A nurse is caring for an intubated patient who is receiving ...

[SGallaher96]

A nurse is caring for an intubated patient who is receiving pancuronium for neuromuscular blockade. The patient's eyes are closed, and the patient is not moving any extremities.
 
  The heart rate is 76 beats per minute, and the blood pressure is 110/70 mm Hg. The nurse caring for this patient will do what? a. Request an order for an antihistamine to prevent a further drop in blood pressure.
  b. Request an order for serum electrolytes to evaluate for hyperkalemia.
  c. Review the patient's chart for a history of myasthenia gravis (MG).
  d. Talk to the patient while giving care and explain all procedures.

Question 2

The nurse assesses a newly diagnosed patient for short-term complications of diabetes. What does this assessment include?
 
  a. Evaluation for hyperglycemia, hypogly-cemia, and ketoacidosis
  b. Cranial nerve testing for peripheral neu-ropathy
  c. Pedal pulse palpation for arterial insuffi-ciency
  d. Auscultation of the carotids for bruits as-sociated with atherosclerosis

[ong527]

Answer to Question 1

D
Pancuronium is a competitive neuromuscular blocker and is used to paralyze skeletal muscles by neuromuscular blockade. The first muscles affected are those of the eyelids, so patients given this medication cannot open their eyes. Inability to move the extremities is an expected effect. Because these medications do not have central nervous system (CNS) effects, the patient is con-scious and awake; therefore, caregivers should continue to talk to the patient while providing care. Atracurium, not pancuronium, can cause hypotension secondary to histamine release. High potassium levels would reduce paralysis. Patients with a history of MG would have increased paralysis. Nothing indicates that this patient is experiencing extreme effects from this medication.

Answer to Question 2

A
High blood sugar, low blood sugar, and ketoacidosis are short-term complications of diabetes. Microvascular and macrovascular complications, such as peripheral neuropathy, are long-term complications of diabetes. Arterial insufficiency and atherosclerosis also are long-term compli-cations of diabetes.

[SGallaher96]

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[ong527]

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