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.
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) Staying current on scheduled immunizations: Staying up-to-date with immunizations is important for overall child health but is not a direct risk factor for sudden infant death syndrome (SIDS). Immunizations can help prevent infections that could contribute to SIDS but are not directly related to the syndrome itself.
B) Maternal smoking during pregnancy: Maternal smoking during pregnancy is a well-documented risk factor for SIDS. Exposure to nicotine and other harmful substances from smoking can affect the baby's respiratory system and increase the likelihood of SIDS.
C) Newborn who is large for gestational age: Being large for gestational age is not a recognized risk factor for SIDS. SIDS risk factors are more closely associated with prenatal and postnatal conditions, rather than birth weight alone.
D) Meconium staining of amniotic fluid: Meconium staining of amniotic fluid is a condition that can indicate fetal distress during labor but is not a direct risk factor for SIDS. It is more related to potential complications during delivery rather than SIDS risk.
Correct Answer is ["A","C","E"]
Explanation
A) Headache:
Headache is a common adverse effect of albuterol due to its action on the central nervous system. The medication can cause vasodilation and changes in blood flow, leading to headaches. Parents should be aware of this potential side effect and manage it accordingly.
B) Hypotension:
Hypotension is not a typical adverse effect of albuterol. Albuterol primarily acts as a beta-2 agonist, leading to bronchodilation and some cardiovascular effects, but it generally does not cause a drop in blood pressure. Instead, it may occasionally increase blood pressure in some individuals.
C) Hyperactivity:
Hyperactivity is a known side effect of albuterol, especially in children. This occurs due to the stimulant effects of the medication on the central nervous system, leading to increased restlessness and activity levels. Parents should monitor their child's behavior for signs of increased hyperactivity.
D) Decreased pulse rate:
Decreased pulse rate (bradycardia) is not associated with albuterol use. Albuterol tends to cause tachycardia, an increased heart rate, due to its beta-adrenergic stimulating effects. Monitoring the pulse rate is essential, but a decreased rate is not a typical concern with this medication.
E) Tremors:
Tremors are a common adverse effect of albuterol, resulting from the stimulation of beta-adrenergic receptors in the muscles. This can cause muscle shaking or jitteriness, particularly in the hands. Parents should be informed about this possible side effect and observe their child for signs of tremors.
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