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Flashcards in NMB Monitoring Deck (30)
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1
Q

What is TOF?

A

Train of Four

2
Q

What two Hz levels are usually used for tetany?

A

50 Hz and 100 Hz

3
Q

What is most common NMBM sites?

A

Unlar nerve

4
Q

What is correct way to orient cathodes when placing them on body?

A

Red closest to heart, black most distal

5
Q

Name 2 other NMBM sites other than ulnar nerve?

A

Facial nerve on side of face between ear and eye

Posterior tibial nerve on inside of ankle near medial malleolous

6
Q

What is unique about facial nerve placement?

A

Red cathode is placed more superior (away from heart) and black more inferior (closer to heart)

7
Q

What is motion that is observed when checking facial nerve using NMBM?

A

Eyebrow will twitch

8
Q

How many twitches are seen when at least 75% of receptors are blocked?

A

3 twitches

9
Q

What percent of receptors are blocked when 4 twitches are observed?

A

0-75% of receptors

10
Q

What percent of receptors are blocked when 2 twitches are seen?

A

80%

11
Q

How many twitches would you expect when 90% of receptors are blocked?

A

1 twitch

12
Q

Explain what you would observe when 100% of receptors are blocked

A

0 twitches and with no tetany

13
Q

How many twitches must be observed before you can give reversals?

A

At least 1

14
Q

What drug produces fasiculations?

A

Succinycholine

15
Q

What are fasiculations?

A

Uncontrolled muscle twitches throughout entire body seen under the skin

16
Q

What is the unit of measure on NMB stimulator?

A

mA

17
Q

Which NMB agent has shortest duration of action?

A

Succinylcholine

18
Q

What NMB agent has longest duration?

A

Pancuronium

19
Q

What is a non depolarizing NMB agent?

A

Roc, Vec, Nimbex, Panc

20
Q

What is the depolarizing NMB agent used in anesthesia?

A

Succinylcholine

21
Q

Define sensory threshold

A

Threshold at which when pt is awake, produces a facial reaction when NMB monitor is turned on

22
Q

What is the motor threshold?

A

Threshold at which produces a motor twitch from NMB stimulation after pt has gone to sleep but before muscle relaxant has been administered

23
Q

How many mA should be administered to determine sensory threshold?

A

4-5 mA

24
Q

How many mA are administerd when determining motor threshold?

A

15-20 mA

25
Q

What is the supermaximal stimulus?

A

25 mA above motor threshold

26
Q

What physiologic significant variable effects stimulation thresholds?

A

Temperature

27
Q

When the nerve stimulator is placed on the ulnar nerve, the actions of which muscle(s) is/are being monitored?

A

Flexor Carpi Ulnaris and Adductor Pollicis

28
Q

What causes prolonged neuromuscular blockade following administration of succinycholine?

A

Pseudocholinesterase deficiancy

29
Q

How do you offset the fasciculations associated with succinycholine?

A

5 mg Rocuronium

30
Q

List order of muscles affected by a neuromuscular blockade?

A

– Laryngeal adductors

– Diaphragm

– Orbicularis oculi

– Rectus abdominus

– Adductor pollicis