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Articles 1 - 14 of 14
Full-Text Articles in Medical Sciences
Malignant Hyperthermia, Joel Jackson
Malignant Hyperthermia, Joel Jackson
Nursing Student Class Projects (Formerly MSN)
Malignant hyperthermia (MH) is a hypermetabolic response to succinylcholine or inhaled volatile gases administered during anesthesia and is caused by an autosomal dominant mutation of RYR1 or CACNA1S genes which affect how calcium channels function. The uncontrolled, unopposed calcium release and excitation-contraction coupling results in sustained skeletal muscle contraction resulting in muscle rigidity, hyperthermia, hypercapnia, hypertension, and tachycardia among other less common clinical features. The sequelae of an MH crisis include renal failure, rhabdomyolysis, hyperkalemia, metabolic disturbance and left untreated will result in mortality. All clinicians involved in peri-operative care both in-hospital and out of hospital must be cognizant of …
Malignant Hyperthermia For The Nurse Anesthetist, Victor Clark
Malignant Hyperthermia For The Nurse Anesthetist, Victor Clark
Nursing Student Class Projects (Formerly MSN)
Malignant Hyperthermia (MH) is a rare, autosomal dominant skeletal muscle disorder that can have an insidious onset in susceptible patients exposed to the triggering agents succinylcholine, halothane, desflurane, sevoflurane, and isoflurane. MH can occur in patients who have received anesthesia with these agents in the past (Nagelhout & Plaus, 2018, p 775). Patients with a family history of MH or associated skeletal muscle disorder must be treated as MH-susceptible until proven otherwise. Failure to detect an MH crisis can lead to kidney failure, profound acidosis, coagulopathies, rhabdomyolysis, cardiac dysrhythmias, cardiovascular collapse, and death (Seifert et al., 2015). It is the …
Local Anesthesia Toxicity, Nicole Mccleery
Local Anesthesia Toxicity, Nicole Mccleery
Nursing Student Class Projects (Formerly MSN)
Local anesthesia (LA) provides a way to relieve temporary pain in a small part of the body and has been used for over 100 years (Fencl, 2015). LA also prevents the passage of surgical stimuli into the central nervous system (CNS) making a surgical procedure less painful for the patient (Noble, 2015). According to Noble, “altering the passage of stimuli from smaller diameter neurons in a confined area with lower drug dosages is called LA, such as the injection of LA around a surgical incision” (Noble, 2015, p.325). LA can be used in a variety of settings, such as in …
Malignant Hyperthermia, Aaron Roth
Malignant Hyperthermia, Aaron Roth
Nursing Student Class Projects (Formerly MSN)
Malignant hyperthermia is a rare disease trait and can take place in a variety of settings. If not treated in a timely manner, the consequences will be dire. It is recommended that nurses and other healthcare personnel be properly educated on MH crises. By detecting the signs and symptoms associated with the disease, providers can efficiently remedy the crisis and save patient lives (Seifert, 2014). Since the discovery of dantrolene in 1975 and the advancement of genetics regarding MH, death rates dropped from about 80% to about 5% (Schneiderbanger et al., 2014). Today there is a MH group called the …
Turning Up The Heat On Malignant Hyperthermia, Katie Carroll
Turning Up The Heat On Malignant Hyperthermia, Katie Carroll
Nursing Student Class Projects (Formerly MSN)
Surgeries are common, everyday procedures within the walls of America’s hospitals. According to Orser, Mazer, and Baker (2008), more than forty million patients in North America are given anesthetics annually. One of the major complications of anesthesia is malignant hyperthermia: a hyper-metabolic state that affects skeletal muscles. If left uncontrolled, malignant hyperthermia can cause multiple reactions within the body leading to metabolic and respiratory acidosis, cardiac dysrhythmias, kidney failure, coagulopathy, neurologic injury, and ultimately death (Seifert, Wahr, Pace, Cochrane, & Bagnola 2014). The incidence of this condition is estimated to be 1:15,000 in children and 1:20,000-50,000 in adults (Redmond, 2001). …
Malignant Hyperthermia, Chase Contri
Malignant Hyperthermia, Chase Contri
Nursing Student Class Projects (Formerly MSN)
Although very rare, occurring one out of every 100,000 anesthesia cases, malignant hyperthermia is a hypermetabolic disorder that anesthesia providers screen and interrogate patients prior to every case they are administering anesthesia. Many research studies about anesthesia induced malignant hyperthermia have explored new methods of testing for the genetic susceptibility for malignant hyperthermia and into hospital based protocols when a patient starts to show the signs and symptoms of the metabolic disorder. This new knowledge and understanding has decreased patient mortality of anesthesia induced malignant hyperthermia from eighty percent to five percent over the past three decades (Rosenberg et al, …
Malignant Hyperthermia, Devin Poncsak
Malignant Hyperthermia, Devin Poncsak
Nursing Student Class Projects (Formerly MSN)
A crisis of malignant hyperthermia is a medical emergency, and must be treated immediately with a coordinated, multidisciplinary team response in order to give the patient the highest chance for a successful recovery (Dirksen, Van Wicklin, Mashman, Neiderer, & Merritt, 2013). Malignant hyperthermia is defined by Bandschapp & Girard (2012), as “a disturbance of the skeletal muscle calcium homeostasis, triggered by volatile anaesthetics and depolarizing muscle relaxants.” Once a vulnerable patient is exposed to one of these triggering agents, a pathologic hypermetabolic response ensues, and the patient has a rapid increase in oxygen consumption and expired carbon dioxide, hyperthermia, acidosis, …
The Pathophysiology Of Tumor Lysis Syndrome In Oncology Patients, Jessica Richardson
The Pathophysiology Of Tumor Lysis Syndrome In Oncology Patients, Jessica Richardson
Nursing Student Class Projects (Formerly MSN)
Patients with oncological conditions are at an increased risk of developing a wide variety of complications from chemotherapy that they would not otherwise be exposed too. One such life threatening complication is tumor lysis syndrome, which is an oncology emergency that frequently lands patients in the intensive care unit. Tumor lysis syndrome (TLS) occurs most frequently after the initiation of chemotherapy or other chemotoxic drugs during the patients’ treatment course [8]. It causes faster than normal tumor cell breakdown and release of intracellular contents into the general circulation. [8]. This leads to a very predictable development of electrolyte imbalances to …
Sports Related Traumatic Brain Injuries, Ky Parrott
Sports Related Traumatic Brain Injuries, Ky Parrott
Nursing Student Class Projects (Formerly MSN)
Traumatic Brain Injuries (TBI) are the leading cause of long-term disability and injury death in the United States of America (Dash, Oh, Santiago, & Wade, 2012, p. 108). It is estimated that approximately 75% of all TBI’s are sports related. Recently, sports related TBI’s have received increased awareness due to the $765 million settlement between 18,000 retired football players who suffer from long-term concussive injuries and the National Football Association (NFL) (Mason, 2013, p. 267). Education regarding the pathophysiology of TBI’s is beneficial to understanding what changes the brain is enduring and why it is important to protect the brain, …
Early-Onset Familial Alzheimer Disease, Laura J. Murphy
Early-Onset Familial Alzheimer Disease, Laura J. Murphy
Nursing Student Class Projects (Formerly MSN)
An Alzheimer’s diagnosis is an overwhelming and devastating diagnosis for both patients and families. Now imagine if this diagnosis was made at age 55. Instead of looking forward to retirement and grandchildren, these people are preparing for a debilitating disease that will rob them of their memory, cognitive and functional abilities. Early-onset familial Alzheimer’s disease (EOFAD) affects people before the age of 65. Although extremely rare, some exhibit symptoms as early as in their 30s. One of the things most frustrating about this disease is so little is known about its cause. That and the fact there is no cure. …
When Exercise Is A Pain In The Head, Rebecca D. Granger
When Exercise Is A Pain In The Head, Rebecca D. Granger
Nursing Student Class Projects (Formerly MSN)
Headache is one of the five most common chief complaints in the US, resulting in nearly 5 million visits to the ED (Lange, 2011). With great variance in quality, etiology, pathophysiology, and as a potential indicator of a serious underlying problem, it is critical that these headaches be accurately diagnosed, primarily for rapid identification of life threatening factors, but also to offer treatment and education specific to the particular type of headache the patient is experiencing. This will result in better outcomes for the patient through better control and will subsequently save health care dollars by reducing ED visits and …
Tension Pneumocephalus, Nicole Liebner
Tension Pneumocephalus, Nicole Liebner
Nursing Student Class Projects (Formerly MSN)
Pneumocephalus is defined as the presence of air within the cranial vault; tension pneumocephalus occurs when air within the cranial vault becomes trapped and causes a mass effect or increased pressure, damaging the brain (Patel, Idicula, Carrau, & Prevedello, 2013). Small amounts of air within the cranial vault can be reabsorbed or metabolized by the body over a few days without causing symptoms, however, in tension pneumocephalus the air cannot escape, causing extensive neurological symptoms (Webber-Jones ,2005). Thus, asymptomatic pneumocephalus can be a common finding following a cranial surgery, where as tension pneumocephalus is extremely rare (Webber-Jones, 2005). Markam (1967) …
Pseudocholinesterase Deficiency, Ross Gerken
Pseudocholinesterase Deficiency, Ross Gerken
Nursing Student Class Projects (Formerly MSN)
Pseudocholinesterase deficiency is a rare genetic or acquired variation in the metabolism of choline esters such as the neuromuscular blockers succinylcholine, mivacurium, and ester local anesthetics. Pseudocholinesterase deficiency genetically is transmitted in an autosomal recessive pattern with the frequency of apnea from a genetic abnormality of pseudocholinesterase between 1:480 and 1:3200 people (Ok et al., 2013). An extended period of neuromuscular blockade results from these medications than what is clinically expected. The signs and symptoms which occur are apnea and paralysis hours longer. This condition is rare but must be known and understood by the clinician in order to provide …
Understanding The Mystery Of Brain Death, Natalie A. Felter
Understanding The Mystery Of Brain Death, Natalie A. Felter
Nursing Student Class Projects (Formerly MSN)
Lack of understanding of brain death has contributed to recent controversial cases (Copnell, 2014). The cases of Jahi McMath and Marlise Munoz were the focus of national news, causing an intense debate among the public and healthcare professionals (Copnell, 2014). The concept of brain death is a mystery to the public (Powell, 2014). Copnell (2014) found that 60% of family members who had been told their loved one was brain dead believed that they were still alive. Health professionals not having a clear grasp of brain death’s definition and assessment can lead to increased confusion in family members (Powell, 2014).