources, promoting self-efficacy, and supporting role transitions
Rationale: Recovery extends far beyond the hospital; adaptation includes physical, psychological, and social domains.
Recall Spheres of Care from Professional Nursing III and Gordon's Functional Health Patterns
Nursing strategies to support a patient experiencing emotional distress due to altered body image post-SCI.
Offer empathetic support, involve counseling if needed, and reinforce achievable goals
Rationale: Body image concerns are common and need therapeutic communication plus access to mental health resources.