Discuss the risk factors for malignant hyperthermia in relation to the patient described in this case study
What will be an ideal response?
Suggested response: The patient described in the case study underwent a stabilisation of a compound fracture of the left tibia and fibula following a workplace fall, and received a volatile anaesthetic (isoflurane), which is recognised as a potential trigger substance for malignant hyperthermia. However, suxamethonium, another trigger substance, was not used at induction. Rapid rewarming and administration of catecholamines are other triggers for the development of malignant hyperthermia. The patient did not have a family history of anaesthetic complications. Preoperatively this is an important question to ask as the development of malignant hyperthermia is linked to a genetic mutation in the skeletal muscle ryanodine receptor 1 (RyR1). When activated by inhaled anaesthetics or depolarising neuromuscular blockade, a prolonged, uncontrolled release of calcium from the sarcoplasmic reticulum occurs and results in sustained contraction of skeletal muscle.
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A vital factor, from a nursing education perspective, that contributes to the nursing shortage is which of the following?
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A nurse documents which of the following as a normal finding when examining the thyroid gland of an older adult client?
A) Nodularity B) Tenderness C) Enlargement D) Bruits