Certified Nurses Operating Room (CNOR) Practice Exam

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Which medication combination is used to treat hyperkalemia in a patient with Malignant Hyperthermia (MH)?

Insulin and dextrose 50%
Calcium chloride and lidocaine
Dextrose and beta blockers
Calcium gluconate and Lactated Ringers

The correct answer is: Insulin and dextrose 50%

The treatment of hyperkalemia, especially in the context of Malignant Hyperthermia, involves using a combination of insulin and dextrose. Insulin facilitates the uptake of potassium into the cells, thereby lowering the serum potassium levels, while dextrose is administered to prevent hypoglycemia that can occur due to insulin administration. This combination is particularly effective in managing elevated potassium levels, which can be critically high during episodes of Malignant Hyperthermia, a condition that can lead to severe metabolic disturbances. Other options provided may not address hyperkalemia effectively in the context of MH. While calcium chloride does play a role in stabilizing myocardial membranes in the presence of elevated potassium, it does not actively lower serum potassium levels like insulin does. Dextrose and beta blockers do not effectively treat hyperkalemia and could potentially worsen metabolic control. Calcium gluconate and Lactated Ringer's solution do not directly lower potassium levels in the same manner as insulin, making the combination of insulin and dextrose the most appropriate choice for treating hyperkalemia in this situation.