Certified Transport Registered Nurse Certification Practice Exam

What condition may increase the risk of hyperkalemia when administering succinylcholine?

1. Arrhythmias

2. Neuromuscular diseases

3. Vascular diseases

4. End-stage renal disease

The correct answer is: Neuromuscular diseases

The condition that may increase the risk of hyperkalemia when administering succinylcholine is neuromuscular diseases. Succinylcholine is a depolarizing neuromuscular blocker that mimics the action of acetylcholine at the neuromuscular junction. In patients with neuromuscular diseases, such as muscular dystrophy or amyotrophic lateral sclerosis, there can be an upregulation of acetylcholine receptors due to the loss of muscle fibers. This upregulation can lead to an increased release of potassium into the bloodstream following succinylcholine administration, resulting in hyperkalemia. Additionally, those with neuromuscular diseases often have muscle cell damage or dysfunction. When the muscle is stimulated by succinylcholine, potassium may be released from these damaged cells, further elevating serum potassium levels. This effect makes administering succinylcholine in patients with neuromuscular conditions particularly risky, as the potential for severely elevated potassium can lead to life-threatening cardiac arrhythmias. In summary, the unique physiological response that occurs in patients with neuromuscular diseases contributes significantly to the risk of hyperkalemia when succinylcholine is administered.