Certified Nurses Operating Room (CNOR) Practice Exam

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What does the acronym MURDER represent in relation to hyperkalemia symptoms?

  1. Myopathy, Urinary retention, Rapid pulse, Dizziness, ECG changes, Respiratory distress

  2. Muscle weakness, Urine oliguria/anuria, Respiratory distress, Decreased cardiac contractility, ECG changes, Reflexes flaccid

  3. Mental confusion, Unusual fatigue, Rapid heart rate, Dehydration, Elevated sodium levels, Respiratory failure

  4. Muscular cramps, Ulceration, Respiratory asthma, Diabetes, Eye twitching, Restlessness

The correct answer is: Muscle weakness, Urine oliguria/anuria, Respiratory distress, Decreased cardiac contractility, ECG changes, Reflexes flaccid

The acronym MURDER is a mnemonic used to remember the symptoms associated with hyperkalemia, particularly emphasizing the systemic effects the condition can have. The correct option details various clinical manifestations of hyperkalemia, which include muscle weakness, urine oliguria or anuria, respiratory distress, decreased cardiac contractility, ECG changes, and flaccid reflexes. Muscle weakness occurs because elevated potassium levels can interfere with the normal electrical activity in muscle cells, leading to diminished strength. The urinary symptoms like oliguria or anuria indicate the kidneys are struggling to excrete potassium efficiently due to hyperkalemia. Respiratory distress arises as muscle weakness extends to respiratory muscles, impacting the ability to breathe effectively. Decreased cardiac contractility means the heart's ability to pump effectively is compromised, which can be life-threatening. ECG changes are critical in diagnosing hyperkalemia, as they can reveal characteristics such as peaked T waves, widened QRS complexes, or prolonged PR intervals. Lastly, reflexes may become flaccid due to the disruption of neuromuscular transmission caused by high potassium levels. The other options present symptoms or manifestations that do not accurately correspond to the hyperkalemia scenario described by the MURDER acronym. Thus, the correct answer provides

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