You are an RN who is precepting a newly graduated nurse. The new grad asks you what the signs and symptoms are for a patient with Cushing's Triad.
Which of the following WOULD NOT be part of your answer?

Choice A rationale

While establishing IV access and fluid replacement are crucial in trauma, they are secondary to ensuring cervical spine stabilization in a patient who is unresponsive after a head-on motor vehicle crash. Uncontrolled movement of an unstable cervical spine can lead to irreversible spinal cord injury, exacerbating neurological deficits or causing paralysis.

Choice B rationale

Monitoring pulse and blood pressure frequently is an important ongoing assessment in a trauma patient to identify shock or other systemic issues. However, in the immediate post-crash scenario with an unresponsive patient, the primary concern is preventing further neurological damage from potential spinal cord injury, making stabilization a higher priority.

Choice C rationale

Inserting a nasogastric tube for decompression might be necessary later in the management of a trauma patient to prevent aspiration or gastric distension. However, it is not the immediate priority action in an unresponsive patient following a head-on collision, where airway, breathing, circulation, and most importantly, cervical spine protection are paramount.

Choice D rationale

In an unresponsive client following a head-on motor vehicle crash, cervical spine injury must be presumed until ruled out. Any movement of the head or neck could further compromise the spinal cord, leading to permanent neurological deficits or even death. Therefore, keeping the neck stabilized using a cervical collar and backboard is the absolute priority to prevent further injury.

Choice A rationale

Vecuronium is a neuromuscular blocking agent, not an anxiolytic. Its primary mechanism of action involves competitive antagonism of acetylcholine at the nicotinic receptors on the motor endplate, leading to muscle paralysis. It does not possess anxiolytic properties, and administering it without concurrent sedation would cause significant distress to a conscious patient who is paralyzed but fully aware.

Choice B rationale

Vecuronium facilitates ventilation by inducing skeletal muscle paralysis, thereby preventing spontaneous breathing and patient-ventilator asynchrony. This allows for precise control of ventilation parameters in critically ill patients, reducing oxygen consumption by respiratory muscles and improving gas exchange. This paralysis is crucial in conditions like ARDS where high airway pressures and controlled ventilation are often required.

Choice C rationale

Vecuronium does not directly decrease inflammation. Its action is specific to the neuromuscular junction, leading to muscle relaxation and paralysis. While mechanical ventilation facilitated by vecuronium can indirectly reduce lung injury by optimizing ventilation, it does not have intrinsic anti-inflammatory properties at a molecular or cellular level. Anti-inflammatory medications would be administered separately if indicated.

Choice D rationale

Vecuronium is not an antimicrobial agent and has no direct activity against infectious pathogens. Its therapeutic role is limited to inducing muscle paralysis for medical procedures or to facilitate mechanical ventilation. Treating infection requires specific antibiotics or antiviral medications. Administering vecuronium would not address the underlying infectious process in a patient with ARDS.