FREE TC-Registered Nurse Questions and Answers
The patient's temperature should typically be decreased and maintained at? with targeted temperature management (TTM), also known as therapeutic hypothermia.
The patient's temperature should typically be decreased and maintained at 32 to 36° C with targeted temperature management (TTM), also known as therapeutic hypothermia. (Normal temperature is around 37° C). TTM is normally kept for 24 hours or so. In cases of sepsis, recent surgery (within two weeks), coagulopathy, or pre-existing coma, hypothermia is not advised. Ice packs, cooling blankets, helmets, and cool infusions or instillations can all be used to cool someone down.
Rapid sequence intubation (RSI) is most commonly used to:
To lower the risk of stomach aspiration, rapid sequence intubation (RSI) is utilized to anesthetize and intubate the non-fasting patient. Patients who are very fat, pregnant, or who have stomach reflux may also benefit from RSI. Prior to RSI, two intravenous lines should be set up and the patient pre-oxygenated for about three minutes. To block the esophagus and avoid aspiration, utilize the Sellick's maneuver, which involves applying pressure to the cricoid with the thumb and index finger on the outside. Thiopental, Entamide®, and propofol are used as induction agents, and suxamethonium is used as a muscle relaxant. A laryngoscopy is used to insert an endotracheal tube 60 seconds after the muscle relaxant, inflate and secure the cuff, and check the location with a capnometer.
What does the trauma nurse anticipate the patient to do if the paramedic reports that a patient is in transit with a Glasgow Coma Score of 7?
The trauma nurse anticipates that a patient in transit who has a Glasgow Coma Score of 7 will be intubated and unconscious. Scores of eight or less signify significant brain damage and a high probability of passing away. Oftentimes, intracranial pressure is increased. The range of GSCs is 3 (the lowest and most severe) to 15 (the highest score): - Mild: 13-15. consciousness for a brief period of time. - Modest: 9 to 12. Possible localized neurological deficits: confused but able to follow simple instructions. - Serious 8. The survivor is comatose and needs ventilator support; they most certainly have neurological damage.
Of the following, which is a strict no-no for nasotracheal intubation?
Nasotracheal intubation is completely contraindicated in cases of apnea. The main warning signs are a clinched jaw but with an intact gag reflex and acute respiratory distress due to a suspected or verified cervical spine injury. Depending on where the fractures are and how severe they are, facial and skull fractures may occasionally be contraindicated. The nares must be large enough to accommodate sizes 7 to 8 endotracheal tubes. Prior to inserting the tube, an anti-decongestant, such as phenylephrine 0.5 mg, is typically given to the nose.
How much mL of fluid should be given during the first eight hours if a burn patient's fluid resuscitation needs have been determined as 12,000 mL/24 hours using the burn/Baxter formula (4 mL of LR X kg body weight X TBSA burned)?
According to the burn/Baxter formula (4 mL of LR X kg body weight X TBSA burnt), a burn patient's fluid resuscitation needs are estimated to be 12,000 mL/24 hours. Of that amount, 6000 mL (50% of the total) should be given within the first 8 hours and the remaining 6000 mL over the following 16 hours. Burns that have burned 20% or more of the total body surface area (TBSA) call for fluid resuscitation. Instead of using NS, lactated Ringers IV solution is utilized, which might cause hypernatremia and hyperchloremia.
Which of the following patients is least likely to require monitoring of intracranial pressure?
Most patients with mild to severe head injuries and a Glasgow coma score of 13 to 15 do not need ICP monitoring. If a person is >40, postures, and has hypotension (90 systolic), they usually need to be monitored if they have suffered a significant head injury (even with a normal CT scan). With subarachnoid and intraventricular hemorrhage, cerebrovascular accident, brain tumors, brain abscesses/infections, and hydrocephalus, ICP monitoring may be necessary. ICP threshold values range from 20 to 25 mm HG for adults and 20 mm HG for children.
Which of the following best describes the statement made by a coworker to a recently recruited trauma nurse: "The suggestions you made were a complete waste of time, and if you want to get along with the staff you need to stop trying to make changes."
Horizontal/lateral violence happens when a peer or coworker utilizes threats, insults, rudeness, or even physical violence against another person. Others may be victimized or intimidated into obedient behavior. Horizontal aggression can be overt or subtle. In addition to creating a hostile work atmosphere and eroding self-confidence, horizontal violence also lowers staff morale and increases absenteeism. According to studies, more than half of nurses have encountered horizontal violence at work. There should be a code of conduct and a strategy in place for dealing with horizontal violence at each institution.