Traumatic Injury and Phases of Trauma Care

Match the element of AMPLE to the corresponding patient statement. "I am currently 30 weeks pregnant." "I had trouble breathing when I ate shellfish." "I ate two eggs for breakfast." "Someone attacked me while I was jogging." A M P E L

"I am currently 30 weeks pregnant." - P "I had trouble breathing when I ate shellfish." - A "I ate two eggs for breakfast." - L "Someone attacked me while I was jogging." - E

When assessing a trauma patient, which pneumonic could the nurse use for assessment during the secondary survey? AUDIT SBAR AVPU AMPLE

AMPLE The patient's history can be assessed by use of the mnemonic AMPLE (allergies, medications currently used, past medical illnesses/pregnancy, last meal, events/environment related to the injury).

Which information will the nurse communicate to the health care provider during the "B" portion of an SBAR report regarding a patient with blunt trauma injury to the chest? Mechanism of injury Blood pressure 102/70 mm Hg; heart rate 70 bpm; respiratory rate 16; temperature 98.6°F Past medical history of hypertension Need for a computerized tomography scan of the chest

Past medical history of hypertension The nurse will communicate any significant medical and surgical history, as well as any medications taken, during the "B" portion of the SBAR report.

Which patient would be a priority by emergency personnel based on findings during triage at an accident site? Patient with bruising on the shoulders Patient with a suspected arm fracture Patient with venous bleeding Patient with arterial bleeding

Patient with arterial bleeding A patient with an arterial bleed is a case of major trauma that requires urgent attention because there is a risk of loss of limb or life.

The nurse identifies that a patient who has undergone massive transfusion protocols is at risk for which complication? Acute respiratory distress syndrome (ARDS) Skin breakdown of the sacrum and coccyx Cardiogenic shock Neurologic injury related to anoxia

Acute respiratory distress syndrome (ARDS) Massive transfusion protocols involve administration of blood products, which potentiates the risk of ARDS and multiple-organ dysfunction syndrome (MODS).

Match the component of the primary survey to the corresponding nursing intervention. Administer 1 L of isotonic IV fluid Administer supplemental oxygen Consider early CT scan Immobilize the spine Circulation Airway Disability Exposure Breathing

Administer 1 L of isotonic IV fluid - Circulation Administer supplemental oxygen - Breathing Consider early CT scan - Disability Immobilize the spine - Airway

Based on best practice guidelines, which intervention would be used when caring for a patient admitted with hemorrhagic shock after a penetrating wound? Select all that apply. One, some, or all responses may be correct. Prepare for immediate surgical closure of the wound. Administer 4 L of isotonic fluid to achieve a systolic blood pressure >100 mm Hg. Administer blood replacement according to the massive transfusion protocols. Maintain the systolic blood pressure between 70 and 90 mm Hg. Prepare the patient for surgical interventions to control hemorrhage.

Administer blood replacement according to the massive transfusion protocols. Massive transfusion protocols are used to administer blood replacement to patients with hemorrhagic shock. Maintain the systolic blood pressure between 70 and 90 mm Hg. The nurse would implement permissive hypotension, maintaining the systolic pressure at 70 to 90 mm Hg. Prepare the patient for surgical interventions to control hemorrhage. Damage control surgery involves surgical intervention to control hemorrhage and prevent infection.

Which venous access is best in the case of a patient with peripheral vasoconstriction and venous collapse? Central venous catheter Forearm peripheral intravenous line Antecubital peripheral intravenous line Midline catheter

Central venous catheter A central venous catheter is best in the case of a patient with peripheral vasoconstriction and venous collapse, as it allows high flow of fluid if necessary.

Which blood test would the nurse anticipate for a 64-year-old female who reports to the emergency department with trauma secondary to a motor vehicle accident? Select all that apply. One, some, or all responses may be correct. Pregnancy test Electrolyte profile Complete blood count Coagulation panel Serum lactate

Electrolyte profile An electrolyte panel is used to assess the potassium, sodium, calcium, and glucose levels. Complete blood count A complete blood count can determine red and white blood cell levels. Coagulation panel A coagulation panel is used to assess the prothrombin and partial thromboplastin times. Serum lactate A serum lactate level would be used to assess for response to trauma and impaired tissue oxygenation.

The majority of deaths during the first peak of trauma occur from which factor? Hemorrhage Infection Hypoxia MODS

Hemorrhage Hemorrhage is a leading cause of death during the first peak of trauma.

Which intervention would be performed during the prehospital stage when caring for a patient who sustained blunt force trauma? Select all that apply. One, some, or all responses may be correct. Maintenance of an open airway Immobilization of the patient Surgical closure of internal hemorrhages Splinting of fractures Pain control

Maintenance of an open airway It is important to maintain an open airway during the prehospital stage. Immobilization of the patient During the prehospital stage, the patient is immobilized to prevent secondary injury. Splinting of fractures To prevent destabilization, fractures are splinted during the prehospital stage. Pain control Pain management is an important element of prehospital care and appropriate pain interventions would be implemented.

The nurse would expect blunt force trauma in a patient who experienced which injury? Select all that apply. One, some, or all responses may be correct. Stabbing Gunshot wound Motor vehicle crash Fall Contact during football

Motor vehicle crash A motor vehicle crash is a leading cause of blunt force trauma. Fall A leading cause of blunt force trauma is a fall. Contact during football Contact sports injuries are a leading cause of blunt force trauma.

The emergency department triage nurse identifies that a patient with which condition should be treated first? Inflammation of the ankle A wound on the toe that has intact skin Multisystem injuries A 1-inch laceration on the hand

Multisystem injuries Multisystem injuries are considered a major trauma, and the patient requires immediate intervention to prevent disability, loss of limb, or death.

Which intervention would the nurse incorporate when implementing damage control resuscitation for a patient with hemorrhagic shock? Select all that apply. One, some, or all responses may be correct. Permissive hypotension Massive transfusion protocol Targeted temperature management Cardiopulmonary resuscitation Damage control surgery

Permissive hypotension Permissive hypotension involves low-volume IV fluid resuscitation and is a component of damage control resuscitation. Massive transfusion protocol A component of damage control resuscitation is massive transfusion protocols to facilitate early, timely release of blood products. Damage control surgery Damage control surgery is a strategy of providing essential surgical interventions to control hemorrhage and limit contamination and is a component of damage control resuscitation.

The critical care nurse would question which request when caring for a patient with a body temperature of 94℉? Remove all wet clothing and linens. Apply a heating blanket. Provide a bath using warm water. Administer warm, humidified oxygen.

Provide a bath using warm water. The nurse would avoid bathing the patient until normothermia is achieved.

Which intervention would the nurse perform during the final step of the primary survey? Select all that apply. One, some, or all responses may be correct. Remove all clothing to inspect the patient. Palpate the spine for obvious deformities. Protect the patient from hypothermia. Administer supplemental oxygen. Assess for signs of poor tissue perfusion.

Remove all clothing to inspect the patient. In the final step of the primary survey, all of the patient's clothing is removed to facilitate a thorough examination of all body surfaces for the presence of injury. Palpate the spine for obvious deformities. The spine is carefully palpated for obvious deformities or fractures during the final step of the primary survey. Protect the patient from hypothermia. During the final step of the primary survey, the patient should be protected from hypothermia with warm blankets or IV fluids.

Which procedure would be considered if a patient with severe maxillofacial trauma requires mechanical ventilation? Select all that apply. One, some, or all responses may be correct. Surgical cricothyroidotomy Oropharyngeal airway placement Needle cricothyroidotomy Oral endotracheal intubation Nasotracheal intubation

Surgical cricothyroidotomy Surgical cricothyroidotomy should be considered if endotracheal intubation through the vocal cords is not feasible, especially in patients with maxillofacial trauma, laryngeal fractures, and severe oropharyngeal hemorrhage. Needle cricothyroidotomy Needle cricothyroidotomy should be considered if severe maxillofacial trauma exists and endotracheal intubation is not an option.

The nurse would closely monitor for impaired ventilation in a patient admitted with which diagnosis? Select all that apply. One, some, or all responses may be correct. Tracheal injury Traumatic brain injury Hemorrhagic shock Cardiovascular injury Hypothermia

Tracheal injury Injury to airway structures is a common cause of impaired ventilation. Traumatic brain injury A common cause of impaired ventilation is loss of central nervous system regulation of breathing, such as with traumatic brain injury.

The nurse would question a prescription for permissive hypotension for a patient with which admitting diagnosis? Hemorrhagic shock Traumatic brain injury Blunt force trauma Penetrating trauma

Traumatic brain injury Permissive hypotension is contraindicated in patients with a traumatic brain injury.

Which rewarming strategy would be classified as an active, internal technique? Warm room Head coverings Warm IV fluids Radiant light

Warm IV fluids Warmed IV fluids are an example of an active internal strategy of warming a hypothermic patient, as fluid flows through the blood.