Which of the following answers lists the Paralytic drug that is associated with the possible development of Malignant Hyperthermia, along with the treatment medication for Malignant Hyperthermia?
Pancuronium; Neostigmine.
Rocuronium; Dantrolene.
Vecuronium; Neostigmine.
Succinylcholine; Dantrolene.
The Correct Answer is D
Choice A rationale
Pancuronium is a non-depolarizing neuromuscular blocker, but it is not directly linked to malignant hyperthermia. Neostigmine is an acetylcholinesterase inhibitor used to reverse the effects of non-depolarizing neuromuscular blockers by increasing acetylcholine at the neuromuscular junction, not a treatment for malignant hyperthermia.
Choice B rationale
Rocuronium is a non-depolarizing neuromuscular blocker and, while generally safe, is not the primary paralytic associated with malignant hyperthermia. Dantrolene is the specific pharmacological treatment for malignant hyperthermia, acting by inhibiting calcium release from the sarcoplasmic reticulum in muscle cells, reducing muscle rigidity and hypermetabolism.
Choice C rationale
Vecuronium is a non-depolarizing neuromuscular blocker and does not directly trigger malignant hyperthermia. Neostigmine, as previously stated, is a reversal agent for non-depolarizing muscle relaxants and has no role in the treatment of malignant hyperthermia, which requires specific intervention to address altered calcium homeostasis.
Choice D rationale
Succinylcholine, a depolarizing neuromuscular blocker, is the only commonly used paralytic drug that can reliably trigger malignant hyperthermia in susceptible individuals due to its direct interaction with the ryanodine receptor. Dantrolene is the definitive treatment, acting to restore intracellular calcium homeostasis by blocking calcium release from the sarcoplasmic reticulum.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Pleurodesis is the most likely recommended procedure for recurrent pleural effusions. This procedure involves inducing inflammation and adhesion between the parietal and visceral pleura, thereby obliterating the pleural space and preventing further fluid accumulation. It is a definitive treatment for recurrent effusions unresponsive to other interventions.
Choice B rationale
A lobectomy involves surgical removal of a lung lobe. This procedure is typically performed for conditions such as lung cancer, severe localized infection, or extensive lung damage, not primarily for recurrent pleural effusions unless the effusion is directly caused by a resectable lung pathology.
Choice C rationale
Endotracheal intubation is a temporary measure to establish an artificial airway for ventilatory support in cases of respiratory failure. It is an acute intervention for airway management and breathing support, not a long-term solution for recurrent pleural effusions. It does not address the underlying cause of fluid accumulation.
Choice D rationale
A pneumonectomy is the surgical removal of an entire lung. This radical procedure is reserved for severe, life-threatening conditions like extensive lung cancer or widespread irreversible lung damage. It is an extremely invasive measure and not a primary treatment for recurrent pleural effusions.
Correct Answer is D
Explanation
Choice A rationale
Defecation, while it can occur during severe neurological events due to autonomic dysregulation, is a non-specific sign and not a primary or direct indicator of brain herniation. Brain herniation primarily affects vital centers and cranial nerves, leading to more direct neurological compromise.
Choice B rationale
Pinpoint pupils are typically associated with pontine lesions or opioid overdose due to parasympathetic overactivity. In contrast, brain herniation, especially uncal herniation, often causes ipsilateral pupil dilation due to compression of the oculomotor nerve (cranial nerve III), leading to parasympathetic blockade.
Choice C rationale
Tachycardia, an increased heart rate, can be a non-specific response to stress, pain, or hypovolemia. In the context of brain herniation, as intracranial pressure rises and compresses the brainstem, bradycardia (slowing of the heart rate) is a more characteristic finding due to the Cushing reflex, not tachycardia.
Choice D rationale
Bilateral dilated pupils, especially when fixed and non-reactive to light, are a critical and often late sign of severe brain herniation, indicating significant brainstem compression and widespread damage, particularly to the midbrain's oculomotor nerve nuclei or their pathways. This signifies severe cerebral anoxia or irreversible brain injury.
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