Certified Ambulatory Perianesthesia Nurse (CAPA) Practice Exam

Which drug should be questioned if dysrhythmias persist after malignant hyperthermia treatment?

1. Amiodarone

2. Verapamil

3. Procainamide

4. Lidocaine

The correct answer is: Verapamil

The appropriate drug to question in the context of persistent dysrhythmias after the treatment of malignant hyperthermia is verapamil. This calcium channel blocker primarily acts on the heart and vascular smooth muscle, affecting heart rate and contractility. In the situation of malignant hyperthermia, the focus is on managing hypermetabolic state and avoiding any agents that may exacerbate cardiac issues. Malignant hyperthermia leads to severe metabolic disturbances and dysrhythmias that necessitate careful consideration of antiarrhythmic agents used to manage cardiac rhythm abnormalities. During management, certain drugs can be counterproductive or have adverse effects in the context of hypermetabolic crises. In contrast, other options like amiodarone, procainamide, and lidocaine are commonly used treatments for various types of dysrhythmias. Amiodarone is effective for both atrial and ventricular dysrhythmias, procainamide is used particularly for ventricular arrhythmias, and lidocaine is mainly used for ventricular tachycardias. These medications are generally more appropriate in the management of dysrhythmias and can be beneficial in stabilizing heart rhythms in this clinical scenario. Thus, questioning verapamil in this context is warranted because its use could potentially