A nurse in the PACU is caring for a client who has received general anesthesia and has manifestations of malignant hyperthermia. Which of the following medications should the nurse expect to administer?
Diazepam
Dantrolene
Cyclobenzaprine
Metaxalone
The Correct Answer is B
Rationale:
A. Diazepam is a benzodiazepine used for anxiety and sedation but is not effective for treating malignant hyperthermia.
B. Dantrolene is the specific antidote for malignant hyperthermia, and the nurse should expect to administer it to help reduce the severe muscle contractions and hypermetabolism associated with this condition.
C. Cyclobenzaprine is a muscle relaxant used for muscle spasms but is not indicated for malignant hyperthermia.
D. Metaxalone is also a muscle relaxant, but like cyclobenzaprine, it is not effective for managing malignant hyperthermia and would not be used in this situation.
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Correct Answer is B
Explanation
Rationale:
A. Abbreviate "daily" as "QD": The abbreviation "QD" is no longer recommended because it can be confused with "QID" (four times daily), potentially leading to dangerous medication errors.
B. Abbreviate "by mouth" as "PO": "PO" is the standard and accepted abbreviation for "by mouth," and it is widely used in medical documentation without ambiguity.
C. Abbreviate "acetaminophen" as "APAP": "APAP" is not universally recognized and may lead to confusion. Using the full name of the drug "acetaminophen" is safer and clearer.
D. Abbreviate "at bedtime" as "qhs": "Qhs" is discouraged as it can be easily misinterpreted. Writing "at bedtime" without abbreviations is the recommended practice to avoid errors.
Correct Answer is A
Explanation
Rationale:
A. Requesting a serum trough level blood draw for 60 minutes after the completion of the infusion is appropriate for monitoring the therapeutic levels of vancomycin and ensuring it is within the desired range to prevent toxicity.
B. Changing the infusion site after each dose administration is not necessary unless there is an issue such as infiltration or phlebitis; typically, the site can be used for multiple doses if it remains patent and functional.
C. Contacting the provider for prescription clarification is not needed unless there are specific concerns about the medication or the administration protocol; in this case, the order is clear and standard.
D. Requesting a serum peak level to be drawn 30 minutes prior to infusion is incorrect, as the peak level should be drawn 30 minutes after the completion of the infusion, not before the next dose.