During a preoperative assessment for a client with a family history of malignant hyperthermia, which of the following actions should the nurse take? Select all that apply.

Choice A rationale Succinylcholine is a depolarizing neuromuscular blocker, and enflurane is a volatile inhalation anesthetic. Both are well-known primary triggers for malignant hyperthermia in genetically susceptible individuals. These agents induce a massive, uncontrolled release of calcium from the sarcoplasmic reticulum in skeletal muscle cells. This leads to a hypermetabolic state characterized by muscle rigidity, hypercapnia, and dangerous pyrexia. Anesthesiologists must strictly avoid these medications and instead use safe alternatives like nitrous oxide or propofol for at-risk clients. Choice B rationale Communication is a critical safety intervention to prevent the accidental administration of triggering agents. Malignant hyperthermia is an autosomal dominant genetic disorder, meaning a family history significantly increases the client's risk. Notifying the entire intraoperative team, including surgeons, scrub nurses, and circulating nurses, ensures that the operating room is prepared with a "clean" anesthesia machine and that the malignant hyperthermia emergency cart, containing the necessary dantrolene, is immediately accessible if a crisis occurs during the procedure. Choice C rationale Placing an allergy or risk-alert band on the client serves as a visual safeguard that persists throughout the perioperative period. In the fast-paced environment of a surgical suite, this band provides a constant reminder to all healthcare providers that the client has a life-threatening contraindication to specific medications. This redundancy in communication helps prevent human errors, such as the administration of succinylcholine during emergency intubation or the use of halogenated gases during the maintenance phase of general anesthesia. Choice D rationale Documentation of a family history of malignant hyperthermia is a legal and clinical necessity for the preoperative record. This information alerts subsequent providers to the risk and ensures that a thorough assessment of the client's own history with anesthesia is conducted. Accurate documentation triggers the hospital's specific malignant hyperthermia protocol, which includes specialized monitoring of end-tidal carbon dioxide and core body temperature, as these are the earliest indicators of a hypermetabolic crisis during the administration of anesthesia. Choice E rationale Naloxone is an opioid antagonist used primarily to reverse the effects of respiratory depression caused by opioid overdose. It has no pharmacological role in the prevention or treatment of malignant hyperthermia. The gold-standard treatment for a malignant hyperthermia crisis is dantrolene sodium, a skeletal muscle relaxant that inhibits calcium release from the sarcoplasmic reticulum. Preparing to administer naloxone instead of focusing on dantrolene or cooling measures would be an inappropriate and ineffective response to this specific genetic risk. .