Which of the following areas of the body shows the effects of ...

[bobbysung]

Which of the following areas of the body shows the effects of tubocurarine last?
 
  a. Levator muscle of the eyelids and the muscles of mastication
  b. Muscles in the lower extremities
  c. Muscles controlling the glottis
  d. Muscles of respiration and the diaphragm

Question 2

A patient will receive atracurium (Tracrium) during surgery for neuromuscular blockade. The nurse caring for this patient will correctly perform which of the following actions?
 
  a. Assess the patient for signs of CNS depression.
  b. Ensure that dantrolene is available in case of a serious adverse reaction.
  c. Monitor the patient's blood pressure closely.
  d. Review the preprocedure laboratory values related to renal and hepatic function.

[pami445]

Answer to Question 1

ANS: D
Although tubocurarine can paralyze all skeletal muscles, not all muscles are affected at once. The last muscles affected by tubocurarine are the muscles of respiration, including the intercostals, and the diaphragm. The first to become paralyzed are the levator muscle of the eyelids and the muscles of mastication. Paralysis occurs next in the muscles of the limbs, abdomen, and glottis.

Answer to Question 2

ANS: C
Atracurium is used for muscle relaxation during surgery. Unlike other drugs in this class, it can cause hypotension secondary to antihistamine release. Cholinesterase inhibitors can reverse this reaction. Drugs in this class do not cause CNS depression. Dantrolene is the agent used to treat malignant hyperthermia, which is triggered by succinylcholine. Atracurium is eliminated primarily by plasma cholinesterase and not by the renal or hepatic routes.

[bobbysung]

Gracias!

[Sarahjh]

Excellent