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Nursing - Bloomberg > 370: Trauma > Flashcards

370: Trauma Flashcards

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1
Q

What is included in a Primary Assessment?

A 
A = Airway with simultaneous c-spine protection
B = Breathing (supplemental oxygen)
C = Circulation  with 
D = Disability (neuro status)
E = expose/environmental controls (remove clothing + keep warm)
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2
Q

What is included in a Secondary Assessment?

A

F = Full set of Vitals, Focused adjuncts (cardiac monitoring, urinary catheter, gastric tube), Family presence

G = Give comfort (verbal, pharmacological, and pain management)

H = History + Head-to-toe

I = Inspect posterior surfaces

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3
Q

What is included in a Trauma Panel and Diagnostics?

A
  1. CBC
  2. Electrolytes
  3. BUN
  4. Creatinine, Amylase, Lipase
  5. PT, PTT
  6. Blood type + crossmatch
  7. Urinalysis (ethanol + tox screen)
  8. ABGs
  9. Lactate
  10. Imaging (X-ray, CT, US, FAST)
  11. ECG
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4
Q

Type of compression fracture with multiple pieces of bone

A

Burst fracture

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5
Q

Type of fracture with fragments out of normal position at fracture site

A

Displaced fracture

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6
Q

Type of fracture that is intact, caused by minor to moderate force applied directly to bone

A

Linear fracture

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7
Q

Type of fracture telescoped, one fragment driven into another

A

Impacted Fracture

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8
Q

Type of fracture results from twisting force

A

Spiral Fracture

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9
Q

Type of fracture occurs at 90-Degree angle to longitudinal axis of bone

A

Transverse Fracture

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10
Q

Type of fracture occurs approximately 45-Degree angle across longitudinal axis of bone

A

Oblique Fracture

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11
Q

Type of fracture where breaks across entire section of bone dividing it into distinct fragments, often displaced

A

Complete Fracture

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12
Q

Type of fracture where more than 1 fracture line, more than 2 bone fragments, fragments may be splintered or crushed

A

Comminuted Fracture

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13
Q

Type of fracture where fracture like extends in direction of bone’s longitudinal axis

A

Longitudinal Fracture

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14
Q

Type of fracture where bone fragments are torn away from the body of the bone at the site of attachment of a ligament or tendon

A

Avulsion Fracture

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15
Q

Type of fracture where fracture lines radiate from one central point

A

Stellate Fracture

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16
Q

An incomplete fracture in which one side of the cortex is broken and the other side is flexed but intact

A

Greenstick Fracture

17
Q

How much blood is lost in a humerus fracture?

A

250mL

18
Q

How much blood is lost for EACH pelvic fracture?

A

500mL

19
Q

How much blood is lost for a Hemothorax?

A

2,000 mL PER LUNG CAVITY

Half of circulating blood

20
Q

How much blood is lost for a femur fracture?

A

1000 - 1500 mL

21
Q

What are primary indications for a Blood Transfusion?

A
  1. Blood loss > 20% (1000mL)
  2. Anemia not benefited from other treatments
  3. Clotting abilities or platelets are low
22
Q

What are the 7 Ps of neuro vascular assessments?

A
  1. Pain
  2. Pallor
  3. Pulselessness
  4. Parathesia (sensory impairment/pins+needles)
  5. Paralysis
  6. Puffiness
  7. Poikilothermia (temp regulation)
23
Q

What are complications of a musculoskeletal trauma?

A
  1. Nerve injury
  2. Fat emboli (SOB, Change in LOC, Petechial rash)
  3. DVT/PE
  4. Infection
24
Q

Cast Syndrome

A

Spica casts (Body casts for hip dysplasia)

Vascular compression of duodenum causing bowel ischemia. Leads to hemorrhage and necrosis of bowel and gastric distension.

25
Q

Compartment Syndrome

A

Progressively increased pressure in a confined space compromising circulation.

  1. Ischemia releases Histamine leading to further edema and further decreased perfusion.
  2. RHABDOMYOLOSIS = cellular release of myoglobin ➡️ toxic to kidneys ➡️ rise in CK value ➡️ kidney failure
26
Q

Volkmann’s Contracture

A

Permanent flexion contracture of the hand at the wrist, resulting in a claw-like deformity of the hand and fingers.

  1. Not enough innervation to site
  2. Muscle tissue replaces by fibrous tissue
  3. Trapsfibres and nerves and results in contracture

Can be due to COMPARTMENT SYNDROME

27
Q

What is the treatment for Compartment Syndrome?

A

Fasciotomy = indecision through skin into fascia of muscle

28
Q

Why do you cycle ice on and off?

A

Rebound vasodilation can increase swelling

29
Q

What are possible causes of Compartment Syndrome?

A
  1. Soft tissue injuries
  2. Fractures
  3. Crush injuries
  4. Casts
  5. Prolonged pressure on limb
  6. Frostbite
  7. Snakebite
30
Q

How does a nurse asses pelvic stability?

A
  1. Apply gentle pressure to iliac crest towards midline (Don’t do #2 of pain)
  2. Gently press down on symphysis pubis
31
Q

What are interventions for a pelvic fracture?

A
  1. High flow O2
  2. Frequent monitoring of vitals
  3. 2 large bore IV sites, crossmatch
  4. Fluid bonuses
  5. Splint pelvis, immobilize spine and legs
  6. NO FOLEY if blood at urinary meatus
32
Q

Which type of hip fractures can be missed on plain X-ray films?

A
  1. Undisplaced femoral Neck

2. Intertrochanteric

33
Q

What are the types of hip fractures?

A
  1. Subcapital neck fracture
  2. Transcervical neck fracture
  3. Intertrochanteric fracture
  4. Subtrochateric Fracture
  5. Greater Trochanter Fracture
  6. Lesser Trochanter Fracture
34
Q

When is it indicated to intubate?

A

GCS < 8

“Less than eight, intubate!”

35
Q

What is important for cervical spine fractures?

A

Support breathing!!

“C3, 4, 5 = keep diaphragm alive!”

36
Q

What is important for thoracic spinal fractures?

A

T2-T8 control intercostals

37
Q

What is important for sacral spinal fractures?

A

S4-S5 control rectal tone

38
Q

When are antibiotics indicated in a trauma setting?

A
  1. Compound fractures
  2. CSF leak
  3. Penetrating injury
  4. Prevent secondary osteomyelitis, meningitis, peritonitis
39
Q

If there is blood at the urinary meatus, should a patient still receive a urinsry catheter?

A

NO!!

Nursing - Bloomberg (52 decks)

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