LA 2

Question 1

What is the purpose of a “drug holiday” with clients who are taking narcotics on a long-term basis?

Answer 1

With narcotics, especially stronger agents, that are used long-term (e.g., ms contin, transdermyl fentanyl), a 3-day drug holiday (or as ordered by the physician) every month has shown evidence of increasing the sensitivity of the client to specific narcotics, as now the receptors have also become more sensitive.

Question 2

true or false and explain your answer:

Cancer clients should never receive strong narcotics at the beginning of any pain experience because of the fear of addiction

Answer 2

False. With cancer pain, a client’s quality of life is far more important than the fear of addiction. Clients who are living with cancer need to experience comfort and maintain quality of life as much as possible. Addiction should not even be a concern for these clients because quality of life is so important for those afflicted with the illness.

Question 3

You administer 100 mg meperidine (Demerol) intramuscularly to a client in severe post-operative pain, as ordered. What assessment data should be gathered before and after administering this drug? Explain your answer.

Answer 3

The nurse should always assess the client’s blood pressure, pulse, and respirations before administering any narcotic or, in this situation, meperidine. This allows comparison of baseline vital signs to those taken after the drug has been administered, as well as the assessment of the effect of the drug on the physiological response to pain.

Question 4

Your client complains that the drugs he is receiving for severe pain are really not helping. What should be the most appropriate response to this client?

Answer 4

• First, it is important to assess the client and his or her previous reactions to pain medications and then assess the dose, action, route, and appropriateness of the agent.
• The client’s medical history, nursing assessment, and medication history should also be studied carefully because the client’s diagnosis may not match up with the type of analgesic ordered.
• Once it has been determined that the client is getting the right medication and dosage, then education about pain management
• The nurse should administer the medication at regular intervals, as ordered
• The nurse should also always include non-pharmacological methods of pain management

Question 5

Compare and contrast the effectiveness of oral, intramuscular, and transdermal routes for narcotic administration, considering ease of self-preparation and administration, onset of therapeutic serum concentrations, degree of sedation, side effects, and ease of management in the home setting.

Ease of self-preparation:
Oral:

Answer 5

Very easy if alert; easy to teach others.

Question 6

Compare and contrast the effectiveness of oral, intramuscular, and transdermal routes for narcotic administration, considering ease of self-preparation and administration, onset of therapeutic serum concentrations, degree of sedation, side effects, and ease of management in the home setting.

Ease of self-preparation:
IM:

Answer 6

Not easy to carry out on own; would need assistance from healthcare personnel or other trained person

Question 7

Compare and contrast the effectiveness of oral, intramuscular, and transdermal routes for narcotic administration, considering ease of self-preparation and administration, onset of therapeutic serum concentrations, degree of sedation, side effects, and ease of management in the home setting.

Ease of self-preparation:
Transdermal

Answer 7

Easy to learn to use and easy to teach to others.

Question 8

Compare and contrast the effectiveness of oral, intramuscular, and transdermal routes for narcotic administration, considering ease of self-preparation and administration, onset of therapeutic serum concentrations, degree of sedation, side effects, and ease of management in the home setting.

Ease of administration:
Oral:

Answer 8

Very easy if alert; easy to teach others.

Question 9

Compare and contrast the effectiveness of oral, intramuscular, and transdermal routes for narcotic administration, considering ease of self-preparation and administration, onset of therapeutic serum concentrations, degree of sedation, side effects, and ease of management in the home setting.

Ease of administration:
IM:

Answer 9

Easy to administer medication by this route if qualified healthcare provider is there to assist

Question 10

Compare and contrast the effectiveness of oral, intramuscular, and transdermal routes for narcotic administration, considering ease of self-preparation and administration, onset of therapeutic serum concentrations, degree of sedation, side effects, and ease of management in the home setting.

Ease of administration:
Transdermal

Answer 10

Easy to administer and learn how to apply. Very easy to instruct on application and administration of patch.

Question 11

Compare and contrast the effectiveness of oral, intramuscular, and transdermal routes for narcotic administration, considering ease of self-preparation and administration, onset of therapeutic serum concentrations, degree of sedation, side effects, and ease of management in the home setting.

Onset of therapeutic effects:
Oral:

Answer 11

Varies depending on specific drug properties and chemical composition of the oral drug; some very predictable and some very unpredictable. Generally speaking, 45 minutes to 1 hour for onset of effects. Remember that some drugs with longer half-lives may take weeks to have therapeutic effects

Question 12

Compare and contrast the effectiveness of oral, intramuscular, and transdermal routes for narcotic administration, considering ease of self-preparation and administration, onset of therapeutic serum concentrations, degree of sedation, side effects, and ease of management in the home setting

Onset of therapeutic effects:
IM

Answer 12

Generally dependable; onset of therapeutic effects within at least 15 to 30 minutes

Question 13

Compare and contrast the effectiveness of oral, intramuscular, and transdermal routes for narcotic administration, considering ease of self-preparation and administration, onset of therapeutic serum concentrations, degree of sedation, side effects, and ease of management in the home setting.

Onset of therapeutic effects:
Transdermal

Answer 13

Dependable onset but is variable in some of the pharmacokinetics until serum steady states are achieved because of the nature of topical absorption into systemic circulation. However, once used for a few days, transdermal patches are very effective in their onset of therapeutic effects.

Question 14

Compare and contrast the effectiveness of oral, intramuscular, and transdermal routes for narcotic administration, considering ease of self-preparation and administration, onset of therapeutic serum concentrations, degree of sedation, side effects, and ease of management in the home setting.

Serum concentrations:
Oral

Answer 14

Serum concentrations are dependent on the drug, its properties, chemical composition and dosage form (i.e., if enteric-coated. If the oral drug is taken at regular intervals, it may achieve adequate serum concentrations; however, many physiological factors provide barriers to predictable concentrations of the drug in the serum.

Question 15

Compare and contrast the effectiveness of oral, intramuscular, and transdermal routes for narcotic administration, considering ease of self-preparation and administration, onset of therapeutic serum concentrations, degree of sedation, side effects, and ease of management in the home setting.

Serum concentrations:
IM

Answer 15

Very effective serum concentrations.

Question 16

Compare and contrast the effectiveness of oral, intramuscular, and transdermal routes for narcotic administration, considering ease of self-preparation and administration, onset of therapeutic serum concentrations, degree of sedation, side effects, and ease of management in the home setting.

Serum concentrations:
Transdermal

Answer 16

Very effective serum concentrations that remain fairly predictable with routine usage and application.

Question 17

Compare and contrast the effectiveness of oral, intramuscular, and transdermal routes for narcotic administration, considering ease of self-preparation and administration, onset of therapeutic serum concentrations, degree of sedation, side effects, and ease of management in the home setting.

Degree of sedation:
Oral:

Answer 17

Degree of sedation is dependent on dosage of drug and the potency of the drug. Medications such as morphine and other opioid derivatives are very sedating, but again, level of sedation depends on dose and other variables.

Question 18

Compare and contrast the effectiveness of oral, intramuscular, and transdermal routes for narcotic administration, considering ease of self-preparation and administration, onset of therapeutic serum concentrations, degree of sedation, side effects, and ease of management in the home setting.

Degree of sedation:
IM

Answer 18

: Once again, the degree of sedation depends on drug and dosage, but because systemic absorption is more rapid, there are more CNS-depressing effects, and thus more CNS sedation

Question 19

Compare and contrast the effectiveness of oral, intramuscular, and transdermal routes for narcotic administration, considering ease of self-preparation and administration, onset of therapeutic serum concentrations, degree of sedation, side effects, and ease of management in the home setting.

Degree of sedation:
Transdermal

Answer 19

CNS sedation depends on drug patch and dosage. Often the client builds up some resistance to the sedation, but this is generally seen with lower dosage forms of the patch.

Question 20

Compare and contrast the effectiveness of oral, intramuscular, and transdermal routes for narcotic administration, considering ease of self-preparation and administration, onset of therapeutic serum concentrations, degree of sedation, side effects, and ease of management in the home setting.

Side-effects:
Oral:

Answer 20

Narcotics usually have many side effects, and even more with oral dosage forms owing to gastric upset related to gastric irritation.

Question 21

Compare and contrast the effectiveness of oral, intramuscular, and transdermal routes for narcotic administration, considering ease of self-preparation and administration, onset of therapeutic serum concentrations, degree of sedation, side effects, and ease of management in the home setting.

Side-effects:
IM

Answer 21

Side effects depend on drug and dosage but with IM route, the effects are generally more profound because of increased absorption. Therefore, the side effects related to CNS depression, such as sedation and decreased vital signs, are more often associated with these dosage forms.

Question 22

Compare and contrast the effectiveness of oral, intramuscular, and transdermal routes for narcotic administration, considering ease of self-preparation and administration, onset of therapeutic serum concentrations, degree of sedation, side effects, and ease of management in the home setting.

Side-effects:
•Transdermal

Answer 22

Side effects are very likely to occur with transdermal patches once the steady state of the drug is achieved. Because of steady absorption with consistent dosing, the side effects will depend on the dosage and drug.

Question 23

Compare and contrast the effectiveness of oral, intramuscular, and transdermal routes for narcotic administration, considering ease of self-preparation and administration, onset of therapeutic serum concentrations, degree of sedation, side effects, and ease of management in the home setting.

Ease of home management:
Oral

Answer 23

Very easy.

Question 24

Compare and contrast the effectiveness of oral, intramuscular, and transdermal routes for narcotic administration, considering ease of self-preparation and administration, onset of therapeutic serum concentrations, degree of sedation, side effects, and ease of management in the home setting.

Ease of home management:
IM

Answer 24

Not easy without medical or nursing assistance.

Question 25

Compare and contrast the effectiveness of oral, intramuscular, and transdermal routes for narcotic administration, considering ease of self-preparation and administration, onset of therapeutic serum concentrations, degree of sedation, side effects, and ease of management in the home setting. Ease of home management: Transdermal

Answer 25

Very easy.

Question 26

When is spinal anesthesia the method of choice?

Answer 26

There are many conditions besides labour and delivery for which spinal anaesthesia would be indicated. Conditions for which one might have a “spinal” rather than general anaesthesia include any that would be exacerbated, causing possible harm to the client—such as a client with severe respiratory or cardiac disease who could not tolerate the effects of general anaesthesia. It is important to remember that spinal anaesthesia is often used with specific types of surgeries or in clients in poor health or with conditions/diseases that would be exacerbated by general anaesthesia.

Question 27

What is the purpose of adding epinephrine to a local anesthetic?

Answer 27

Epinephrine is added to topical and local anesthetics to enhance blood vessel constriction at the area and decrease the risk of possible systemic absorption.

Question 28

What are potential complications of local anesthetics used in dental offices, such as lidocaine with epinephrine, in a client with a variety of cardiac or vessel diseases?

Answer 28

there is concern regarding the absorption of epinephrine, which could lead to blood vessel constriction and rapid elevation in blood pressure and pulse. For the “at-risk” client who might have vessel disease and weakened vessels, there is concern regarding the subsequent rupture of a vessel and cerebrovascular accident or death. Rapid acceleration of pulse rate could also be detrimental to at-risk clients because of the potential for ischemia from excessive oxygen demand oversupply

Question 29

pain that originates from organs or smooth muscles

Answer 29

visceral pain

Question 30

pain that originates from skeletal muscles, ligaments, or joints

Answer 30

somatic pain

Question 31

pain that is psychological in nature but is truly pain in terms of actual pain impulses that travel through nerve cells

Answer 31

psychogenic pain

Question 32

pain experienced in a body part that has been surgically or traumatically removed

Answer 32

phantom pain

Question 33

pain that results from a disturbance of function or pathological change in a nerve

Answer 33

neuropathic pain

Question 34

Enflurane is a(n) ______ anaesthetic.

Answer 34

inhalation general

Question 35

Halothane is a(n) ____________ anaesthetic.

Answer 35

inhalation general

Question 36

Nitrous oxide is primarily indicated for use in __________?

Answer 36

dental procedures (such as removal of “wisdom teeth”) or as a useful supplement to other, more potent anaesthetics.

Question 37

Three major complications of general anaesthesia include _____________________

Answer 37

respiratory and/or cardiac depression, cardiac and/or respiratory arrest, irregular heart rhythms, malignant hyperthermia, aspiration pneumonia, and central nervous system depression

Question 38

pain that results from any disorder that causes central nervous system damage

Answer 38

central pain

Question 39

These contraindications are for??? i) known drug allergy ii) severe asthma or other respiratory insufficiency, especially in the absence of resuscitative equipment, iii) conditions involving elevated intracranial pressure, and iv) pregnancy, especially in long-term or high doses

Answer 39

Narcotics

Question 40

An antidote to an overdose of morphine is ____________________.

Answer 40

naloxone hydrochloride

Question 41

Opioid analgesics bind to an opioid pain receptor in the brain and cause an analgesic response—the reduction of the pain sensation.

Answer 41

mechanism of action of the opiates

Question 42

What are the neurotransmitters that are produced by the body to fight pain. They bind to opioid receptors and inhibit the transmission of pain by closing the "GATE" to the pain impulse

Answer 42

Endogenous enkephalins and endorphins

Question 43

Any of a group of highly addictive analgesic drugs derived from opium or opium like compounds. Narcotics can cause drowsiness and significant alterations of mood and behavior.

Answer 43

Narcotic

Question 44

Medications that relieve pain without causing | loss of consciousness (sometimes referred to as painkillers).

Answer 44

Analgesic

Question 45

Any of various sedative narcotics containing opium or one or more of its natural or synthetic derivatives. or A drug, hormone, or other chemical substance having sedative or narcotic effects similar to those containing opium or its derivatives: a natural brain opiate. Also called opioid

Answer 45

Opiate

Question 46

Is it a narcotic and non-narcotic analgesics? -Acts centrally-

Answer 46

Narcotic Analgesics

Question 47

Is it a narcotic and non-narcotic analgesics? Does not produce CNS depression

Answer 47

Non-Narcotic Analgesics

Question 48

Is it a narcotic and non-narcotic analgesics? Cause addiction

Answer 48

Narcotic Analgesics

Question 49

Is it a narcotic and non-narcotic analgesics? Produce CNS depression

Answer 49

Narcotic Analgesics

Question 50

Is it a narcotic and non-narcotic analgesics? Do not produce gastric irritation

Answer 50

Narcotic Analgesics

Question 51

Is it a narcotic and non-narcotic analgesics? Has anti-inflammatory effect

Answer 51

Non-Narcotic Analgesics

Question 52

Is it a narcotic and non-narcotic analgesics? Act peripherally

Answer 52

Non-Narcotic Analgesics

Question 53

A synthetic analgesic drug that is used as a substitute to treat morphine and heroin addiction

Answer 53

Methadone

Question 54

pain that continues or recurs over a prolonged period, caused by various diseases or abnormal conditions. Chronic pain may be less intense than acute pain. The person with chronic pain does not usually display increased pulse and rapid respiration because these autonomic reactions to pain cannot be sustained for long periods. Some factors that can complicate the treatment of persons with chronic pain are scarring, continuing psychologic stress, and medication

Answer 54

Chronic Pain

Question 55

Acute pain is sudden and usually subsides when treated—for example, postoperative pain or the sudden onset of a headache.

Answer 55

Acute Pain

Question 56

pain anywhere in the body of unknown cause

Answer 56

Idiopathic pain

Question 57

What medications relieve pain without causing loss of consciousness?

Answer 57

“Painkillers” Opioids Nonsteroidal anti-inflammatory drugs (NSAIDs)

Question 58

Pain felt in a different are of the body

Answer 58

Referred Pian

Question 59

Persistent or recurring Lasting 6 weeks or longer Often difficult to treat

Answer 59

Persistent pain/Chronic Pain

Question 60

It uses the analogy of a gate to describe how impulses from damaged tissues are sensed in the brain Many current pain management strategies are aimed at altering this system

Answer 60

Gate Theory

Question 61

What are the four processes to the gate theory?

Answer 61

Transduction Transmission Perception Modulation

Question 62

What are the two types of nerves stimulated?

Answer 62

A fibres | C fibres

Question 63

real pain of psychological orgin eg. Fibromyalgia, chest pain from anxiety

Answer 63

Psychogenic Pain

Question 64

Pain felt from touching a hot stove

Answer 64

superficial pain

Question 65

The amount of pain a patient can endure without its interfering with normal function

Answer 65

Pain tolerance

Question 66

The level of stimulus needed to PRODUCE THE PERCEPTION OF PAIN

Answer 66

Pain Threshold

Question 67

What are the two endogenous neurotransmitters the body produces in pain modulation?

Answer 67

Endorphins & Enkephalins

Question 68

In pain modulation, rubbing or applying liniment to a painful area stimulates the?

Answer 68

large sensory fibres

Question 69

Pain relievers that contain opium, derived from the opium poppy or chemically related to opium:

Answer 69

Opioid Analgesics

Question 70

What are the three Chemical Classification of Opioids

Answer 70

Meperidine-like drugs Methadone-like drugs Morphine-Like drugs

Question 71

What are the actions based on the three classifications?

Answer 71

Agonist- cause analgesic response Partial agonist Antagonist

Question 72

Often given with adjuvant analgesic drugs to assist the primary drugs with pain relief NSAIDS AND CORTISONES reduce

Answer 72

INFLAMMATION

Question 73

Often given with adjuvant analgesic drugs to assist the primary drugs with pain relief Antidepressants and Anticonvulsants

Answer 73

Are used for NERVE PAIN

Question 74

What kind of drug can be used for Cough centre suppression,Treatment of diarrhea (causes constipation), & Procedural pain during surgery as an adjunct to anaesthesia

Answer 74

Opioids

Question 75

What are some contraindications to opioid use?

Answer 75

Known drug allergy Severe asthma or other respiratory insufficiency Elevated intracranial pressure Pregnancy

Question 76

Hypotension, palpitations, flushing Sedation, disorientation, euphoria, lightheadedness, dysphoria, lowered seizure threshold, tremors Nausea, vomiting, constipation, biliary tract spasm Urinary retention Itching, rash, wheal formation **Respiratory depression and aggravation of asthma**

Answer 76

ADVERSE

Question 77

What is the most common Opiate Antagonists?

Answer 77

Naloxone (Narcan) Used for complete or partial reversal of opioid-induced respiratory depression

Question 78

What is a common physiological result of chronic opioid treatment?

Answer 78

Opioid tolerance

Question 79

Definition The physiological adaptation of the body to the presence of an opioid

Answer 79

Physical Dependence

Question 80

Definition A pattern of compulsive drug use characterized by a continued craving for an opioid and the need to use the opioid for effects other than pain relief

Answer 80

Psychological Dependence

Question 81

What is expected with long-term opioid treatment and should not be confused with psychological dependence (addiction)?

Answer 81

Opioid tolerance and physical dependence Misunderstanding of these terms leads to ineffective pain management and contributes to the problem of undertreatment

Question 82

What occurs when opioid are abruptly discontinued or when an opioid antagonist is administered

Answer 82

``` Opioid withdrawal (opioid abstinence syndrome) because the body has a physical dependence on them ```

Question 83

Anxiety, irritability, chills and hot flashes, joint pain, lacrimation (teary), rhinorrhea(runny nose), diaphoresis, nausea, vomiting, abdominal cramps, diarrhea are symptoms of?

Answer 83

Withdrawal

Question 84

What drug Has analgesic and antipyretic effects Has little to no anti-inflammatory effects Is available over-the-counter (OTC) Is a component of many combination products with opioids?

Answer 84

Acetaminophen

Question 85

Overdose, whether intentional or due to chronic unintentional misuse, can cause?

Answer 85

hepatic necrosis (liver)

Question 86

Long-term ingestion of large doses of acetaminophen can also cause?

Answer 86

nephropathy (kidneys damage)

Question 87

What is the recommended antidote to acetaminophen?

Answer 87

Acetylcysteine regimen

Question 88

What is the Maximum daily dose of acetaminophen for healthy adults?

Answer 88

4000 mg per day

Question 89

What are some interactions to Acetaminophen?

Answer 89

Alcohol use Liver dysfunction Possible liver failure Other hepatotoxic drugs

Question 90

Opioid Analgesics:Nursing Implications What is the most significant nursing implication to opioid use?

Answer 90

Withhold dose and contact physician if there is a decline in the patient’s condition or if vital signs are abnormal, ESPECIALLY IF THE RESPIRATORY RATE IS LESS THAN 12 BREATHS/MIN

Question 91

What is the most common adverse effect and may be prevented with adequate fluid and fibre intake

Answer 91

CONSTIPATION

Question 92

Should vital signs change, patient’s condition decline, or pain continue a nurse should

Answer 92

contact physician immediately

Question 93

Manifested by respiratory rate of less than 12 breaths/min, dyspnea, diminished breath sounds, or shallow breathing

Answer 93

Respiratory Depression

Question 94

Definition- | *Drugs that depress the central nervous system (CNS)*

Answer 94

Anaesthetics

Question 95

What are the two types of anaesthesia?

Answer 95

Two types: General anaesthesia Local anaesthesia

Question 96

What are the effects of anaesthesia?

Answer 96

Depression of consciousness Loss of responsiveness to sensory stimulation (including pain) Muscle relaxation

Question 97

``` Definition: Drugs that induce a state in which the CNS is altered to produce varying degrees of Depression of consciousness Skeletal muscle relaxation Visceral smooth muscle relaxation ```

Answer 97

General Anaesthetics

Question 98

How is general anaestheia administered?

Answer 98

Inhaled anaesthetics-Volatile liquids or gases that are vaporized in oxygen and inhaled Injectable anaesthetics-Administered intravenously

Question 99

Inhaled Anaesthetics | What is an example of Inhaled gas

Answer 99

nitrous oxide (“laughing gas”)

Question 100

Inhaled Anaesthetics | What is an example of Inhaled volatile liquids

Answer 100

halothane (Halothane) | isoflurane (Forane)

Question 101

When would an Injectable Anaesthetics be used?

Answer 101

To induce or maintain general anaesthesia To induce amnesia To reduce anxiety As an adjunct to inhalation-type anaesthetics

Question 102

Which theory explains the more fat soluble the better it works?

Answer 102

Overton-Meyer theory

Question 103

During surgical procedures general anaesthetics is used to produce

Answer 103

Unconsciousness Skeletal muscular relaxation Visceral smooth muscle relaxation

Question 104

What are some General Anaesthetics: Contraindications?

Answer 104

Known drug allergy Pregnancy (depending on drug type) Narrow-angle glaucoma (depending on drug type) Known susceptibility to malignant hyperthermia- genetic condition from prior experience with anaesthetics (depending on drug type)

Question 105

General Anaesthetics: What are some possible Adverse Effects?

Answer 105

Primarily affect: Heart, peripheral circulation, liver, kidneys, respiratory tract Commonly include myocardial depression Sudden elevation in body temperature (greater than 40°C) Tachypnea, tachycardia, muscular rigidity Life-threatening emergency Very dangerous when given anasthesia

Question 106

General Anaesthetics: Interactions General anaesthetics are associated with a wide array of drug interactions varying in severity More common drug–drug interactions occur with:

Answer 106

ANTIHYPERTENSIVES β-blockers Tetracycline **Blood pressure drugs**

Question 107

What would a Local Anaesthetics be used for?

Answer 107

Used to render a specific portion of the body insensitive to pain *Do not cause loss of consciousness*

Question 108

What are ways to administer Local Anaesthetics?

Answer 108

Topical-(Applied directly to skin or mucous membranes) Parenteral- outside the GI tract-(Injected intravenously or into the CNS)

Question 109

What are the two types of Local Anaesthetics?

Answer 109

* Central - Spinal or intraspinal - Intrathecal - Epidural * Peripheral - Infiltration - Nerve block - Topical

Question 110

What is a common form of a Parenteral Anaesthetic Drug?

Answer 110

lidocaine (Xylocaine)-freezing, used in combination with ephinephrine to keep it local

Question 111

In what order would Local Anaesthetic Drugs Effect Paralysis?

Answer 111

First, autonomic activity is lost, then sensory, and motor last As local drugs wear off, recovery occurs in reverse order (motor, sensory, and then autonomic activity)

Question 112

What are Local anaesthetics are used for:

Answer 112

Surgical, dental, and diagnostic procedures | Treatment of certain types of chronic pain

Question 113

What are some Local Anaesthetics: Contraindications

Answer 113

Contraindications include known drug allergy | Ophthalmic use requires specially designed dosage forms

Question 114

What is a Local Anaesthetics: Adverse Effects

Answer 114

May include “spinal headache,” which is treated by an “epidural blood patch”

Question 115

What does NMBAs stand for?

Answer 115

Neuromuscular Blocking Drugs

Question 116

A neuromuscular blocking drug is used to?

Answer 116

Prevent nerve transmission in certain muscles, resulting in paralysis of the muscle

Question 117

True or False | NMBAs cause sedation or relief of pain

Answer 117

FALSE

Question 118

TRUE OR FALSE | When NMBAS are used during surgery, artificial mechanical ventilation is required

Answer 118

TRUE

Question 119

TRUE or FALSE | Patient may be paralyzed yet conscious when NMBAs are used

Answer 119

TRUE

Question 120

Drugs ending in AM such as diazepam, | lorazepam are what types of drugs

Answer 120

anti anxiety

Question 121

Drugs ending in IUM such as | atracurium

Answer 121

nondepolarizing

Question 122

Nondepolarizing NMBAs prevent ______ from acting at the neuromuscular junctions

Answer 122

ACh

Question 123

A Short-acting NMBAs is mainly used for ?

Answer 123

endotracheal intubation

Question 124

What are some contraindications to NMBAs?

Answer 124

Known drug allergy Previous history of malignant hyperthermia Penetrating eye injuries Narrow-angle glaucoma

Question 125

Overdose of a NMBA can cause?

Answer 125

prolonged paralysis

Question 126

What are the main things to know about NMBAs?

Answer 126

- Lots of drugs interact with neuromuscular drugs - Causes Paralysis - Can feel pain - Doesn’t treat pain

Question 127

Moderate Sedation is also known as?

Answer 127

conscious sedation

Question 128

During moderate/conscious sedation a combination of ______________and an _______ is often used.

Answer 128

intravenous (IV) Benzodiazepine and Opiate analgesic

Question 129

Used for diagnostic procedures and minor surgical procedures that do not require deep anaesthesia

Answer 129

Moderate sedation

Question 130

What are some adverse effects to NMBAs

Answer 130

Hypotension (blockade of autonomic ganglia) Tachycardia (blockade of muscarinic receptors) Hypotension (release of histamine)

Question 131

Assessment is vital during pre-, intra-, and postoperative phases of sedation. What would you assess for?

Answer 131

``` Vital signs Baseline laboratory tests, electrocardiogram Pulse oximetry ABCs (airway, breathing, circulation) All body systems ```

Question 132

Nursing considerations during the perioperative phase include what three phases?

Answer 132

Preoperative phase Intraoperative phase Postoperative phase

Question 133

What do we monitor during recovery?

Answer 133

During recovery, monitor for cardiovascular depression, respiratory depression, and complications of anaesthesia

Question 134

During conscious sedation it preserves the patient’s ability to maintain____________________.

Answer 134

own airway and to respond to verbal commands

Question 135

-First sensation felt is muscle weakness -This is followed by total flaccid paralysis Small, rapidly moving muscles (fingers, eyes) are affected first, and then limbs, neck, trunk -Finally, intercostal muscles and the diaphragm are affected, resulting in cessation of respirations -Recovery of muscular activity usually occurs in reverse order -Transient muscle fasciculations may result in later muscle soreness

Answer 135

NMBAs