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Neurological Trauma Management Flashcards

7 cards from real CFRN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Neurological Trauma Management flashcards as text

  1. A flight patient with severe TBI has a GCS of 6 and a BP of 90/60 mmHg. What is the primary hemodynamic goal during transport?

    Answer: Maintain SBP ≥ 90 mmHg to prevent secondary brain injury

    Hypotension (SBP < 90 mmHg) in TBI significantly worsens outcomes by reducing cerebral perfusion pressure and causing secondary brain injury.

  2. During air transport, a TBI patient develops Cushing's triad. Which combination correctly identifies this reflex?

    Answer: Hypertension, bradycardia, and irregular respirations

    Cushing's triad—hypertension, bradycardia, and irregular respirations—is a late sign of severely elevated ICP and impending herniation.

  3. A patient with a basilar skull fracture is exhibiting CSF rhinorrhea. What intervention is contraindicated?

    Answer: Nasogastric tube insertion

    Nasogastric tube insertion is contraindicated in basilar skull fracture due to risk of the tube entering the cranial vault through the fractured cribriform plate.

  4. Which pupillary finding is most consistent with uncal herniation in a TBI patient?

    Answer: Unilateral fixed and dilated pupil ipsilateral to the lesion

    Uncal herniation compresses CN III on the ipsilateral side, causing a fixed, dilated pupil on the same side as the expanding lesion.

  5. A patient with a spinal cord injury at C4 is being transported. What immediate respiratory concern should the flight nurse anticipate?

    Answer: Loss of diaphragmatic function requiring ventilatory support

    C4 and above injuries disrupt phrenic nerve function (C3-C5), eliminating diaphragm control and requiring immediate ventilatory support.

  6. During transport, a TBI patient's EtCO2 reads 28 mmHg. What is the appropriate action?

    Answer: Reduce ventilation rate to target EtCO2 of 35-45 mmHg

    EtCO2 of 28 mmHg represents excessive hyperventilation causing cerebral vasoconstriction; target 35-45 mmHg unless herniation is imminent.

  7. A flight nurse is managing a patient with a penetrating brain injury. Which action is most appropriate regarding the impaled object?

    Answer: Stabilize the object in place and do not remove it

    Impaled objects should be stabilized in place, as removal can cause massive hemorrhage and worsen brain injury; removal occurs in the OR.

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