TNCC Notes for Written Exam 2022
What is kinematics? - A branch of mechanics (energy transfer) that refers to
motion and does not consider the concepts of force and mass of the object or
body.
What is Newton's First Law? - A body at rest will remain at rest. A body in
motion will remain in motion until acted on by an outside force.
What is the Law of Conservation of Energy? - Energy can neither be
created nor destroyed. It is only changed from one form to another.
What is Newton's Second Law? - Force equals mass multiplied by
acceleration of deceleration.
What is kinetic energy (KE)? - KE equals 1/2 the mass (M) multiplied by the
velocity squared.
What is the Mnemonic for the Initial Assessment? - A = Airway with
simultaneous cervical spine protection
B=
Breathing C
= Circulation
D = Disability (neurologic status)
E = Expose/Environmental controls (remove clothing and keep the patient
warm)
What is the Mnemonic for the Secondary Assessment? - F = Full set of
VS/Focused adjuncts (includes cardiac monitor, urinary catheter, and
gastric tube)/Family presence G = Give comfort measures (verbal
reassurance, touch, and pharmacologic and nonpharmacologic
management of pain).
H = Hx and Head-to-toe
assessment I = Inspect
posterior surfaces
Where do you listen to auscultate breath sounds? - Auscultate the lungs
bilaterally at the second intercostal space midclavicular line and at the
fifth intercostal space at the anterior axillary line.
What are the late signs of breathing compromise? - - Tracheal deviation
- JVD
What are signs of ineffective breathing? - - AMS
- Cyanosis, especially around the mouth
- Asymmetric expansion of chest wall
- Paradoxical movement of the chest wall during inspiration and expiration
- Use of accessory muscles or abdominal muscles or both or diaphragmatic
,breathing
- Sucking chest wounds
, - Absent or diminished breath sounds
- Administer O2 via NRB or assist ventilations with a bag-mask device, as
indicated
- Anticipate definitive airway management to support ventilation.
Upon initial assessment, what type of oxygen should be used for a pt
breathing effectively? - A tight-fitting nonrebreather mask at 12-15 lpm.
What intervention should be done if a pt presents with effective
circulation? - - Insert 2 large caliber IV's
- Administer warmed isotonic crystalloid solution at an appropriate rate
What are signs of ineffective circulation? - - Tachycardia
- AMS
- Uncontrolled external bleeding
- Pale, cool, moist skin
- Distended or abnormally flattened external jugular veins
- Distant heart sounds
What are the interventions for Effective/Ineffective Circulation? - -
Control any uncontrolled external bleeding by:
- Applying direct pressure over bleeding site
- Elevating bleeding extremity
- Applying pressure over arterial pressure points
- Using tourniquet (last resort).
- Cannulate 2 large-caliber IV's and initiate infusions of an isotonic crystalloid
solution
- Use warmed solution
- Use pressure bags to increase speed of IVF infusion
- Use blood administration tubing for possible administration of blood
- Use rapid infusion device based on protocol
- Use NS 0.9% in same tubing as blood product
- IV = surgical cut-down, central line, or both.
- Blood sample to determine ABO and Rh group
- IO in sternum, legs, arms or pelvis
- Administer blood products
- PASG (without interfering with fluid resuscitation)
How do you assess Mnemonic "D"? -
DISABILITY A = Alert
V=
Verbal P
= Pain
U = Unresponsive
- GCS
- PERRL?
- Determine presence of lateralizing signs including:
- Unilateral deterioration in motor movements or unequal pupils
- Symptoms that help to locate area of injury in brain
What is kinematics? - A branch of mechanics (energy transfer) that refers to
motion and does not consider the concepts of force and mass of the object or
body.
What is Newton's First Law? - A body at rest will remain at rest. A body in
motion will remain in motion until acted on by an outside force.
What is the Law of Conservation of Energy? - Energy can neither be
created nor destroyed. It is only changed from one form to another.
What is Newton's Second Law? - Force equals mass multiplied by
acceleration of deceleration.
What is kinetic energy (KE)? - KE equals 1/2 the mass (M) multiplied by the
velocity squared.
What is the Mnemonic for the Initial Assessment? - A = Airway with
simultaneous cervical spine protection
B=
Breathing C
= Circulation
D = Disability (neurologic status)
E = Expose/Environmental controls (remove clothing and keep the patient
warm)
What is the Mnemonic for the Secondary Assessment? - F = Full set of
VS/Focused adjuncts (includes cardiac monitor, urinary catheter, and
gastric tube)/Family presence G = Give comfort measures (verbal
reassurance, touch, and pharmacologic and nonpharmacologic
management of pain).
H = Hx and Head-to-toe
assessment I = Inspect
posterior surfaces
Where do you listen to auscultate breath sounds? - Auscultate the lungs
bilaterally at the second intercostal space midclavicular line and at the
fifth intercostal space at the anterior axillary line.
What are the late signs of breathing compromise? - - Tracheal deviation
- JVD
What are signs of ineffective breathing? - - AMS
- Cyanosis, especially around the mouth
- Asymmetric expansion of chest wall
- Paradoxical movement of the chest wall during inspiration and expiration
- Use of accessory muscles or abdominal muscles or both or diaphragmatic
,breathing
- Sucking chest wounds
, - Absent or diminished breath sounds
- Administer O2 via NRB or assist ventilations with a bag-mask device, as
indicated
- Anticipate definitive airway management to support ventilation.
Upon initial assessment, what type of oxygen should be used for a pt
breathing effectively? - A tight-fitting nonrebreather mask at 12-15 lpm.
What intervention should be done if a pt presents with effective
circulation? - - Insert 2 large caliber IV's
- Administer warmed isotonic crystalloid solution at an appropriate rate
What are signs of ineffective circulation? - - Tachycardia
- AMS
- Uncontrolled external bleeding
- Pale, cool, moist skin
- Distended or abnormally flattened external jugular veins
- Distant heart sounds
What are the interventions for Effective/Ineffective Circulation? - -
Control any uncontrolled external bleeding by:
- Applying direct pressure over bleeding site
- Elevating bleeding extremity
- Applying pressure over arterial pressure points
- Using tourniquet (last resort).
- Cannulate 2 large-caliber IV's and initiate infusions of an isotonic crystalloid
solution
- Use warmed solution
- Use pressure bags to increase speed of IVF infusion
- Use blood administration tubing for possible administration of blood
- Use rapid infusion device based on protocol
- Use NS 0.9% in same tubing as blood product
- IV = surgical cut-down, central line, or both.
- Blood sample to determine ABO and Rh group
- IO in sternum, legs, arms or pelvis
- Administer blood products
- PASG (without interfering with fluid resuscitation)
How do you assess Mnemonic "D"? -
DISABILITY A = Alert
V=
Verbal P
= Pain
U = Unresponsive
- GCS
- PERRL?
- Determine presence of lateralizing signs including:
- Unilateral deterioration in motor movements or unequal pupils
- Symptoms that help to locate area of injury in brain
