NUR 751 Exam 2 - Answers Rated A+ Why do inhalation agents incre...

NUR 751 Exam 2 Update Questions and Correct Answers Rated A+

Why do inhalation agents increase NDNMBD potency (3) -ANSWER- 1) central effect on alpha motor neurons and inter-neuronal synapses 2) post-synaptic inhibition of nachr 3) increased affinity for the nachr binding site

• meds that can increase NDNMBD potency -ANSWER-1) ABX

2) inhalation agents 3) magnesium 4) LA

Hypothermia or hyperthermia increased NDNMBD potency - ANSWER-hypothermia

• factors that decrease potency of NDNMBD -ANSWER-1)

anticonvulsant admin 2) hypercalcemia

Why does anticonvulsant admin decrease NDNMBD potency - ANSWER-1) increased clearance 2) increased binding of NMBD to alpha 1 glyocproteins 3) up regulation of nachr

Rate of onset of NMBD is inversely proportional to -ANSWER-potency

What is buffered diffusion -ANSWER-Drug binds to receptor --> falls off --> binds to another receptor --> leads to long acting

Which NMBD causes ganglionic blockade leading to hypotension - ANSWER-tubocurarine

Which NMBD causes stimulation of catecholamine release - ANSWER-pancuronium

Histamine release is most common with which NDNMBD class - ANSWER-benzylisoquinolinium

• except cisatracurium

• symptoms associated with histamine release causes by NMBD -

ANSWER-1) flushing 2) decreased BP 3) decreased SVR 4) increased HR ( + inotropic and chronotropic effect)

• associated with 200-200% of baseline levels

Histamine effects can be attenuated by which 2 things -ANSWER-1) slow admin of NMBD 2) prophy admin of H1 or H2 receptor agonists

Immune mediated allergic reactions occur how frequently -ANSWER-

1:1000-1:2500

Mortality of allergic reactions -ANSWER-5%

• most common causes of anaphylaxis -ANSWER-1) NMBD

2) latex

3) ABX (#1)

Allergic reactions are mediate through: -ANSWER-ige antibodies fixed

to mast cells

___ accounts for 43% of annaphylaxis caused by anesthesia and ___ accounts for 22% -ANSWER-roc - 43% Succs - 22%

Treatment for allergic reactions (5) -ANSWER-1) 100% O2 2) intubation 3) fluids 4) vasopressors 5) treat dysrhythmias

T/F acetylcholinesterase inhibitors can antagonize profound block/deep block -ANSWER-FALSE

MOA of acetylcholinesterase inhibitors -ANSWER-inhibit acetylcholinesterase Ach competes with the NDNMBD for nachr binding sites

T/F Acetylcholinesterase inhibitors can have a ceiling effect -

ANSWER-TRUE

• important factors for acetylcholinesterase inhibitors -ANSWER-1)

degree of neuromuscular blockade 2) choice of antcholinesterase 3) dose of anticholinesterase 4) rate of clearance of NMBD 5) type and depth of anesthetic

Edrophonium, neostigmine, and pyridostigmine undergo approx ___% renal excretion -ANSWER-50%

Acetylcholinesterase inhibitors causes ach to accumulate where - ANSWER-at all ach receptors

• side effects of acetylcholinesterase inhibitors -ANSWER-1)

bradycardia 2) bronchospasm 3) increased GI motility 4) N&V - controversial

Acetylcholinesterase inhibitors must be administered with an: -

ANSWER-anticholinergic agent

Which anticholinergic must be given with edrophonium and at what dose -ANSWER-atropine 7-10 mcg/kg

Which anticholinergic must be given with neostigmine and pyridostigmine and at what dose -ANSWER-glycopyrrolate 7- 15mcg/kg

Common sites for neuromuscular function monitoring -ANSWER-1) adductor pollicis (ulnar nerve) 2) peroneal nerve 3) facial nerve

Monitoring neuromuscular function allows: -ANSWER-1) more precise

dosing 2) reduces the likelihood of residual neuromuscular blockade

___ monitoring of TOF is strongly recommended ___ monitoring of TOF is extremely inaccurate -ANSWER- OBJECTIVE monitoring of TOF is strongly recommended