Abdominal Trauma Flashcards

A patient with splenic laceration is being managed non-operatively. Which vital sign trend is the most critical indicator requiring reassessment for operative intervention?

Answer: Persistent tachycardia above 100 bpm despite 2L crystalloid

Persistent tachycardia despite adequate fluid resuscitation indicates ongoing hemorrhage and failure of non-operative management, requiring surgical intervention.

In the TNCC framework, which finding on abdominal inspection is considered a high-priority finding suggesting serious intra-abdominal injury?

Answer: Mild periumbilical ecchymosis appearing 6 hours post-injury

Cullen's sign (periumbilical ecchymosis) indicates retroperitoneal hemorrhage tracking to the umbilicus, suggesting significant intra-abdominal injury; its presence within hours is a serious finding.

When performing the abdominal assessment in the TNCC primary survey, auscultation is performed before palpation because:

Answer: Palpation may stimulate bowel sounds and falsely alter auscultation findings

Palpation can artificially stimulate or suppress bowel sounds, so auscultation must precede palpation to obtain accurate bowel sound assessment.

A patient with abdominal trauma has Grey Turner's sign. This finding is associated with:

Answer: Retroperitoneal hemorrhage tracking to the flank

Grey Turner's sign is flank ecchymosis caused by retroperitoneal blood dissecting through fascial planes to the flank region.

Which of the following is the most appropriate fluid resuscitation strategy for a hemodynamically unstable patient with suspected massive intra-abdominal hemorrhage?

Answer: Permissive hypotension with damage control resuscitation using blood products

Damage control resuscitation with permissive hypotension (target SBP 80–90 mmHg) and balanced blood product transfusion prevents dilutional coagulopathy and reduces ongoing hemorrhage.

A patient with a grade III liver laceration is being monitored in the ICU. Which complication, specific to liver injury, must the trauma nurse monitor for in the first 72 hours?

Answer: Delayed bile leak or biloma formation

Bile leaks and biloma formation are delayed complications of liver lacerations, typically presenting 48–72 hours post-injury with rising abdominal pain, fever, and elevated bilirubin.

In a child with blunt abdominal trauma, which organ is most commonly injured, and why is it at greater risk compared to adults?

Answer: Spleen, because the pediatric spleen is proportionally larger and the rib cage is more pliable

The spleen is the most commonly injured solid organ in pediatric abdominal trauma because it is relatively larger and the flexible rib cage provides less protection than in adults.