During the immediate postoperative period, the Post Anesthesia Care Unit nurse is assessing a patient who had hip surgery. The patient is experiencing tachycardia, tachypnea, and muscle rigidity, and his temperature is 103°F (39.4°C). The nurse will prepare for what immediate treatment?
Dantrolene injection, a skeletal muscle relaxant
Cardiopulmonary resuscitation (CPR) and intubation
An anticholinesterase drug, such as neostigmine
Naltrexone hydrochloride injection, an opioid reversal drug
The Correct Answer is A
A. Dantrolene injection, a skeletal muscle relaxant: The patient is exhibiting signs of malignant hyperthermia, a potentially life-threatening complication of anesthesia. Dantrolene is the primary treatment for malignant hyperthermia as it acts as a skeletal muscle relaxant, reducing muscle rigidity and hypermetabolism associated with the condition.
B. Cardiopulmonary resuscitation (CPR) and intubation: While the patient is experiencing significant physiological distress, initiating CPR and intubation would be premature without first addressing the underlying cause, which appears to be malignant hyperthermia.
C. An anticholinesterase drug, such as neostigmine: Anticholinesterase drugs like neostigmine are not indicated for the treatment of malignant hyperthermia.
D. Naltrexone hydrochloride injection, an opioid reversal drug: Naltrexone is used for opioid overdose reversal and is not appropriate for the treatment of malignant hyperthermia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. "I will need to take extra care of my teeth and gums while on this medication.": Phenytoin can cause gum overgrowth (gingival hyperplasia), so taking extra care of oral hygiene is important.
B. "I will be able to stop taking this drug once the seizures stop.": Phenytoin is typically used as a long-term therapy for seizure control; stopping abruptly can lead to rebound seizures.
C. "I can go out for a beer while on this medication.": Alcohol consumption may interact with phenytoin and should be avoided or limited.
D. "I can skip doses if the side effects bother me.": Skipping doses of phenytoin can lead to inadequate seizure control and should not be done without consulting a healthcare provider.
Correct Answer is C
Explanation
A. These are adverse effects that usually subside after a few weeks: While some adverse effects of phenobarbital may diminish over time, the symptoms described by the patient are more likely related to its impact on REM sleep.
B. The drug must be stopped immediately because of possible adverse effects: Stopping phenobarbital abruptly can lead to withdrawal symptoms and potential rebound seizures; discontinuation should be done gradually under medical supervision.
C. This drug causes deprivation of REM sleep and may cause the inability to deal with normal stress: Phenobarbital is known to disrupt REM sleep, leading to emotional lability, irritability, and difficulty coping with stress.
D. This drug causes the rapid eye movement (REM) sleep period to increase, resulting in nightmares and restlessness: Phenobarbital actually decreases REM sleep, which can lead to disturbances in sleep patterns and mood changes.
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