October 1, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
The most important adverse response to beta activation is hyperglycemia (elevation of blood glucose). The mechanism is activation of beta receptors in the liver and skeletal muscles, which promotes breakdown of glycogen into glucose.

September 30, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Alpha agonists can cause reflex slowing of the heart. The mechanism is caused by alpha-mediated vasoconstriction which elevates blood pressure. This triggers the baroreceptor reflex, causing heart rate to decline.

September 29, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
If the IV line with alpha agonist becomes extravasated, local seepage of the drug may result in necrosis (tissue death). Treatment includes phentolamine, which will counteract alpha-mediated vasoconstriction and thereby help minimize injury.

September 28, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
An intermediate-acting neuromuscular blocker can be used to diagnose myasthenia gravis (MG) when safer diagnostic procedures have been inconclusive. To diagnose MG, a small test dose of the blocker is administered.

September 27, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
An endotracheal tube is a large catheter that is inserted past the glottis and into the trachea to facilitate ventilation. Gag reflexes can fight tube insertion. By suppressing these reflexes, neuromuscular blockers can make intubation easier.

September 26, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Some patients who require mechanical ventilation still have some spontaneous respirations, which can fight the rhythm of the respirator. By suppressing these movements, neuromuscular blocking agents can reduce resistance to ventilation.

September 25, 2014

#AskNacole | Adult ADD/ADHD & My Experience

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Cisatracurium (Nimbex) is approved for muscle relaxation during surgery, intubation and mechanical ventilation. Elimination is by spontaneous degradation, not by hepatic metabolism or renal excretion.

September 24, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Responses to neuromuscular blockers can be altered by electrolyte abnormalities. For example, low potassium levels can enhance paralysis, whereas high potassium levels can reduce paralysis.

September 23, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Neuromuscular blockers can't cross the blood-brain barrier. Consequently, these drugs have no effect on the CNS. These agents do not diminish consciousness or perception of pain, even when doses produce complete paralysis. 

September 22, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Some neuromuscular blockers can lower blood pressure through: (1) release of histamine from mast cells and (2) partial blockade of nicotinic receptors in autonomic ganglia. Histamine lowers blood pressure by causing vasodilation.

September 21, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Neuromuscular blocking agents paralyze in phases. 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.

September 20, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
All of the neuromuscular blocking agents contain at least one quaternary nitrogen atom. As a result, these drugs always carry a positive charge and therefore cannot readily cross membranes.

September 19, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Neuromuscular blocking agents prevent acetylcholine from activating nicotinic receptors on skeletal muscles, and thereby cause muscle relaxation. These drugs are given during surgery, intubation, mechanical ventilation and other procedures.

September 18, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Reversible cholinesterase inhibitors (Neostigmine) are the mainstay of therapy for myasthenia gravis. By preventing ACh inactivation, anticholinesterase agents intensify the effects of ACh from motor neurons and can increase muscle strength.

September 17, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
The “irreversible” cholinesterase inhibitors are highly toxic. These agents are used primarily as insecticides. During World War II, huge quantities of irreversible cholinesterase inhibitors were produced for possible use as nerve agents.

September 16, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Overdose with cholinesterase inhibitors causes excessive muscarinic stimulation and respiratory depression. The state produced by cholinesterase inhibitor poisoning is sometimes referred to as cholinergic crisis.

September 15, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Cholinesterase inhibitors are drugs that prevent the degradation of acetylcholine (ACh) by acetylcholinesterase (also known simply as cholinesterase). By preventing the inactivation of ACh, cholinesterase inhibitors enhance the actions of ACh.

September 14, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
By blocking muscarinic receptors in the intestine, atropine can decrease both the tone and motility of intestinal smooth muscle. This can be beneficial in conditions of excessive intestinal motility, such as mild dysentery and diverticulitis.

September 13, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Atropine produces its effects through competitive blockade at muscarinic receptors. Like all other receptor antagonists, atropine has no direct effects of its own. Rather, all responses to atropine result from preventing receptor activation.