Malignant Hyperthermia Guided CASE Study PDF

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Done during online clinical for PN1...

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MALIGNANT HYPERTHERMIA GUIDED CASE STUDY Please watch the following videos for Malignant Hyperthermia. The last video is for this Guided Case Study.   

Malignant Hyperthermia- Everything You Need to Know- Dr. Nabil Ebraheim (5:51) o https://www.youtube.com/watch?v=OvnUt2JzdxM Malignant Hyperthermia- Education (5:10) o https://www.youtube.com/watch?v=wQ_ZY4_tPp8 Malignant Hyperthermia Crisis Simulation (5:21) o https://www.youtube.com/watch?v=WX55MO6yOoM

1. What is the patient’s past medical history? None

2. Is there anything in his past medical history that puts this patient at risk? No, patient has NKDA and no prior anesthetic complications 3. What are the triggering agents/medications for MH? Volatile anesthetics and depolarizing muscle relaxants

4. What are some of the signs and symptoms of MH? Increase in ETCO2, generalized muscle rigidity, tachycardia, tachypnea, hyperthermia, hyperkalemia, and myoglobinuria. 5. What are some of the differential diagnoses to consider? Anaphylaxis, insufficient anesthesia, insufficient ventilation, neuroleptic malignant syndrome, and serotonin syndrome.

6. What was the first indicator that MH is occurring? The CO2 levels went up as well as the temperature and heartrate. Blood pressure also has a slight change. Respirations also went up quite a bit. 7. How is MH managed? Notify surgeon, stop the procedure, discontinue volate agents and succinylcholine, call for malignant hyperthermia cart, reconstitute dantrolene or ryanodex, call MHAUS, monitor vital signs, insert foley catheter, initiate colling blanket. By hyperventilating the patient to get CO2 down, putting a cooling blanket on the patient, initiating an A line,

8. This patient weighs 70 kg. How much of the desired medication should he receive? How many vials? 2.5mg/kg. 8.75 vials

175 mg of dantrole should be given.

1 vial has 20 mg of dantrole in it so you would have to administer

* Be prepared to discuss this patient in the debriefing session. * Complete these answers, submit to the drop box. * Complete a drug card on the medication used in this scenario (attached) Brand Name & Generic Name Pharmacologic Class Therapeutic Class Mechanism of Action

Reason Given-

Dantrolene Ryanodex

Muscle relaxer Skeletal muscle relaxer Acts directly on skeletal muscles, causing relation by decreasing calcium release from sarcoplasmic reticulum in muscle cells. Prevents intense catabolic process associated with malignant hyperthermia. Reduction of muscle spasticity. Treatment and prevention of malignant hyperthermia. Patient is in malignant hyperthermia

Why is this relevant to this patient? Pre-Administration Assessment(s)

Evaluate renal function and CBC before and periodically during therapy.

Post-Administration Assessment(s)

Monitor liver function, frequently during therapy, monitor vital signs, monitor urine output

Nursing Considerations

Assess bowel functions periodically, assess neuromuscular status and muscle spasticity, assess previous anesthesia history, monitor vital signs.

How do you administer this medication?

Iv patient will be unconscious in malignant hyperthermia and it will be given through an IV it has a rapid onset

Be specific Drug-Specific Nutritional Education

Do not consume alcohol while taking this medication

Drug-Specific Patient Education

Calcium channel blocks, CNS depressants, alcohol, antihistamines, opioid analgesics, sedative/hypnotics, magnesium sulfate, hepatotoxic agents or estrogens, verapamil, and vedcuronium...