A nurse is monitoring a patient who recently received a local anesthetic for signs of local anesthetic systemic toxicity (LAST). Which of the following clinical manifestations should the nurse recognize as early signs of LAST?
Respiratory arrest and coma
Ventricular arrhythmias and cardiac arrest
Hypotension and tachycardia
Tinnitus, metallic taste, and perioral numbness
The Correct Answer is D
A. Respiratory arrest and coma: These are late, life-threatening manifestations of local anesthetic systemic toxicity (LAST) that occur after CNS and cardiovascular collapse. Recognizing early signs is critical to preventing progression to this severe stage.
B. Ventricular arrhythmias and cardiac arrest: These are also late signs of LAST, resulting from the anesthetic’s depressant effects on cardiac conduction. By the time these occur, toxicity is advanced and may require immediate resuscitation measures.
C. Hypotension and tachycardia: Although cardiovascular symptoms may eventually develop, they are typically preceded by neurological signs. Early identification and management of CNS symptoms can often prevent progression to cardiovascular compromise.
D. Tinnitus, metallic taste, and perioral numbness: These are classic early signs of LAST and indicate CNS involvement. They often occur within minutes of administration and should prompt immediate intervention to stop drug absorption and initiate supportive care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["2"]
Explanation
Desired dose rate = 0.6 mg/hr
Available concentration = 50 mg / 150 mL
- Calculate the concentration in mg/mL:
Concentration (mg/mL) = 50 mg / 150 mL
= 1/3 mg/mL
- Calculate the flow rate in mL/hr:
Flow rate (mL/hr) = Desired dose rate (mg/hr) / Concentration (mg/mL)
= 0.6 mg/hr / (1/3 mg/mL)
= 0.6 × 3 mL/hr
Flow rate (mL/hr) = 1.8 mL/hr
- Round to the nearest whole number:
= 2 mL/hr
Correct Answer is ["12.5"]
Explanation
Desired dose = 25 mg
Available concentration = 10 mg per 5 mL
- Calculate the concentration in mg/mL:
Concentration (mg/mL) = Available dose / Available volume
= 10 mg / 5 mL
= 2 mg/mL
Volume to administer = Desired dose / Available concentration
= 25 mg / 2 mg/mL
= 12.5 mL
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