Author Question: A nurse is reviewing nursing actions for emergency treatment of malignant hyperthermia with a group ... (Read 62 times)

jenna1 · **on:** Jul 23, 2018

A nurse is reviewing nursing actions for emergency treatment of malignant hyperthermia with a group of nursing students. Which statement by a student indicates a need for further teaching?

a. Analgesics should be given to help with muscle pain.
b. Dantrolene helps to slow the metabolic activity in skeletal muscles.
c. If malignant hyperthermia occurs, the succinylcholine must be stopped imme-diately.
d. The patient may need an intravenous in-fusion of cold saline.

Question 2

A patient who has just found out she is pregnant tells the nurse she wants to quit smoking. She asks about pharmacologic aids to help her quit. The nurse is correct to tell her what?

a. Nicotine replacement therapy is harmful, but it is safer than smoking, so it can be used.
b. Psychosocial support is the only recom-mended treatment for smoking cessation during pregnancy.
c. Varenicline Chantix is safe to use dur-ing pregnancy.
d. You should try to taper off your smoking gradually, because none of the drugs are safe.

parshano · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

A
Malignant hyperthermia is a rare but potentially fatal adverse reaction that can be triggered by succinylcholine. Muscle pain is an expected adverse effect of succinylcholine that is thought to be caused by the muscle contractions that occur during induction and does not indicate malignant hyperthermia; analgesics can be given, but this effect usually occurs 10 to 12 hours after the procedure and is not an emergency. Dantrolene is given because it slows metabolic activity in skeletal muscles, resulting in decreased heat production. Succinylcholine should be stopped immediately if malignant hyperthermia occurs. Cold saline, given intravenously, often is necessary to lower a patient's temperature.

Answer to Question 2

A
Because nicotine is a component of nicotine replacement therapy (NRT), NRT is not safe during pregnancy. However, it is safer than smoking, and if it can help the patient stop smoking, it is recommended with caution. Psychosocial support is more effective when combined with a first-line pharmacologic agent. Varenicline has been shown to have harmful effects on fetuses in animal testing, so it should be avoided during pregnancy. Tapering nicotine withdrawal only seems to prolong the withdrawal symptoms; abrupt cessation is better than a taper.