A nurse in a post anesthesia care unit is caring for a client who is recovering from general anesthesia and is experiencing malignant hyperthermia. Which of the following actions should the nurse take?

Administer dantrolene sodium IV.

Monitor client for rapid decrease in heart rate.

Infuse chilled lactated Ringer's IV.

Provide oxygen at 12 L/min via Venturi mask.

Answer and Explanation

The Correct Answer is A

A) Administer dantrolene sodium IV: Dantrolene sodium is the treatment of choice for malignant hyperthermia. It acts as a muscle relaxant by inhibiting calcium release from the sarcoplasmic reticulum in skeletal muscles, which helps to halt the hypermetabolic crisis.

B) Monitor client for rapid decrease in heart rate: While monitoring vital signs is essential, a rapid decrease in heart rate is not a typical manifestation of malignant hyperthermia. The nurse should primarily focus on interventions to reduce hyperthermia and stabilize the client's condition.

C) Infuse chilled lactated Ringer's IV: Infusing chilled IV fluids can help lower the body temperature in malignant hyperthermia. However, this intervention is supportive and secondary to the administration of dantrolene sodium, which directly addresses the underlying pathophysiology.

D) Provide oxygen at 12 L/min via Venturi mask: Providing high-flow oxygen is necessary to manage hypoxia and metabolic acidosis associated with malignant hyperthermia. Nonetheless, this action is secondary to administering dantrolene sodium, which is crucial to stopping the hyperthermic crisis.

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Correct Answer is A

Explanation

A) Respiratory acidosis: This condition is indicated by a low pH (7.32) and an elevated PaCO2 (48 mm Hg), while HCO3 remains normal (24 mEq/L). Respiratory acidosis occurs when there is an accumulation of carbon dioxide in the blood, usually due to hypoventilation or impaired gas exchange in the lungs.

B) Metabolic acidosis: Metabolic acidosis is characterized by a low pH and a decreased HCO3 level. In this scenario, the HCO3 level is normal, ruling out metabolic acidosis.

C) Respiratory alkalosis: Respiratory alkalosis is indicated by a high pH and a decreased PaCO2. In this case, the pH is low, and the PaCO2 is elevated, which contradicts the characteristics of respiratory alkalosis.

D) Metabolic alkalosis: Metabolic alkalosis would show a high pH and an elevated HCO3 level. Since the pH is low and the HCO3 is normal, this condition does not fit the criteria for metabolic alkalosis.

A. Fever B. Hypernatremia C. Hypertension D. Hypoglycemia

Correct Answer is B

Explanation

A) Fever: Myxedema coma is characterized by hypothermia rather than fever. The client with myxedema coma may experience a lowered body temperature, reflecting the severe hypothyroidism associated with this condition.

B) Hypernatremia: Hypernatremia, or elevated sodium levels, is a common finding in myxedema coma. This occurs due to impaired renal function and decreased aldosterone levels, leading to an imbalance in electrolytes, including sodium.

C) Hypertension: Typically, myxedema coma presents with hypotension rather than hypertension. The condition is associated with decreased cardiac output and low blood pressure, not elevated blood pressure.

D) Hypoglycemia: In myxedema coma, hypoglycemia is not typically expected. Instead, patients may experience hypoglycemia due to reduced metabolic rate and decreased glycogen stores. However, hyperglycemia is more commonly observed in other endocrine disorders, not specifically in myxedema coma.

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A nurse in a post anesthesia care unit is caring for a client who is recovering from general anesthesia and is experiencing malignant hyperthermia. Which of the following actions should the nurse take?

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Naxlex Comprehensive Predictor Exams

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Explanation

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