Abd Trauma

Abd/Chest Trauma

Match

Match the following

• Cullen's Sign

• Grey Turner's Sign

• Kehr’s Sign

blue discoloration at umbilicus

flank ecchymosis

Left Shoulder Pain

• blue discoloration at umbilicus

• flank ecchymosis

• Left Shoulder Pain

Multiple Choice

Which of the following is the most commonly injured organ in blunt abdominal trauma?

• Pancreas
• Kidney
• Spleen
• Liver

Multiple Choice

A patient with a suspected bowel perforation has sudden severe abdominal pain, a rigid abdomen, and rebound tenderness. What is the nurse’s priority action?

• Administer IV Fluids and broad spectrum antibiotics

• Prepare the patient for emergent surgery

• Perform Abdominal ultrasound to confirm diagnosis

• Insert NG tube to decompress the stomach

Multiple Choice

A patient with a liver laceration following a blunt trauma is hemodynamically stable but has a persistently elevated international normalized ratio (INR) despite initial fluid resuscitation and blood transfusion. What is the nurse’s priority intervention?

• Administer vitamin K and monitor coagulation studies.

• Notify the healthcare provider to prepare for surgery.

• Continue to monitor vital signs and fluid balance.

• Administer a vasopressor to maintain blood pressure.

Multiple Choice

A patient presents with referred pain to the left shoulder and ecchymosis in the left flank. Based on these findings, what is the most likely injury?

• Pancreatic Injury

• Kidney Laceration

• Ruptured Spleen

• Bowel Perforation

Word Cloud

What additional signs would confirm your suspicion of a ruptured spleen?

Multiple Choice

A patient involved in an MVC is suspected of having a diaphragm rupture. Which assessment finding supports this diagnosis?

• Absent bowel sounds in the abdomen.

• Diminished breath sounds on the left with bowel sounds heard in the chest.

• Distended abdomen with dullness to percussion.

• Referred pain to the right shoulder.

Multiple Choice

Which of the following hemodynamic changes would you expect in hypovolemic shock?

• ↑ CVP, ↑ CO, ↓ SVR

• ↓ CVP, ↑ CO, ↑ SVR

• ↑ CVP, ↑ CO, ↑ SVR

• ↓ CVP, ↓ CO, ↑ SVR

Multiple Choice

A patient with abdominal trauma develops worsening hypotension, metabolic acidosis, and coagulopathy despite fluid resuscitation and transfusions. What is the most critical next step?

• Continue fluid resuscitation and monitor lactate levels.

• Administer vasopressors to maintain blood pressure.

• Initiate warming measures and administer clotting factors.

• Perform abdominal decompression immediately.

Multiple Choice

A patient post-trauma shows elevated lactate, prolonged PT/INR, and signs of organ dysfunction. Which intervention should the nurse prioritize to prevent progression to sepsis?

• Administer broad-spectrum antibiotics and begin fluid resuscitation.

• Transfer the patient for immediate surgical exploration.

• Monitor coagulation studies and provide supportive care.

• Insert a central line for vasopressor administration.

Multiple Choice

A client involved in a high-speed collision presents with bright red blood at the urethral meatus. What is your immediate action?

• Insert a Foley catheter.

• Notify physician

• Observe the site for additional bleeding or tissue damage.

• Collect a urine sample for analysis.

Multiple Choice

A patient with suspected renal trauma presents with flank pain and gross hematuria following a fall from a significant height. What is the priority intervention?

• Prepare for a CT scan with IV contrast to assess for renal damage

• Insert a Foley catheter to monitor urinary output.

• Administer IV fluids to maintain blood pressure.

• Prepare the patient for emergent surgical exploration.

Multiple Choice

A patient with an open-book pelvic fracture is hemodynamically unstable despite fluid resuscitation. What is the next appropriate step?

• Apply a pelvic binder to stabilize the fracture and reduce bleeding.

• Perform a retrograde urethrogram to assess for urethral injury.

• Insert a suprapubic catheter to drain the bladder.

• Administer vasopressors to maintain mean arterial pressure.

Multiple Choice

A trauma patient with severe hypovolemia has the following hemodynamic readings: CVP 1 mmHg, CO 3 L/min, SVR 1800 dynes/sec/cm⁵. What intervention should the nurse anticipate?

• Administer diuretics to manage fluid overload.

• Begin vasopressor therapy to improve SVR.

• Prepare for emergent dialysis to address acidosis.

• Administer isotonic fluids to increase preload.

Multiple Choice

A patient with blunt abdominal trauma has a MAP of 60 mmHg, lactate level of 4 mmol/L, and ongoing tachycardia. Which nursing intervention takes prio

• Administer a fluid bolus to improve MAP.

• Notify the provider to schedule a CT scan.

• Prepare the patient for immediate surgical intervention.

• Start broad-spectrum antibiotics to prevent infection.

Multiple Choice

A patient presents with gross hematuria and reports flank pain after a motor vehicle accident. Imaging confirms a grade II renal laceration. What intervention should the nurse expect?

• Emergent surgical repair to control bleeding.

• Bed rest with serial monitoring of hemoglobin and hematocrit.

• Administration of IV antibiotics to prevent infection.

• Placement of a nephrostomy tube to relieve pressure.

Multiple Choice

What clinical finding strongly suggests tension pneumothorax?

• Hypotension and tracheal deviation

• Chest pain and bradycardia

• Widened pulse pressure

• Dullness to percussion.

Multiple Choice

Which finding is most concerning for a patient with suspected cardiac tamponade?

• Jugular venous distension while lying flat

• Oxygen saturation of 92% on room air

• Respiratory rate of 22 breaths per minute

• Hypotension with narrow pulse pressure

Multiple Choice

What action should the nurse take if the chest tube becomes disconnected?

• Clamp the chest tube and call for help.

• Place the end in sterile water to maintain the seal.

• Reconnect the tube without cleaning it.

• Remove the chest tube entirely.

Multiple Choice

What is the nurse’s priority if the drainage system is knocked over?

• Document the incident and monitor the patient.

• Reposition the system upright and continue monitoring.

• Replace the system and reattach the chest tube.

• Disconnect the system and apply an occlusive dressing.

Multiple Choice

What should the nurse monitor to ensure the chest tube is functioning correctly?

• The fluctuation in the water seal chamber with respiration.

• Continuous bubbling in the suction control chamber.

• The absence of drainage in the collection chamber.

• The patient's ability to perform deep breathing exercises.

Multiple Choice

A patient with blunt chest trauma presents with a MAP of 55 mmHg, absent breath sounds on the right, and tracheal deviation to the left. What is the nurse’s priority action?

• Notify the provider to prepare for chest tube placement.

• Administer 100% oxygen and prepare for needle decompression.

• Obtain a chest X-ray to confirm the diagnosis.

• Begin fluid resuscitation for suspected hypovolemic shock.

Multiple Choice

A patient with chest trauma exhibits hypotension, muffled heart sounds, and jugular venous distension. What is the nurse’s priority?

• Administer IV fluids to improve preload.

• Apply a cardiac monitor and assess for dysrhythmias.

• Place the patient in a high Fowler’s position.

• Notify the provider and prepare for pericardiocentesis.

Multiple Choice

A patient involved in a high-speed MVC presents with unequal blood pressures in the upper extremities and a widened mediastinum on chest X-ray. What is the nurse’s priority?

• Administer oxygen and prepare for surgery.

• Notify the provider and initiate fluid resuscitation.

• Place the patient supine to reduce strain on the aorta.

• Monitor vital signs and observe for deterioration.

Multiple Choice

A patient with flail chest develops worsening hypoxia despite high-flow oxygen. What intervention should the nurse anticipate?

• Administration of bronchodilators.

• Placement of a chest tube.

• Intubation and mechanical ventilation.

• Needle decompression.

Multiple Choice

A patient with multiple rib fractures is reluctant to breathe deeply due to pain. What is the nurse’s best intervention to prevent complications?

• Prepare the patient for emergent intubation.

• Administer prescribed analgesics and encourage incentive spirometry

• Apply a chest binder to stabilize the rib fractures.

• Reposition the patient in high Fowler’s position.

Multiple Choice

A patient’s chest tube drainage suddenly stops, and the nurse notices absent fluctuation in the water seal chamber. What is the nurse’s priority action?

• Clamp the chest tube to assess patency.

• Check for kinks or clots in the tubing.

• Notify the provider for possible tube removal.

• Increase suction to restore drainage.

Multiple Choice

A patient with a chest tube complains of sudden chest pain and dyspnea. On assessment, the nurse finds continuous bubbling in the water seal chamber. What is the nurse’s best action?

• Clamp the chest tube and call the provider.

• Reinforce the dressing and monitor the patient.

• Check for an air leak and tighten connections.

• Increase suction to resolve the bubbling.

Word Cloud

What part of the material for next week's exam are you the most worried about?

Questions??

Understanding this material is a bit like dating. If you don’t ask the right questions, you’ll never know if you’re heading for something amazing or a complete disaster. So keep asking, stay curious, and remember—we’re all just trying to keep things from crashing and burning (or bubbling and leaking!).