Chapter 42: Drugs Used to Treat Glaucoma and Other Eye Disorders, Pharmacology 45

Which common adverse effects occur with neuromuscular-blocking agents?

Flushing

Patients with which conditions must be carefully assessed to determine whether they would tolerate treatment with a neuromuscular-blocking agent?

Hepatic disease Pulmonary disease Renal disease Neurologic disorders

In the intensive care unit, the nurse is taking care of a patient who is on a ventilator and is receiving succinylcholine (Anectine). Which is a priority nursing diagnosis for this patient?

Pain

Why are neuromuscular-blocking agents used?

Reducing the use and adverse effects of general anesthetics Easing endotracheal intubation and prevent laryngospasm Decreasing muscular activity in electroshock therapy

Which assessment is most important for the nurse to obtain when a patient is being treated with a neuromuscular-blocking agent?

Respiratory assessment for patent airway

When assessing a patient for signs and symptoms of early respiratory depression immediately after leaving the postoperative area, the nurse will be alert for signs of what?

Restlessness Anxiety Lethargy

The nurse receives a conscious patient from the postoperative unit after administration of a neuromuscular blocker. Once the patient's vital signs are stable, the best position for the nurse to assist the patient into is _____ position.

semi-Fowler's

The patient's family asks why neuromuscular blocking agents are used before electroconvulsive therapy. Which explanation by the nurse is most accurate?

"They reduce the risk of injury during therapy."

A patient taking a neuromuscular blocking agent is assessed to have a heart rate of 120 and blood pressure of 80/50. The nurse will anticipate the physician writing an order for:

ABGs.

7. What information will the nurse include when teaching the patient and family about postoperative care for a trabeculectomy? (Select all that apply.)

a. Use aseptic technique for all dressing changes and medication administration. c. Avoid heavy lifting. d. Redness in the eye, pain, and swelling are common occurrences after surgery. e. Avoid straining on defecation. ANS: A, C, D, E

The nurse is educating a patient about a newly prescribed cholinergic agent. When relaying common adverse effects of this type of medication, the nurse will include information about (Select all that apply.)

a. conjunctival irritation. b. headache. ANS: A, B

Which laboratory values will the nurse review prior to beginning medication therapy for skeletal and muscle disorders?

C-reactive protein (CRP), human leukocyte antigen (HLA), and liver function tests

Which medication will be prescribed for a patient complaining of muscle spasms resulting from a back injury?

Cyclobenzaprine (Flexeril)

A patient taking antipsychotic medication for schizophrenia is admitted with a temperature of 106° F. The admitting diagnosis is neuroleptic malignant syndrome resulting from antipsychotic medication. Which drug is indicated in treatment of this condition?

Dantrolene, a direct acting skeletal muscle relaxant, is used to treat neuroleptic malignant syndrome associated with the use of antipsychotic agents

The nurse is examining a patient in the emergency department whose chief complaint is a dislocated shoulder. Which assessment data are needed to evaluate the patient?

Details related to the mechanism of injury Degree of impairment Pain level Inspection of the affected part for swelling, capillary refill, bruising, redness, localized tenderness, deformities, and paresthesia

Which drug interaction may occur when an aminoglycoside or tetracycline is given in conjunction with neuromuscular-blocking agents?

Increased neuromuscular-blocking activity

An employee at a factory has not been to work because of low back muscle spasms. His wife contacts the occupational health nurse to report that her spouse is on a centrally acting skeletal muscle relaxant and is having problems with sleepiness. Based on the medication action, what will the nurse tell her?

"Your husband should avoid activities requiring alertness, such as driving or operating power equipment." "I need additional and specific information regarding the amount of your husband's sedation." "I will review baseline laboratory studies, discuss your husband's status with the health care provider, and call you back." "Sedation is an adverse effect of these medications and tends to resolve with continued therapy."

Which symptoms will be most important for the nurse to assess for early signs of respiratory distress in the patient who has been given a neuromuscular-blocking agent?

Restlessness, anxiety, and lethargy

The nurse is preparing a patient for an ophthalmic examination. Which action occurs when the nurse instills eyedrops to produce mydriasis?

Extreme dilation of the pupil

What is the reason for paraplegic patient to receive baclofen (Lioresal)?

It interrupts reflexes at the level of the spinal cord.

A patient who has undergone a lengthy surgical procedure under general anesthesia is unable to breathe on his own following the procedure. Which drug will the nurse expect to be administered as an antidote to the neuromuscular-blocking agent?

Neostigmine methylsulfate (Prostigmin)