NCLEX-RNPhysiological AdaptationHard
A client is receiving general anesthesia with succinylcholine for surgery. The nurse in the operating room notes the client's end-tidal CO2 rising rapidly, muscle rigidity, and a temperature increasing from 37°C to 39.5°C (98.6°F to 103.1°F) within 15 minutes. Which medication should the nurse prepare to administer immediately?
- APhysostigmine
- BNaloxone
- CFlumazenil
- DDantrolene sodium
Show answer & explanationAnswer & explanation
Correct answer: D. Dantrolene sodium
These findings indicate malignant hyperthermia, a life-threatening hypermetabolic reaction to certain anesthetics and succinylcholine. Dantrolene sodium is the specific antidote; it inhibits calcium release from the sarcoplasmic reticulum, halting the hypermetabolic muscle response, and must be given immediately along with discontinuing the triggering agent and cooling measures.
Why the other options are wrong
- A. Physostigmine reverses anticholinergic toxicity, not malignant hyperthermia.
- B. Naloxone reverses opioid overdose, not malignant hyperthermia.
- C. Flumazenil reverses benzodiazepine sedation, unrelated to this crisis.
Malignant Hyperthermia
A rare, life-threatening hypermetabolic reaction to certain anesthetic agents (e.g., succinylcholine, volatile anesthetics) causing rapid rise in temperature, muscle rigidity, and hypercapnia.
- Genetic predisposition affecting calcium channels in skeletal muscle
- Treatment: stop triggering agent, give dantrolene sodium, cool the client
- Untreated can cause rhabdomyolysis, cardiac arrest, and death
Memory trick: Dan the man saves the day with Dantrolene