Question

Case Study, Chapter 18, Intraoperative Nursing Management

2. Mr. Bond is a 32-year-old Caucasian man who plays professional football. He was admitted for repair of a rotator cuff injury sustained in a game. In excellent shape, Mr. Bond has a muscular build and his body fat is 18%. Mr. Bond is transferred to the operating room, and the anesthesiologist begins to administer general anesthesia. During the induction of anesthesia, Mr. Bond develops tachycardia and dysrhythmias. His condition continues to deteriorate and he becomes severely hypotensive and exhibits decreased cardiac output. The anesthesiologist states that Mr. Bond is developing malignant hyperthermia. (Learning Objective 5)

What risk factor does Mr. Bond have for malignant hyperthermia?

What clinical manifestations of malignant hyperthermia does Mr. Bond demonstrate?

Based on the patient’s condition, the surgical procedure is stopped and 100% oxygen is started. Additionally, a muscle relaxant and sodium bicarbonate are administered. What are the rationales for these medications?

Answer 1

1. Risk factor that Mr. Bond have for malignant hyperthermia is strong bulky muscles.

2. Clinical manifestations of malignant hyperthermia that Mr. Bond have are-

-?Tachycardia (earliest sign)

-dysrhythnmias within 10-20 minutes of induction phase, but can occur within first 24 hours post surgery.

-decreased cardiac output

-hypotensive

3. Prevent an MI as the heart is a muscle, tetanus like movement occur due to abnormal transport of Calcium to the muscles.

- Dantrolene helps to relieve spasms and muscles.

- Sodium Bicarbonate to treat metabolic acidosis.