Certified Post Anesthesia Nurse (CPAN) Practice Exam

In the PACU, if a patient exhibits tachypnea, muscle rigidity, tachycardia, and dysrhythmia, which condition is suspected?

1. Neuroleptic malignant syndrome

2. Post operative hemorrhage

3. Hypoxic brain damage

4. Malignant hyperthermia

The correct answer is: Malignant hyperthermia

The presence of tachypnea, muscle rigidity, tachycardia, and dysrhythmia in the postoperative setting indicates a high suspicion for malignant hyperthermia. This life-threatening condition is triggered by certain anesthetic agents and is characterized by a hypermetabolic state of skeletal muscle. The rapid increase in metabolism leads to an increase in carbon dioxide production, which often results in tachypnea as the body attempts to expel excess carbon dioxide. Muscle rigidity is another hallmark sign of malignant hyperthermia, occurring due to sustained muscle contraction as a result of the uncontrolled release of calcium from the sarcoplasmic reticulum of muscle cells. In response to this metabolic crisis, the body's circulatory system may become stressed, leading to tachycardia and dysrhythmias as the heart works harder to maintain adequate blood flow and oxygen delivery. On the other hand, neuroleptic malignant syndrome is related to the use of antipsychotic medications and presents with similar symptoms; however, it is not usually directly linked to the immediate postoperative context and does not typically cause significant tachypnea right after anesthesia. Postoperative hemorrhage would primarily manifest with changes in blood pressure and signs of bleeding rather than the combination of symptoms listed. Hypoxic