Author Question: A patient with hepatitis requires endotracheal intubation. Which agent does the nurse expect to be ... (Read 39 times)

armygirl · **on:** Jul 23, 2018

A patient with hepatitis requires endotracheal intubation. Which agent does the nurse expect to be administered to facilitate this procedure?

a. Atropine
b. Cisatracurium Nimbex
c. Rocuronium Zemuron
d. Vecuronium Norcuron

Question 2

A patient with type 1 diabetes who takes insulin reports taking propranolol for hypertension. Why is the nurse concerned?

a. The beta blocker can cause insulin resis-tance.
b. Using the two agents together increases the risk of ketoacidosis.
c. Propranolol increases insulin requirements because of receptor blocking.
d. The beta blocker can mask the symptoms of hypoglycemia.

pratush dev · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

B
Cisatracurium is used for muscle relaxation during intubation. It is eliminated by spontaneous degradation, not by hepatic metabolism or renal excretion. Atropine is not used for muscle relax-ation; it is an anticholinergic drug used to control secretions during procedures. Rocuronium is eliminated by hepatic metabolism. Vecuronium is excreted in bile and can cause prolonged pa-ralysis in patients with liver dysfunction.

Answer to Question 2

D
Beta blockers can delay awareness of and response to hypoglycemia by masking signs associated with stimulation of the sympathetic nervous system (eg, tachycardia, palpitations) that hypogly-cemia normally causes. Furthermore, beta blockade impairs glycogenolysis, which is one means by which the body can counteract a fall in blood glucose; beta blockers, therefore, can worsen insulin-induced hypoglycemia. Propranolol does not cause insulin resistance. The incidence of DKA is not increased by concurrent use of propranolol and insulin. Insulin requirements are not increased because of receptor blocking by propranolol.