A nurse is caring for a patient who received a nondepolarizing ...

[genevieve1028]

A nurse is caring for a patient who received a nondepolarizing neuromuscular blocker during a minor procedure.
 
  The patient begins to awake sooner than anticipated. The nurse suspects that the patient has received which medication that has the shortest duration of action?
  a. Pancuronium
  b. Rocuronium (Zemuron)
  c. Vecuronium (Norcuron)
  d. Mivacurium (Mivacron)

Question 2

A patient in the ICU is on a mechanical ventilator with an endotracheal tube. The patient begins trying to pull at the endotracheal tube and other tubing. The nurse administers a prn order for tubocurarine.
 
  The nurse can anticipate which of the following areas of the body will experience the effects of the medication first?
  a. The levator muscle of the eyelid and muscles of mastication
  b. The muscles in the lower extremities
  c. The muscles controlling the glottis
  d. The muscles of respiration and the diaphragm

[taylorsonier]

Answer to Question 1

ANS: D
Mivacurium is the shortest acting nondepolarizing neuromuscular blocker, therefore the patient may wake sooner than anticipated.
Pancuronium, rocuronium, and vecuronium are intermediate blocking agents, not short-acting agents that would cause the patient to awaken sooner than expected.

Answer to Question 2

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

[genevieve1028]

Excellent

[diana chang]

TYSM