A patient in the operating room has been administered succinylcholine and is now experiencing muscle rigidity and an extremely high temperature. What should the nurse do next?

Call the PACU nurse to prepare for prolonged ventilatory support.

Hold a prescription for dantrolene until the fever is reduced.

Prepare ice packs for placement in the patient’s axillary area.

Determine if prescribed antibiotics were administered preoperatively.

None

Answer and Explanation

The Correct Answer is C

C. Prepare ice packs for placement in the patient’s axillary area.This response is crucial because the symptoms described—muscle rigidity and hyperthermia—are indicative of malignant hyperthermia, a serious reaction that can occur after the administration of succinylcholine, especially in conjunction with certain anesthetics. Immediate cooling measures, such as applying ice packs, are essential to help reduce the patient's elevated body temperature.

Rationale for Other Options:

A. Call the PACU nurse to prepare for prolonged ventilatory support.: While preparing for ventilatory support may be necessary later, immediate action to address hyperthermia is critical.
B. Hold a prescription for dantrolene until the fever is reduced.: Dantrolene is the antidote for malignant hyperthermia and should be administered as soon as possible rather than held.
D. Determine if prescribed antibiotics were administered preoperatively.: This action is not relevant to the immediate management of malignant hyperthermia.

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Correct Answer is D

Explanation

Choice A rationale
Cold and dry skin can be a symptom of hypothyroidism, but it’s not typically a sign that requires immediate action.
Choice B rationale
Facial puffiness and periorbital edema can be symptoms of hypothyroidism, but they’re not typically signs that require immediate action.
Choice C rationale
A hematocrit of 30% (0.30 volume fraction) is lower than the normal range, indicating anemia. While this is a concern and should be addressed, it’s not typically a sign that requires immediate action in the context of hypothyroidism.
Choice D rationale
A further decline in the level of consciousness can be a serious sign of deteriorating health in a client with hypothyroidism and should be acted upon immediately.

A. Take prescribed cortisone accurately. B. Use a walker when weakness occurs. C. Avoid extreme environmental temperatures. D. Increase daily intake of sodium in diet.

Correct Answer is A

Explanation

Choice A rationale
Taking prescribed cortisone accurately is the most important instruction for a client diagnosed with Addison’s disease. Cortisone is a type of glucocorticoid replacement therapy that helps to manage the symptoms of Addison’s disease and prevent adrenal crisis, a life-threatening condition characterized by acute insufficiency of adrenal hormones.
Choice B rationale
Using a walker when weakness occurs may be helpful for some clients with Addison’s disease, as muscle weakness is a common symptom. However, it is not the most important instruction. The primary treatment for Addison’s disease is hormone replacement therapy, which should help to alleviate symptoms such as muscle weakness.
Choice C rationale
Avoiding extreme environmental temperatures can be beneficial for individuals with Addison’s disease, as they may have difficulty regulating body temperature due to cortisol deficiency.
However, this is not the most important instruction. The cornerstone of managing Addison’s disease is hormone replacement therapy.
Choice D rationale
Increasing daily intake of sodium in the diet can be beneficial for some individuals with Addison’s disease, particularly during periods of gastrointestinal illness or intense physical activity. However, this is not the most important instruction. The primary treatment for Addison’s disease is hormone replacement therapy.

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A patient in the operating room has been administered succinylcholine and is now experiencing muscle rigidity and an extremely high temperature. What should the nurse do next?

Rationale for Other Options:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a history of hypothyroidism was initially admitted with lethargy and confusion. Which additional finding should the nurse act upon immediately?

Correct Answer is D

Explanation

The nurse is preparing a client for discharge who was recently diagnosed with Addison’s disease. Which instruction is most important for the nurse to include in this client’s discharge teaching plan?

Correct Answer is A

Explanation

The nurse is educating a client, who was admitted with a blood glucose level of 580 mg/dL, on how to prevent complications related to diabetes mellitus. Which statement made by the client indicates they have understood the information?

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