A nurse is educating community members about how to prepare for a disaster. Which of the following items should be included in a disaster preparedness kit? (Select all that apply)

Choice A reason: Induce Sedation

Pancuronium is not used to induce sedation. It is a neuromuscular blocking agent (NMBA) that causes paralysis of skeletal muscles. Sedation is typically achieved using medications such as benzodiazepines or propofol, which act on the central nervous system to produce a calming effect.

Choice B reason: Suppress Respiratory Effort

Pancuronium is used to suppress respiratory effort in patients with ARDS who require mechanical ventilation. By causing muscle paralysis, pancuronium helps to synchronize the patient’s breathing with the ventilator, reducing the risk of ventilator-induced lung injury and improving oxygenation. This is particularly important in severe cases of ARDS where patient-ventilator dyssynchrony can be detrimental.

Choice C reason: Decrease Chest Wall Compliance

Decreasing chest wall compliance is not a purpose of pancuronium. In fact, pancuronium does not directly affect chest wall compliance. Instead, it works by blocking the transmission of nerve impulses to the muscles, leading to muscle relaxation and paralysis.

Choice D reason: Decrease Respiratory Secretions

Pancuronium does not decrease respiratory secretions. Medications such as anticholinergics (e.g., atropine) are used to reduce secretions. Pancuronium’s primary role is to facilitate mechanical ventilation by ensuring complete muscle relaxation.

Choice A reason:

Using the palm of the hand, feel for lumps using a circular motion: This instruction is incorrect. The correct method for a breast self-exam involves using the pads of the three middle fingers, not the palm of the hand. The fingers should move in a circular motion to feel for lumps or abnormalities.

Choice B reason:

Expect some breast dimpling or discharge with age: This is misleading and potentially harmful advice. While some changes in the breast can occur with age, dimpling or discharge can also be signs of breast cancer and should be reported to a healthcare provider immediately.

Choice C reason:

Breasts can be examined in the shower with soapy hands: This is correct. Examining the breasts in the shower with soapy hands can make it easier to feel for lumps or changes. The soapy water helps the fingers glide smoothly over the skin, making it easier to detect any abnormalities.

Choice D reason:

For those who have a menstrual cycle, perform a BSE every month, 2 or 3 days before menstruation: This instruction is incorrect. The best time to perform a breast self-exam is a few days after the menstrual period ends, when the breasts are least likely to be swollen or tender.