TCR-Nurse Flashcards

In a pediatric trauma patient, which finding MOST reliably indicates significant blood loss?

Answer: Tachycardia with altered mental status

Children compensate well and maintain blood pressure until late; tachycardia combined with altered mental status is an earlier and more reliable sign of significant hemorrhage.

The BEST indicator of adequate fluid resuscitation in a trauma patient is:

Answer: Urine output of 0.5 mL/kg/hr in adults

Urine output of 0.5 mL/kg/hr in adults reflects adequate end-organ perfusion and is the gold standard for fluid resuscitation monitoring.

A trauma patient develops Beck's triad. Which intervention is MOST immediately appropriate?

Answer: Pericardiocentesis

Beck's triad (hypotension, muffled heart sounds, JVD) indicates cardiac tamponade; pericardiocentesis decompresses the pericardial sac emergently.

Which burn depth classification involves destruction of ALL skin layers including subcutaneous tissue, and may appear white, leathery, or charred?

Answer: Full-thickness (third-degree)

Full-thickness (third-degree) burns destroy epidermis, dermis, and subcutaneous tissue, presenting as white, leathery, or charred with no pain due to nerve destruction.

Using the Rule of Nines in an adult, what percentage of TBSA does a burn covering the entire anterior trunk represent?

Answer: 18%

The anterior trunk (chest and abdomen) represents 18% of TBSA in adults using the Rule of Nines.

A patient with a traumatic brain injury has a sudden drop in GCS from 13 to 7 with ipsilateral pupil dilation. This is MOST consistent with:

Answer: Epidural hematoma

Epidural hematoma classically presents with a lucid interval followed by rapid neurological deterioration and ipsilateral (uncal herniation) pupil dilation from arterial bleeding.

Which pressure value defines the threshold for decompressive intervention in compartment syndrome?

Answer: Compartment pressure within 30 mmHg of diastolic BP

Fasciotomy is indicated when compartment pressure is within 30 mmHg of diastolic BP (delta pressure ≤30 mmHg), as this compromises perfusion.