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TCRN EXAM REVIEW EXAM WITH VERIFIED 100% QUESTIONS AND CORRECT ANSWERS RATED A+ ()

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TCRN EXAM REVIEW EXAM WITH VERIFIED 100% QUESTIONS AND CORRECT ANSWERS RATED A+ (2024- 2025) Circumfrential burns - ANS-Full-thickness burns result in the formation of an eschar that is tough and unyielding. Hydrofluoric acid - ANS-Chemical that pulls calcium out of the bone Requires fre...

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  • August 1, 2024
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  • 2024/2025
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TCRN EXAM REVIEW EXAM WITH
VERIFIED 100% QUESTIONS AND
CORRECT ANSWERS RATED A+ (2024-
2025)




Circumfrential burns - ANS-Full-thickness burns result in the formation of an eschar that is tough and
unyielding.

Hydrofluoric acid - ANS-Chemical that pulls calcium out of the bone



Requires frequent irrigation at burn site and calcium replacement as needed



Tar/Asphalt treatment - ANS-Immediately cool with cold water



Remove with fat emmolient (Mayo, mineral oil, butter soaked gauze)



Treat like any other thermal burn when removed



Hydrocarbon burns (Gasoline, butane) - ANS-Skin will be red and blistered

,Often results in respiratory failure as vapors line the airways



Can result in eventual hepatic toxicity



*think kids in trauma bay with butane torch

Can cause a burn compartment syndrome, and often requires escharotomy



Shock - ANS-Systemic reaction to insult that causes decreased oxygen delivery to the cells



4 Classifications of Shock - ANS-1. Hypovolemic

2. Distributive

3. Cardiogenic

4. Obstruction



Hypovolemic Shock - ANS-Low blood volume results in altered perfusion (Ex: Hemorrhage, third spacing)



Distributive Shock - ANS-Severe vasodilation with normal blood volume results in altered perfusion (Ex:
Sepsis, anaphylaxis, neurogenic)



Cardiogenic Shock - ANS-Altered cardiac function results in reduced perfusion (Ex: Blunt chest injury,
CHF)



Obstructive Shock - ANS-Blockage in the system causes altered perfusion (Ex: PE, high PEEP, tension
pneumothorax)



Alpha Receptors - ANS-Activated by sympathetic nervous system, causing:

Vasoconstriction

Glycogenolysis

Diaphoresis

,Glycogenolysis - ANS-Breakdown of glucose stores in the liver to provide increased circulating glucose,
stimulated by Alpha receptors



Beta 1 Receptors - ANS-*Think: 1 heart

Cause increased heart rate and contractility



Beta 2 receptors - ANS-*Think: 2 lungs



Cause bronchodilation and increased respiratory rate



RAAS System - ANS-Increases resorption of sodium and water in the kidneys to increase vascular
volume, decreasing urine output



3 hr. Sepsis Bundle - ANS-Lactic level

Blood cultures before antibiotics

Broad spectrum antibiotics

30 ml/kg fluid bolus for hypotension



6 hr. Sepsis Bundle - ANS-Repeat lactic

Start pressors if fluid bolus ineffective

Gain central access for pressors



Symptoms of Early Shock - ANS-Normotensive with NARROWING pulse pressure

Tachycardia

Weak and thready pulse

Tachypnea with DEEP respirations

Normal lactic

Cool and clammy

Anxiety, impending doom

, Decreased urine output



Symptoms of Late Shock - ANS-Hypotension

Tachycardia

Tachypnea with shallow respirations

Elevated lactic

Cool, clammy, and mottled skin

Confusion, decreased LOC

SUPER decreased to no urine output



Stages of Shock - ANS-1. Early (Compensatory)

2. Late (Decompensated)

3. Irreversible



Irreversible Shock Symptoms - ANS-MODS

Severe acidosis

Obtunded

Cardiac arrest



Trauma Triad of Death - ANS-Hypothermia

Acidosis

Coagulopathy



Symptoms of Hypothermia - ANS-Decreased cardiac output and HR (reduced perfusion)

Vasoconstriction

Depressed CNS

Bleeding due to decreased coagulation



Symptoms of acidosis - ANS-Decreased myocardial contractility

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