A 27-year-old male client develops malignant hyperthermia during a herniorrhaphy; his temperature is 105.4 degrees F. The client has had no previous health problems other than hypertension. A nurse orienting in the OR says, 'I thought only people with brain tumors had this problem.' Which of the following answers explains malignant hyperthermia?

Correct Answer: D

Rationale: Epinephrine is a hormone employed in the fight-or-flight stress response. It does not contribute to malignant hyperthermia. Stimulation of the sympathetic adrenal medullary mechanism helps the body cope with stress. It does not contribute to malignant hyperthermia. Catecholamine release is one of the physiological effects of stress. It does not contribute to malignant hyperthermia. Malignant hyperthermia is an inherited disorder of muscle metabolism that increases intracellular calcium, which causes generalized muscle rigidity, fever, tachycardia, and tachypnea.

Correct Answer: A

Rationale: Respiratory obstruction due to edema of the glottis, bilateral laryngeal nerve damage, or tracheal compression from hemorrhage is a major complication after a thyroidectomy. Hypocalcemia and tetany from accidental removal of one or more parathyroid glands are major complications; not hypercalcemia. Fistula formation is not a major complication associated with a thyroidectomy. Fistula formation is a major complication with a laryngectomy. Myxedema is hypothyroidism occurring in adults. It is not a complication of a thyroidectomy. A thyroidectomy client tends to develop thyroid storm from an excess of the thyroid hormones released during surgery.

Correct Answer: B

Rationale: Cathartics, not antibiotics, promote the evacuation of intestinal contents. The client undergoing intestinal surgery is at an increased risk for infection from large numbers of anaerobic bacteria that inhabit the intestines. Administering antibiotics prophylactically can reduce the client's risk for infection. Antibiotics are indicated in the treatment of infections and have no effect on emotions. Antibiotics would have an effect on an infection which causes a temperature elevation, but they would not directly affect the temperature elevation.

Correct Answer: C

Rationale: An adult Valium dosage for treatment of anxiety is 2-10 mg PO from two to four times daily. As written, the order would place a client at risk for an overdose. A high room temperature could increase the hyperventilating episodes by stimulating the respiratory system. Holding one's breath and breathing into a paper bag may be useful in controlling hyperventilation. Both measures increase CO2 retention. Distraction will not prevent or control hyperventilation, which is caused by anxiety or fear.

Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.