A nurse is assisting with the care of a postoperative client who has developed malignant hyperthermia. Which of the following actions should the nurse take?
Administer meperidine IM.
Instill a warm enema solution.
Apply a cooling blanket.
Ventilate client with 50% oxygen.
The Correct Answer is C
Choice A Reason:
Administer meperidine IM is incorrect. Reason why it's not the answer: Meperidine (Demerol) is not recommended in cases of malignant hyperthermia. It can potentially exacerbate the situation by further increasing muscle rigidity and potentially contributing to the hypermetabolic state. Meperidine can trigger additional release of calcium from the sarcoplasmic reticulum in muscles, worsening the symptoms.
Choice B Reason:
Instill a warm enema solution is incorrect. Reason why it's not the answer: Introducing warm solutions can exacerbate the client's condition by further increasing body temperature. Malignant hyperthermia is characterized by a dangerous increase in body temperature, and adding heat through an enema would only make the situation worse.
Choice C Reason:
Applying a cooling blanket is recommendable. Reason why it's the answer: A cooling blanket is a recommended intervention for managing malignant hyperthermia. Lowering the body temperature is crucial in preventing further complications associated with the high fever. Cooling blankets help dissipate heat from the body, aiding in rapidly reducing the dangerously elevated temperature associated with malignant hyperthermia.
Choice D Reason:
Ventilate client with 50% oxygen is incorrect. Reason why it's not the answer: While providing oxygen support might be necessary as part of managing the overall condition, ventilating with 50% oxygen specifically may not directly address the core issue of rapidly cooling the body during a malignant hyperthermia crisis. Ventilation may be required, but the immediate concern is to cool the body to prevent complications arising from the elevated body temperature.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason:
Polyuria is incorrect. Peritonitis doesn’t directly influence urine output. Polyuria (increased urine production) is more commonly associated with conditions affecting the kidneys or diabetes mellitus rather than peritonitis.
Choice B Reason:
Peripheral edema is incorrect. Peritonitis typically involves abdominal symptoms and signs rather than peripheral issues like edema. Edema can be related to heart, kidney, or circulatory system problems, but it's not a typical manifestation of peritonitis.
Choice C Reason:
Decreased respirations is incorrect. Peritonitis can cause pain and discomfort, which might affect the depth of breathing or result in shallow breathing due to guarding against abdominal pain. However, decreased respirations as a specific finding wouldn't commonly be expected in peritonitis. Pain might cause shallow breathing, but it wouldn't lead to a consistent decrease in respiratory rate.
Choice D Reason:
Absent bowel sounds is correct. Peritonitis is an inflammation of the peritoneum, the lining of the abdominal cavity. This condition often leads to the loss or significant reduction of bowel sounds due to the irritation and inflammation of the abdominal structures.
Correct Answer is C
Explanation
Choice A Reason:
Digoxin is a cardiac medication used to treat heart conditions such as heart failure and certain arrhythmias. There's no direct chemical relationship between digoxin and sulfa compounds. Generally, digoxin does not contain sulfa components, so it's less likely to cause an allergic reaction in individuals with sulfa allergies. This medication does not typically require clarification for someone with a sulfa allergy.
Choice B Reason:
Prednisone is a corticosteroid used to treat a variety of conditions, including inflammation, allergies, and autoimmune disorders. It does not contain sulfonamide groups in its structure. As a corticosteroid, prednisone is distinct from sulfonamide drugs and is generally considered safe for individuals with sulfa allergies. There is typically no need to clarify this medication for a sulfa-allergic client.
Choice C Reason:
Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) that belongs to the sulfonamide class. While it is not the same as sulfonamide antibiotics, it contains a sulfonamide moiety in its chemical structure. There's a possibility of cross-reactivity or allergic reactions in individuals with sulfa allergies due to the structural similarity, making it essential to clarify this prescription for someone with a sulfa allergy.
Choice D Reason:
Atorvastatin is a statin medication used to lower cholesterol levels. It does not contain a sulfonamide group in its structure. Statins belong to a different drug class and do not typically pose a risk of cross-reactivity in individuals with sulfa allergies. Therefore, atorvastatin is generally considered safe and does not usually require clarification for a sulfa-allergic client.
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