105 musculoskeletal

The nurse tells a client with leukemia that allopurinol has been added to the medication list. The client is currently receiving busulfan. When the client asks the purpose of the new medication, the nurse responds that allopurinol is intended to prevent which complication?

Hyperuricemia

During the monitoring of a client's response to disease-modifying antirheumatic drugs (DMARDs), which findings would the nurse interpret as acceptable responses? Select all that apply.

1 Symptom control during periods of emotional stress 2 Normal white blood cell, platelet, and neutrophil counts 3 Radiological findings that show nonprogression of joint degeneration 4 An increased range of motion in the affected joints 3 months into therapy

The nurse is caring for a client who just been prescribed alendronate. Which conditions contraindicate this medication being given to the client? Select all that apply.

Hypocalcemia Poor renal function Gastroesophageal reflux disease (GERD)

The nurse reviews the medication history of a client admitted to the hospital and notes that the client is taking leflunomide. During data collection, the nurse asks which question to determine if the medication is effective?

"Do you have any joint pain?"

The nurse has given medication instructions to a client beginning therapy with carisoprodol. The nurse determines that the client understands the effects of the medication if the client makes which statement?

"I need to avoid alcohol while taking this medication."

The nurse has reinforced discharge instructions to a client with multiple sclerosis who is receiving baclofen. Which statement by the client indicates an understanding of the medication?

"I need to watch for urinary retention."

The nurse is providing instructions to a client with a diagnosis of rheumatoid arthritis (RA) who is receiving acetylsalicylic acid 5 g orally daily. Which statement by the client would indicate an understanding of the instructions?

"I should notify the primary health care provider if I get any ringing in my ears."

The nurse is teaching a client with osteoporosis who is being discharged with a prescription for a bisphosphonate. What comment by the client shows a need for further teaching?

"I'll take it before supper with 8 ounces of water and stay in an upright position for 30 to 60 minutes."

Carisoprodol is been prescribed for a client to relieve muscle spasms. The client is being discharged and the nurse is instructing the client and family about the medication. What comment by the client indicates a need for further teaching?

"I'm glad there are no withdrawal problems when I stop taking this medication."

A client receives a prescription for methocarbamol, and the nurse reinforces instructions to the client regarding the medication. Which client statement would indicate a need for further teaching?

"If my vision becomes blurred, I don't need to be concerned about it."

A client is receiving a maintenance dose of oral dantrolene sodium for the treatment of spasticity. The nurse reviews the medication record, expecting which dose to be prescribed?

100 mg twice daily

The nurse is reviewing the laboratory studies on a client receiving dantrolene sodium. Which laboratory test(s) would identify an adverse effect associated with the administration of this medication?

2 Liver function tests

Auranofin has been prescribed for a client with rheumatoid arthritis. The nurse who is collecting data 2 weeks later interprets that the client may be experiencing the signs of medication toxicity based on what data collection findings? Select all that apply.

2 Observes several mouth lesions 3 Notes a rash on trunk and neck 4 Reports a metallic taste in the mouth 5 Notes purplish blotches on the skin

A client with multiple sclerosis is receiving dantrolene for relief of muscle spasticity. When would this medication be discontinued if there is no relief of spasticity?

2 months

The nurse is reviewing the record of a client who has been prescribed baclofen. Which disorder would alert the nurse to contact the primary health care provider (PHCP)?

A seizure disorder

Dantrolene sodium is prescribed for a client experiencing flexor spasms, and the client asks the nurse about the action of the medication. The nurse responds knowing that which is the therapeutic action of this medication?

Acts directly on the skeletal muscle to relieve spasticity

Allopurinol has been prescribed for a client with chronic tophaceous gout. The nurse explains to the client that what condition can occur during the first few months of treatment?

Acute gouty arthritis

The nurse prepares to reinforce instructions to a client who is taking allopurinol. The nurse would include which instruction in the plan?

Instruct the client to drink 3000 mL of fluid per day.

The nurse is reviewing medications with the client receiving colchicine for the treatment of gout. The nurse determines that the medication is effective if the client reports a decrease in which?

Joint inflammation

A licensed practical nurse (LPN) is reviewing the medical record of a newly assigned client and notes that the client is receiving cyclobenzaprine hydrochloride for the treatment of muscle spasms. The LPN questions the prescription if which disorder is noted in the admission history?

Angle-closure glaucoma

The nurse is preparing discharge instructions for a client receiving baclofen. Which instruction would be included in the teaching plan?

Avoid the use of alcohol.

The nurse is reinforcing discharge instructions to a client receiving baclofen. Which would the nurse include in the instructions?

Avoid the use of alcohol.

The nurse is administering an intravenous dose of methocarbamol to a client with multiple sclerosis. For which adverse effect would the nurse monitor?

Bradycardia

A primary health care provider prescribes auranofin for a client with rheumatoid arthritis. Which data would indicate to the nurse that the client is experiencing toxicity related to the medication?

Complaints of a metallic taste in the mouth

A client with multiple sclerosis is receiving baclofen. The nurse monitoring this client would look for which outcome to indicate a primary therapeutic response from the medication?

Decreased muscle spasms

A client has been prescribed allopurinol. The nurse reinforces which information concerning the administration of the medication?

Drink at least 8 glasses of fluid every day.

A client with a history of spinal cord injury is receiving baclofen for muscle spasms. The nurse determines that the client is experiencing a side effect of this medication if the client experiences which sign/symptom?

Drowsiness

A client with multiple sclerosis is receiving diazepam, a centrally acting skeletal muscle relaxant. Which data would indicate that the client is experiencing a side effect related to this medication?

Drowsiness

The nurse is monitoring a client receiving baclofen for side effects related to the medication. Which would indicate that the client is experiencing a side effect?

Drowsiness

Cyclobenzaprine is prescribed for a client for muscle spasms, and the nurse is reviewing the client's record. Which disorder, if noted in the record, would indicate a need to contact the primary health care provider about the administration of this medication?

Glaucoma

Cyclobenzaprine is prescribed for a client to treat muscle spasms, and the nurse is reviewing the client's record. Which disorder would indicate a need to contact the primary health care provider (PHCP) regarding the administration of this medication

Glaucoma

A licensed practical nurse (LPN) is reviewing laboratory results for a client taking dantrolene sodium. The LPN would suggest that the registered nurse notify the primary health care provider if which finding is noted on the laboratory report sheet?

Lactate dehydrogenase (LDH) 600 units/L

Baclofen is prescribed for a client with a spinal cord injury who is experiencing muscle spasms, and the nurse prepares a list of the associated side effects of the medication and reviews the list with the client. Which side effect identified by the client indicates a need for further teaching?

Photosensitivity

Colchicine is prescribed for a client with a diagnosis of gout. The nurse reviews the client's medical history in the health record, knowing that the medication would be contraindicated in which disorder?

Renal failure

A client diagnosed with rheumatoid arthritis (RA) has been started on medication therapy with hydroxychloroquine. The nurse reinforces teaching with this client regarding the most serious adverse effect of this medication?

Retinal damage

The nurse is caring for a client with gout who is taking colchicine. The client has been instructed to restrict the diet to low-purine foods. Which food would the nurse instruct the client to avoid while taking this medication?

Scallops

An adult client with severe muscle spasticity is receiving intrathecal baclofen (ITB). The nurse knows that what adverse effects may occur if the medication is suddenly withdrawn. Select all that apply.

Seizures Hallucinations

A client is receiving baclofen for muscle spasms caused by a spinal cord injury. The nurse monitors the client, knowing that which is a side effect of this medication?

Slurred speech

The nurse is reinforcing dietary instructions to a client who is currently prescribed probenecid. Which food would the nurse encourage the client to continue to eat?

Spinach

A film-coated form of diflunisal has been prescribed for a client for the treatment of chronic rheumatoid arthritis. The client calls the clinic nurse because of difficulty swallowing the tablets. Which initial instruction would the nurse reinforce to the client?

Swallow the tablets with large amounts of water or milk."

The client has been taking medication for rheumatoid arthritis for 3 weeks. During the administration of etanercept, it is most important for the nurse to collect which data?

The white blood cell and platelet counts

The client has been on treatment for rheumatoid arthritis for 3 weeks. Which is most important for the nurse to check during the administration of etanercept?

The white blood cell counts and platelet counts

The nurse is caring for a client with muscle spasticity characterized by heightened muscle tone, spasm, and loss of dexterity caused by multiple sclerosis. Which centrally acting skeletal muscle relaxants might be prescribed for this client? Select all that apply.

1 Baclofen 2 Diazepam 4 Dantrolene

The nurse notes that meloxicam is prescribed for a client. The nurse knows that what are the specific actions of this medication? Select all that apply.

1 Analgesic 2Antipyretic 6 Anti-inflammatory

A client with acute muscle spasms has been taking baclofen. The client calls the clinic nurse because of continuous feelings of weakness and fatigue and asks the nurse about discontinuing the medication. The nurse would make which appropriate response to the client?

4 "Weakness and fatigue commonly occur and will diminish with continued medication use."

A primary health care provider instructs a client with rheumatoid arthritis to take ibuprofen. The nurse reinforces the instructions, knowing that the normal adult dose for this client is which?

400 mg orally 3 times a day

A client is receiving diazepam for its skeletal muscle relaxant effects. The nurse would monitor this client for which side effect of this medication

Incoordination

A client with multiple sclerosis is receiving diazepam, and the home care nurse reinforces instructions to the client regarding the side effects of the medication. The nurse tells the client that which is a side effect of this medication?

Incoordination

A client newly diagnosed with gout has been prescribed allopurinol. The nurse would question the primary health care provider if the dose for which medication already prescribed has not changed?

Warfarin sodium

A client has been started on cyclobenzaprine for the management of muscle spasms in the cervical spine. The client is experiencing drowsiness, dizziness, and dry mouth. The nurse interprets these signs/symptoms as which response?

These are the common side effects of this medication.

A client has been prescribed cyclobenzaprine in the treatment of painful muscle spasms accompanying a herniated intervertebral disk. The nurse would withhold the medication and question the prescription if the client had which concurrent prescriptions to take?

Tranylcypromine

Alendronate is prescribed for a client with osteoporosis, and the nurse is providing instructions for the administration of the medication. Which instruction would the nurse reinforce?

4 Take the medication with a full glass of water after rising in the morning.