Trauma Emergencies (Shock/Hemo, TBI)

Question 1

The _____ the kinetic energy of a projectile, the _____ the wounding potential.

Answer 1

greater; greater

Question 2

Intracranial hemorrhage between the skull and dura mater

Answer 2

Epidural hematoma

Question 3

Urine output of ____ is indicative of shock

Answer 3

25 mL/hr

Question 4

Diffuse Axonal Injury describes an extensive damage involving a wide area of neural tissues throughout the ___ and ___; the damage involves the __________ of the neural _____ matter.

Answer 4

cerebrum; brainstem
innermost centroaxial areas
white

Question 5

Results from a single blunt strike that creates a fissure line in the cranium

Answer 5

Linear fracture

Question 6

A collective term describing a wide range of pathologic conditions and types of trauma involving the brain

Answer 6

Traumatic brain injury

Question 7

Periorbital ecchymosis

Answer 7

Raccoon’s eyes

Question 8

A distortion in the integrity of the bony skull

Answer 8

Skull fracture

Question 9

Tissue that is _____ has a tendency to take up more _____, resulting in greater _____.

Answer 9

dense; energy; damage

Question 10

A term that refers to inadequate tissue perfusion

Answer 10

Shock

Question 11

Pulse in Class IV Hemorrhage

Answer 11

> 140 bpm

Question 12

Possible causes of shock

Answer 12

Massive bleeding
Infection
Severe allergic reaction
Severe dehydration
Heart problems

Question 13

The important indicators of determining the extent of injuries includes:

(American Trauma Life Support, 2020)

Answer 13

Gun’s caliber
Presumed path and velocity
Distance from the weapon to the victim’s entrance point

Question 14

It is administered to maintain cardiac output, but not until volume is replaced.

Answer 14

Vasopressors

Question 15

A life-threatening condition that occurs when the body is not getting enough blood flow

Answer 15

Shock

Question 16

Amount of blood loss in Class I Hemorrhage

Answer 16

≤750 mL

Question 17

It is the bruising of the brain tissue that occurs when the head suffers a direct impact with a rigid object

Answer 17

Contusion

Question 18

Anterior Basilar Skull Fracture results from a ______ fall that damages _____ area

Answer 18

forward; frontal

Question 19

Entrance wound is called V1 (inlet velocity) as the

Answer 19

maximal point of energy

Question 20

It is carried by the bullet and subsequently transferred into the tissues causing damage in a GSW victim

Answer 20

Kinetic Energy (KE)

Question 21

In blood transfusion, ____ packed RBC can be administered.

Answer 21

O-negative

Question 22

Intracranial bleeding between the arachnoid mater and pia mater.

Answer 22

Subarachnoid hematoma

Question 23

Occurs when the generated force is greater than the cranial vault can absorb

Answer 23

Head trauma

Question 24

Stimulation of the gag reflex can ___ ICP

Answer 24

increase

Question 25

Mental status in Class II Hemorrhage

Answer 25

Mildly anxious

Question 26

CSF leak that may cause an _____ infection

Answer 26

ascending

Question 27

Behavioral changes in primary assessment of shock

Answer 27

Agitation Confusion Unresponsiveness

Question 28

The study of projectile penetration of the tissues

Answer 28

Wound ballistics

Question 29

A perforated scalp is observed

Answer 29

Open skull fracture

Question 30

The amount of destruction is directly related to the:

Answer 30

Caliber of the gun Type of bullet Proximity of the muzzle to the victim

Question 31

Type of dressing to control bleeding

Answer 31

loose, bulky

Question 32

If a projectile does not exit the body, then ___ its kinetic energy has been transferred to the tissues.

Answer 32

all

Question 33

True or False: Basal Skull Fracture results from a backward fall that damages the occiput

Answer 33

True

Question 34

Result from a fall and may result laceration of bone tissues.

Answer 34

Depressed skull fracture

Question 35

Hypovolemic shock may result from

Answer 35

Hemorrhage Burns GI losses Fluid shifts

Question 36

The inadequacy to perfuse tissue is a result of one or more of the following:

Answer 36

Pump failure of the heart Decrease circulating blood volume Changes in the arterial resistance vessels Changes in the capacity of the venous beds

Question 37

Usually ____ liters of blood volume is loss in hemorrhage

Answer 37

5

Question 38

True or False: Do not assume a cervical spine fracture for any patient with a significant head injury, until otherwise proven.

Answer 38

False; Assume

Question 39

Priority nursing diagnosis for shock and hemorrhage

Answer 39

Altered tissue perfusion

Question 40

Late signs of increased ICP:

Answer 40

Hypertension Bradycardia

Question 41

Fluid management in Class III Hemorrhage

Answer 41

Crystalloids with BT

Question 42

Occurs when significant amount of fluid (blood, plasma, or electrolyte solution) is lost from intravascular space

Answer 42

Hypovolemic shock

Question 43

A subjective feeling as a sign of shock

Answer 43

Impending doom

Question 44

In relation to physics, KE is computed based on:

Answer 44

KE=WVG Weight of the bullet Velocity Gravitational acceleration

Question 45

Fluid of choice for the initial treatment of hemorrhage

Answer 45

PLR

Question 46

If the bullet does not exit the body, outlet velocity is _____

Answer 46

zero or V0

Question 47

CSF leak ear: _____ nose: _____

Answer 47

otorrhea rhinorrhea

Question 48

Intracranial bleeding between the arachnoid mater and pia mater.

Answer 48

Subarachnoid hematoma

Question 49

Ture or False: Concussion is a direct brain injury involving neural tissue; a permanent loss of consciousness that results from a transient interruption on the brain's normal functioning

Answer 49

False; temporary

Question 50

Drugs for TBI:

Answer 50

anticonvulsants Mannitol antibiotics antipyretics

Question 51

If basilar skull fracture or severe midface fractures are suspected, ___ is contraindicated.

Answer 51

NGT

Question 52

The science of the motion of projectiles

Answer 52

Ballistics

Question 53

The high v1 creates an _____ path along which the bullet travels, but also _____ pressure also exists behind the bullet, which _____ debris and bacteria to the wound.

Answer 53

inward; negative; pulls

Question 54

_____ is one of the leading causes of _____, and _____ are the leading source of high-velocity penetrating trauma

Answer 54

Penetrating trauma; hemorrhage; gunshot wounds

Question 55

Refers to rapid loss of circulating blood volume

Answer 55

Hemorrhage

Question 56

Periauricular ecchymosis; a bluish discoloration behind the ears

Answer 56

Battle's sign

Question 57

Goals of treatment for hemorrhage

Answer 57

To decrease blood loss To increase intravascular volume

Question 58

If the projectile _____ the body, then only some of its kinetic energy has been transferred to the tissues.

Answer 58

exits

Question 59

Significant bleeding into a space or potential space between the skull and the brain

Answer 59

Intracranial hemorrhage

Question 60

True or False: Fluid should be restricted in TBI

Answer 60

True

Question 61

True or False: Hypotension as a sign of shock is the fall of diastolic blood pressure.

Answer 61

False; SBP yon teh

Question 62

Intracranial hemorrhage between the dura mater and arachnoid mater.

Answer 62

Subdural hematoma