Exam 28: Trauma Surgery

The emergency medical services system consists of trained prehospital personnel who arrive at the scene and perform definitive interventions designed to reduce morbidity and mortality.What is the primary role of the prehospital personnel?

Traumatic injury is the most common indication for nonobstetric surgery during pregnancy.The normal physiologic changes that occur during pregnancy increase the challenge of evaluation and treatment when pregnant women are victims of trauma.Select the statements which best describe considerations in perioperative assessment of the pregnant trauma patient.

If an injury to a patient is a result of a violent crime,the team must give special attention to preservation of evidence during patient care.When clothing is removed from the patient,why must it be placed and secured in a paper bag rather than a plastic bag?

With injury to the brain,swelling may occur quickly,requiring aggressive decisions to manage increasing ICP.What is an appropriate diuretic medication to give,and what nursing actions would be indicated for an older adult patient with traumatic brain injury,increased ICP,and a history of congestive heart failure (CHF)?

A trauma patient is rushed to the OR after a primary survey is completed in the ED.He is a 36-year-old man with multiple penetrating gunshot wounds to the abdomen.He is bleeding profusely.What appropriate nursing actions are critical in the rapid preparation for this procedure?

A 26-year-old woman is rushed to the OR after a primary and secondary survey in the ED.She was hit by a small truck as she was riding her bicycle through a busy intersection.She has sustained rib fractures and several fractured transverse vertebral processes.Renal injury is suspected.As the perioperative nurse prepares to insert a urinary catheter,she notices blood at the urinary meatus.What should the nurse's next action be?

The perioperative nurse may not be able to assess the trauma patient until the patient arrives in the OR for surgical intervention.If the patient's condition permits,the perioperative nurse should obtain a brief,precise report from the ED nurse.One component of this report is the SAMPLE history.What are the components of the SAMPLE mnemonic?

What is the description of damage control surgery,and what conditions may be present?

When the patient arrives in the emergency department (ED),the trauma team initiates a primary assessment.This is a logical,orderly process of patient assessment for potential life threats.These assessment activities are based on established protocols for advanced trauma life support (ATLS).The mnemonic "ABCDE" is used,representing assessment of the following: airway,breathing,circulation,disability,and exposure.The D and E represent what degree of investigation?

The extent of injury after blunt trauma may be difficult to determine.What noninvasive diagnostic test is critical to diagnosis in potential traumatic brain injury?

Autotransfusion can present a vital asset in trauma care when considering the high blood loss associated with many traumatic injuries.This process provides immediate volume replacement,decreases the amount of bank blood used,and reduces the possibility of transfusion reactions or risk of transfusion with bloodborne pathogens.What are the contraindications to using autotransfusion as a blood replacement source?

Mechanism of injury (MOI),or kinematics,involves the action of forces on the human body and their effects.Motor vehicle collisions (MVCs)account for a high degree of blunt trauma.In the case of an adult trauma victim who is the driver in a head-on MVC at high speed,where the head hits the windshield and the chest impacts the steering wheel,what is the MOI and description of the possible injuries?

Traumatic deaths may occur in three phases or time frames.Which phase occurs within the first 1 to 2 hours after the injury,where definitive trauma care has the most significant effect?

Trauma to the chest area is the primary cause of death in approximately 20% to 25% of trauma victims.Involvement of the heart,great vessels,lungs,and diaphragm,attributable to penetrating or blunt injury,can provide multiple unexpected findings when the chest is opened.Because of the nature of the potential findings and expected surgical intervention,what would be an appropriate preparatory nursing action?

Focused assessment with sonography in trauma (FAST)may assist with diagnosis in difficult situations.Which group of scans is performed,and what do they identify?

An adult man was the victim of a low-velocity,low-caliber gunshot wound to the anterior left quadrant of the lower abdomen.The gun was shot at far range.What is the trajectory of the gunshot?

A 7-year-old girl fell from a swing at school and landed on her head.She is not conscious.On the baseline neurologic exam,her Glascow Coma Scale (GCS)is 5.What is the recommended immediate treatment of choice?

Which statement regarding level III and level IV TCs best describes the difference between the two types of centers?

What special consideration should be made when assessing geriatric trauma patients before surgery?

Blunt force to the larynx can result in a fracture and impose immediate airway obstruction.These patients are at risk for a lost airway and may require immediate tracheotomy followed by repair of the fracture when the fracture is unstable or displaced.It is also important to consider that a trauma patient is assumed to have a full stomach; thus,these patients are at high risk for aspiration and resultant pneumonia.What is an appropriate nursing action in the event of a lost airway after anesthesia induction and before intubation?