NSG-430 Exam 3 Latest Update 2024-2025 Actual
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abdominal injury - CORRECT ANSWER: Blunt Injuries:
-Compression forces from seat belts, steering wheel can cause rupture of hollow organs
and capsules of solid organs
-Deceleration forces can tear organs from the peritoneum or blood vessels
-Symptoms may be subtle
Penetrating Injuries:
-Stab wounds 3x more likely than gunshot wounds
-Liver, bowel, and diaphragm most commonly injured
Abdominal Compartment Syndrome:
-Hypertension of the abdomen
-Bleeding, fluid cause increased pressure which decreases perfusion to the organs
-Leads to decreased CO, abdominal organ failure
Iceberg Effect:
-Minimal external signs, symptoms, cues
-Major internal organ damage and bleeding
,Symptoms:
-VS changes indicating development of hypovolemic shock:
•Hypotension, tachycardia, pale cool extremities, low urine output
-Assess for:
•Guarding, splinting
•Hard, distended abdomen
•Hypoactive or absent bowel sounds
•Pain
•Hematemesis
•Hematuria
•Bruits on auscultation: turbulent flow, damaged vessels
Hepatic Injury:
-5% of all admissions to ER
-Graded by severity: 1-6, laceration to avulsion
-Profuse bleeding
-Right upper quadrant pain
-Hypoactive or absent bowel sounds
-Hypovolemic shock
-May require surgical intervention
Splenic Injury:
-Most common from blunt trauma: 49% of all blunt injuries
-Graded by severity: 1-5, laceration to shattered spleen
-Signs of hypovolemic shock
-Kehr's sign: pain in left shoulder
-Rigidity and guarding
,-Bedrest if hemodynamically stable
-May require surgical intervention
Bowel Injuries:
-Small bowel injury most common
-Blunt and penetrating trauma
-Shearing injury may cause avulsion of small bowel
-Compression may cause rupture
-Hypovolemic shock
-Bleeding from rectum
-Abdominal wall rigidity, guarding, pain
Esophageal Injuri
abdominal trauma - CORRECT ANSWER: -3rd leading cause of traumatic death after
head and chest injuries
-Blunt injuries more deadly than penetrating
-25% require surgical intervention
-Motor vehicle crashes most common type of blunt injury
-Stab wounds and gunshots are most common penetrating injuries
-Largest hollow space in the body, separated from the thoracic cavity by the diaphragm
-Contains digestive tract, stomach, liver, pancreas, spleen, kidneys and adrenal glands,
bladder
-Entire cavity is lined with peritoneum
acute low back pain - CORRECT ANSWER: -Low back pain is common and has
affected about 80% of adults in the United States at least once during their lives.
-Backache is second only to headache as the most common pain complaint.
-Low back pain is the leading cause of job-related disability, and a major contributor to
missed work days.
, -Most concern about cervical spinal injuries
Etiology and Pathophysiology:
-Low back pain is most often due to a musculoskeletal problem.
-It may be experienced as localized or diffuse.
-In localized pain patients will feel soreness or discomfort when a specific area of the
lower back is palpated or pressed.
-Diffuse pain occurs over a larger area and comes from deep tissue layers.
-Low back pain may be radicular or referred.
-Radicular pain is caused by irritation of a nerve root.
-Radicular pain is not typically isolated to a single location, but instead radiates or
moves along a nerve distribution. -Sciatica is an example of radicular pain.
-Referred pain is "felt" or perceived in the lower back, but the source of the pain is
another location (e.g., kidneys, lower abdomen).
-Low back pain is a common problem because the lumbar region (1) bears most of the
weight of the body, (2) is the most flexible region of the spinal column, (3) contains
nerve roots that are at risk for injury or disease, and (4) has a naturally poor
biomechanical structure.
Risk Factors:
-Lack of muscle tone
-Excess body weight
-Pregnancy
-Stress
-Poor posture
-Cigarette smoking
-Prior compression fractures of the spine
-Congenital spinal problems
-Family history of back pain
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