Question 1

The nurse understands that certain trauma patients are at risk for developing fat embolism syndrome.Which group of patients is a high risk for this complication?

Accepted Answer

Fat embolism syndrome can occur as a complication of orthopedic trauma.

Question 2

Major trauma patients are at high risk of developing deep venous thrombosis and pulmonary embolism.The nurse understands that trauma patients are at risk due to which factors?

Accepted Answer

The factors that form the basis of venous thromboembolism (VTE)pathophysiology are blood stasis,injury to the intimal surface of the vessel,and hypercoagulopathy.Trauma patients are at risk for VTE because of endothelial injury,coagulopathy,and immobility.Hypernatremia and hyperosmolarity are associated with acute kidney injury.

Question 3

A patient was admitted after a motor vehicle crash (MVC).The nurse knows that this type of injury is the greatest cause of what type of trauma?

Accepted Answer

Blunt trauma to the chest most often is caused by motor vehicle crashes (MVCs)or falls.Spinal shock is a condition that can occur shortly after traumatic injury to the spinal cord.Maxillofacial injury results from blunt or penetrating trauma.Blunt trauma may occur from motor vehicle,industrial,or athletic injuries; violent blows to the head; or falls.The penetrating object involved determines the damage sustained from penetrating thoracic trauma.Low-velocity weapons (eg,22-caliber gun,knife)usually damage only what is in the weapon's direct path.

Question 4

A patient has been admitted with muscle trauma and crush injuries.The nurse understands that this patient is at high risk for the development of acute kidney injury secondary to rhabdomyolysis.Which findings would suggest the patient is developing this complication?

Accepted Answer

Circulating myoglobin can lead to the development of kidney failure by three mechanisms: decreased renal perfusion,cast formation with tubular obstruction,and direct toxic effects of myoglobin in the kidney tubules.Dark tea-colored urine suggests myoglobinuria.The most rapid screening test is a serum creatine kinase level.Urine output and serial creatine kinase levels should be monitored.Hypoxemia and diminished pulses are not associated with rhabdomyolysis.

Question 5

During assessment of a new trauma patient,the nurse observes perianal ecchymosis.The nurse suspects the patient has what problem?

Accepted Answer

Signs of pelvic fracture include swelling,tenderness,and/or bruising to the pubis,iliac bones,hips,or sacrum.Perianal ecchymosis (scrotum or vulva),indicating extravasation of urine or blood,may be present.

Question 6

The nurse is caring for a patient with extensive trauma to the lower extremities.The nurse understands that patient is at risk for compartment syndrome.Which findings would the nurse expect to note as evidence of this complication?

Accepted Answer

Clinical manifestations of compartment syndrome include obvious swelling and tightness of an extremity,paresis,and pain of the affected extremity.Diminished pulses and decreased capillary refill do not reliably identify compartment syndrome because they may be intact until after irreversible changes have occurred.Elevated intracompartmental pressures confirm the diagnosis.

Question 7

The nurse is caring for a patient with blunt abdominal trauma.The nurse understands that patient is at risk for abdominal compartment syndrome.Which findings would the nurse expect to note as evidence of this complication?

Accepted Answer

Clinical manifestations of abdominal compartment syndrome include decreased cardiac output,decreased tidal volumes,increased peak pulmonary pressures,decreased urine output,and hypoxemia.

Question 8

A trauma patient's condition has deteriorated.The nurse notes changes in patient's condition,including trachea shift,absence of breath sounds on the left side,and hypotension.The nurse suspects that the patient has developed what complication?

Accepted Answer

Assessment findings for patients with a hemothorax include hypovolemic shock.Breath sounds may be diminished or absent over the affected lung.With hemothorax,the neck veins are collapsed,and the trachea is at midline.Massive hemothorax can be diagnosed on the basis of clinical manifestations of hypotension associated with the absence of breath sounds or dullness to percussion on one side of the chest.

Question 9

A patient developed a hemothorax after a blunt chest trauma.The practitioner inserted a chest tube on the left side,and 1800 mL of blood was evacuated from the chest.The nurse expects that the patient will be taken to surgery for what procedure?

Accepted Answer

Thoracotomy may be necessary for patients who require persistent blood transfusions or who have significant bleeding (200 mL/h for 2 to 4 hours or more than 1500 mL on initial tube insertion)or when there are injuries to major cardiovascular structures.

Question 10

Patients immobilized because of spinal trauma are at a high risk for contractures.The nursing management plan for these patients should include which preventive measures?

Accepted Answer

Physical therapy and occupational therapy personnel should be consulted early in the patient's course.Range-of-motion exercises are initiated as soon as the spine has been stabilized.Footdrop splints should be applied on admission to prevent contractures and prevent skin breakdown of the heels.Hand splints should be applied for patients with quadriplegia.Hand and foot splints should be removed every 2 hours.

Quiz 33: Trauma