A nurse is assisting the physician, who is inserting a central venous access port into a patient at the bedside
A local anesthetic is administered. Within minutes of administration of the anesthetic, the vital signs reveal a pulse of 54/minute, respirations of 18/minute, and blood pressure of 90/42. The nurse should monitor the patient for further signs of
a. heart block.
b. anaphylaxis.
c. central nervous system excitation.
d. respiratory depression.
ANS: A
When absorbed in sufficient amount, local anesthetics can affect the heart and blood vessels. These drugs suppress excitability in the myocardium and conduction system and can cause hypotension, bradycardia, heart block, and potentially cardiac arrest.
Anaphylaxis would be manifested by hypotension, bronchoconstriction, and edema of the glottis.
Central nervous system excitation would be manifested by hyperactivity, restlessness, and anxiety and may be followed by convulsions.
No evidence indicates respiratory depression; this patient's respirations are within normal limits.
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