Certified Ambulatory Perianesthesia Nurse (CAPA) Practice Exam

A patient on ventilator support has a history of alcoholism and tuberculosis. Following the administration of succinylcholine, which condition is the perianesthesia nurse likely to suspect?

1. Noncardiogenic pulmonary edema

2. Hypokalemia

3. Hypoglycemia

4. Plasma cholinesterase deficiency

The correct answer is: Plasma cholinesterase deficiency

In the context of a patient with a history of alcoholism and recent administration of succinylcholine, the perianesthesia nurse would be particularly concerned about plasma cholinesterase deficiency. Succinylcholine is a neuromuscular blocking agent that is metabolized by plasma cholinesterase. If a patient has a deficiency in this enzyme, it can lead to prolonged neuromuscular blockade because the drug would not be broken down as quickly as expected. Patients with alcoholism may have impaired liver function, which can affect the production of enzymes, including plasma cholinesterase. Additionally, certain genetic factors can lead to inherited deficiencies in this enzyme, which can also be relevant in assessing the patient's response to succinylcholine. Consequently, monitoring for prolonged muscle paralysis and respiratory depression is crucial in this scenario. Other presented conditions, while important, do not directly relate to the administration of succinylcholine or the patient’s specific history in the same way. Noncardiogenic pulmonary edema could occur due to various factors but does not have a clear link to succinylcholine. Hypokalemia and hypoglycemia may occur in different clinical situations but are not typically associated with succinylcholine use or the conditions outlined in this patient's history