Malignant Hyperthermia
The malignant hyperthermia cart is located
In front of PACU
Sensor placement should have one lead in each quadrant with tabs pointed towards
the toes
The first task for obtaining port access
Obtaining an order
Referring to team dynamics, when responding to a code blue alert you should first
assign roles
Depending on your shift; by 0900 or 2100, you will want to have this determined to guide your end of shift report
Shift focus - picking 1 to 5 things to focus on helps generate an end of shift report that focuses on the issues and goals of that patient for your shift.
Malignant hyperthermia is an inherited syndrome that can be triggered by physical and environmental factors such as excessive heat, exercise, and stress as well as medically with the most common conducer being
Succinylcholine
SVI stands for
Stroke Volume Index
Dry and intact central dressings with no gauze under them should be changed
every 7 days
Arrhythmias that require immediate defibrillation
ventricular fibrillation and pulseless/unstable ventricular tachycardia
A swingbed patient requires what plan of care
Life Enrichment
Early signs of malignant hyperthermia include
ETCO2 increase, Masseter rigidity, generalized muscle rigidity, cardiac arrhythmias, metabolic or respiratory acidosis, tachycardia, tachypnea, unstable arterial pressure, or profuse sweating
A patient being fluid responsive is determined by the NICOMM/Starling when their SVI is
greater than 10%
Central lines can pose significant infection risk. What documentation should be done every 12 hours as a measure to mitigate that risk?
Line Necessity Documentation
RSI's will be performed by
a licensed qualified practitioner who is credentialed through the Medical Staff Office.
A care plan must be established for patient care within
24 hours
Name 2 Late signs and symptoms of malignant hyperthermia.
Hyperthermia, hyperkalemia, rhabdomyolysis, severe cardiac arrhythmias, cardiac arrest, dark colored urine, acute renal failure, circulatory failure, elevated blood CK levels
The nursing driven protocol to perform diagnostic testing with the Starling on a patient with a sustained low blood pressure is called
Passive leg raise
Upon discontinuation of port access, unless otherwise ordered by a physician, is the only time that you flush with
Heparin Flush
Comfort measures taken when cardioverting, pacing, or rapid sequence intubating a patient that should be performed with a physician immediately available
Sedation
Your plan of care review can be documented each day now in the
Care Plan Flowsheet
The medication dosed at 2.5mg/kg that is mixed with 60mL of sterile water to treat Malignant Hyperthermia
Dantrolene
Sensors should remain on the patient due to cost for up to
72 hours
A port-a-cath needle should be changed
every 4-6 weeks
A device that determines quality CPR that should be documented at least every 2 minutes
End Tidal CO2
There are two care plans that we should ensure are on every patient for every encounter and they are
Discharge Planning
Fall safety