A nurse is assessing a postoperative patient who has a family history of malignant hyperthermia. Which findings would be of most concern to the nurse?
1. Mild spasms of the patient's jaw muscles
2. Dark urine 3 hours after surgery
3. Tachycardia in the first hour after surgery
4. Temperature elevation 3 hours after the procedure
5. Respiratory rate increase to 18 breaths per minute 2 hours after the procedure
Correct Answer: 1,2,3
Rationale 1: Mild jaw spasms often herald the development of malignant hyperthermia.
Rationale 2: Darkened urine may signify rhabdomyolysis, which occurs with malignant hyperthermia.
Rationale 3: Tachycardia is a potential herald of malignant hyperthermia.
Rationale 4: Temperature elevation more than 2 hours after anesthesia is not a precursor of malignant hyperthermia.
Rationale 5: Respiratory rate may increase as anesthesia passes, but this is a rate still within normal ranges.
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