Paralytics, TOF, and BIS: Clinical Applications

Front

What is the purpose of using Nimbex in a patient with ARDS?

Back

To promote ventilator synchrony and improve oxygenation

Front

How does Nimbex (Cisatracurium) work?

Back

Blocks acetylcholine at the neuromuscular junction

Front

What is the preferred site for TOF monitoring in most ICU patients?

Back

Ulnar nerve

Front

What is the desired Train-of-Four response in a paralyzed patient receiving Nimbex?

Back

1-2/4 twitches

Front

What does a TOF result of 4/4 twitches indicate?

Back

Inadequate neuromuscular blockade

Front

Which statement is TRUE about BIS monitoring? Options: It measures muscle twitch response, It determines the dose of paralytic needed, It helps assess the depth of sedation, It replaces the need for TOF

Back

It helps assess the depth of sedation

Front

Where should BIS electrodes be placed? Options: On the ulnar nerve, On the forehead and temple, Behind the ears, On the chest and neck

Back

On the forehead and temple

Front

What BIS range indicates appropriate sedation in a paralyzed ICU patient?

Back

40-60

Front

What assessment is no longer reliable once the patient is paralyzed? Options: Heart rate, BIS monitoring, Physical response to pain, Blood pressure

Back

Physical response to pain

Front

If your patient has a BIS of 75 and TOF 0/4, what should you do first?

Back

Notify the provider; sedation may be inadequate