The 22-year-old patient is brought to the emergency room with decreased level of consciousness after ingesting 3,4-methylenedioxymethamphetamine. The patient is noted to have a rectal temperature of 40°C. The nurse performs which interventions? Select all that apply.

Question

The 22-year-old patient is brought to the emergency room with decreased level of consciousness after ingesting 3,4-methylenedioxymethamphetamine. The patient is noted to have a rectal temperature of 40&deg;C. The nurse performs which interventions? Select all that apply.

Accepted Answer

Institute seizure precautions, Place ice packs over axillae and groin, Titrate intravenous midazolam as ordered to effect, Regularly spritz the patient with water and have a circulating fan directed at the patient. It is vital to bring down the temperature of the patient who has ingested 3,4-methylenedioxymethamphetamine (MDMA, or Ecstasy). The nurse places ice packs over the axillae and groin and spritzes the patient with water with a fan blowing over the patient for cooling by evaporation. An intravenous benzodiazepine such as midazolam is used to control shivering, which will increase the patient&rsquo;s temperature and metabolic demand. The patient is at risk for seizures both due to hyperthermia and to the hyponatremia associated with MDMA toxicity. Antipyretics, such as acetaminophen per rectum, are ineffective for MDMA-induced hyperthermia.

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