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While being intubated, a client with a head injury experienced bradycardia. Atropine was consequently administered. What assessment should be postponed until all atropine is excreted and no longer exerting an effect?

A.

CT of the brain

B.

Electroencephalogram

C.

Brain stem reflexes

D.

Pupil response

Answer and Explanation

The Correct Answer is C

A.    CT of the brain can proceed regardless of atropine administration, as it does not directly affect the assessment of brain stem reflexes.
B.    Electroencephalogram (EEG) can also proceed regardless of atropine administration, as it evaluates brain electrical activity rather than brain stem reflexes.
C.    Assessment of brain stem reflexes should be postponed until all atropine is excreted and no

longer exerting its effects. Atropine can mask or alter the pupillary response and other brain stem reflexes, such as gag reflex and cough reflex, which are important indicators of neurological function.
D.    Pupil response assessment should be postponed until atropine effects have dissipated, as

atropine can cause pupillary dilation, which may interfere with accurate assessment of pupil size and reactivity
 


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Related Questions

Correct Answer is ["A","D","E"]

Explanation

A. Oral contraceptives: Phenobarbital can decrease the effectiveness of oral contraceptives, increasing the risk of contraceptive failure and unintended pregnancy.
B. Antihistamines: While phenobarbital can induce hepatic enzymes, leading to increased

metabolism of some antihistamines, this interaction is less clinically significant compared to the interactions with oral contraceptives, opioids, and diuretics.
C. Warfarin: Phenobarbital can induce the metabolism of warfarin, potentially reducing its anticoagulant effects and necessitating closer monitoring of international normalized ratio (INR) levels.
D. Opioids: Phenobarbital can increase the metabolism of opioids, leading to reduced analgesic effects and potentially causing inadequate pain control.

E. Diuretics: Phenobarbital can accelerate the metabolism of diuretics, potentially reducing their efficacy and necessitating adjustments in dosage or monitoring of electrolyte levels.

Correct Answer is C

Explanation

A. These are adverse effects that usually subside after a few weeks: While some adverse effects of phenobarbital may diminish over time, the symptoms described by the patient are more likely related to its impact on REM sleep.
B. The drug must be stopped immediately because of possible adverse effects: Stopping phenobarbital abruptly can lead to withdrawal symptoms and potential rebound seizures; discontinuation should be done gradually under medical supervision.
C. This drug causes deprivation of REM sleep and may cause the inability to deal with normal stress: Phenobarbital is known to disrupt REM sleep, leading to emotional lability, irritability, and difficulty coping with stress.
D. This drug causes the rapid eye movement (REM) sleep period to increase, resulting in nightmares and restlessness: Phenobarbital actually decreases REM sleep, which can lead to disturbances in sleep patterns and mood changes.

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