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.
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Related Questions
Correct Answer is D
Explanation
Choice A Reason:
Age 45 years is incorrect. While age is a significant factor in osteoporosis risk, 45 years old isn't inherently considered a high-risk age for developing osteoporosis. However, bone density tends to decrease gradually with age, and after menopause in women, there's a more significant decline due to hormonal changes.
Choice B Reason:
Regular aerobic exercise is incorrect. Regular exercise, particularly weight-bearing and muscle-strengthening activities, is typically beneficial for bone health. It can help maintain or improve bone density and strength, reducing the risk of osteoporosis. Therefore, regular aerobic exercise is generally considered a protective factor against osteoporosis, rather than a risk factor.
Choice C Reason:
Uses NSAIDs for pain relief is incorrect. While long-term use of certain medications, such as glucocorticoids (steroids), can increase the risk of osteoporosis due to their impact on bone density, the use of NSAIDs (nonsteroidal anti-inflammatory drugs) for pain relief isn't directly linked to osteoporosis as a significant risk factor. However, chronic use of certain medications might have implications for bone health and should be assessed on an individual basis.
Choice D Reason:
Smoking is a known risk factor for osteoporosis. It can have detrimental effects on bone health by interfering with the body's ability to absorb calcium, decreasing estrogen levels, and impairing bone-forming cells. Consequently, smokers have a higher risk of developing osteoporosis compared to non-smokers.
Correct Answer is B
Explanation
Choice A Reason:
Requesting a dosage increase if the apical heart rate is less than 60/min is not necessary. Propranolol is used to lower heart rate in conditions like atrial fibrillation, so a heart rate below 60/min might be the desired effect of the medication.
Choice B Reason:
Withholding the medication if the systolic blood pressure is less than 90 mm Hg is necessary. Propranolol is a beta-blocker that can lower blood pressure. If the systolic blood pressure drops below 90 mm Hg, withholding the medication is necessary to prevent further lowering of blood pressure, which could lead to adverse effects like dizziness, fainting, or inadequate blood perfusion to vital organs.
Choice C Reason:
Administering the medication with an antacid might interfere with the absorption of propranolol, so they shouldn't be taken together unless instructed by the healthcare provider.
Choice D Reason:
Expecting increased hair growth is not an anticipated effect of propranolol. Hair growth is not a usual side effect associated with this medication.
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