CHAPTER 25: MUSCLE RELAXANTS
A 56-year-old woman with a diagnosis of multiple sclerosis has begun taking dantrolene. What client teaching should the nurse provide?
"Make sure to see your health care provider promptly if you develop yellowish skin or eyes."
Which medication would the nurse expect to administer if prescribed to achieve skeletal muscle relaxation?
Baclofen
What is the most important teaching from the plan of care, to emphasize, when a client is prescribed a skeletal muscle relaxant?
Do not drive or operate machinery until individual drug effects are known.
A client with muscle spasticity has been prescribed baclofen. In order to promote the safe use of this medication, the nurse should encourage the client to:
avoid drinking alcohol for the duration of treatment.
Dantrolene should be avoided in all patients who are 35 or older because of the increased risk of:
hepatocellular disease.
An operating room nurse is assisting the anesthesiologist in the preparation of an intravenous dose of dantrolene. What emergent issue most likely prompted the need to give the patient dantrolene?
Malignant hyperthermia
A nurse is caring for a client who is receiving cyclobenzaprine. The nurse would expect to assess which finding as indicating the therapeutic effect of the drug?
Reduction of muscle spasm
A nurse should review a client's medical conditions prior to administering a dantrolene as its use is contraindicated in clients with which condition(s)? Select all that apply.
1. Hepatic Disease 2. Lactation
Signs and symptoms of what would necessitate discontinuation of dantrolene therapy?
Hepatic dysfunction
A nurse is caring for a patient who is receiving cyclobenzaprine. Which of is the action of the drug on the patient?
Reduction of muscle spasm
A client has been prescribed baclofen and will be taking the drug on an outpatient basis. The client asks the nurse if it is still okay to drink wine with meals or end the day with a "nightcap." What is the nurse's best response?
"The combination of baclofen and alcohol could depress your nervous system to a dangerous level."
A client with a lower back injury was recently prescribed chlorzoxazone 250 mg PO t.i.d. The client has phoned the clinic, telling the nurse, "My pain's better, but I'm worried that my bladder is bleeding because there's been blood in my urine." What is the nurse's best response"
"This drug causes your urine to change color, so it's not likely blood that you're seeing."
A client who is experiencing lower back pain has been prescribed cyclobenzaprine. The nurse should provide what health education in order to ensure safe and effective treatment?
"This will likely make you drowsy, so don't take it before doing anything that would require alertness."
Which instruction should the nurse specifically stress when administering drugs used for muscle spasm and cramping?
Avoid alcohol or other CNS depressants.
The client is taking cyclobenzaprine for muscle spasms secondary to an injury to the lumbar spine that occurred while lifting a motor at work. The client is being seen for a follow-up visit by the health care provider. The client reports dry mouth, blurred vision, and constipation. Why is the client having these side effects from cyclobenzaprine?
Cyclobenzaprine produces an anticholinergic response
A client with a history of malignant hyperthermia is scheduled for surgery. Which agent would the nurse most likely expect to administer?
Dantrolene
A client with amyotrophic lateral sclerosis is experiencing muscle spasticity. Which drug would the nurse expect the physician to order?
Dantrolene
A client has been admitted to the unit for treatment of a multiple sclerosis exacerbation. The admission order indicates that the client is taking baclofen. Which outcome would the nurse expect to be associated with use of this medication?
Decreased muscle spasms
Which medication is classified as an antianxiety medication but is also used to treat muscle spasms?
Diazepam (Valium)
A nurse administers carisoprodol to a client for the treatment of an acute musculoskeletal condition. The nurse would be alert for which adverse effect after administering the drug?
Drowsiness
The nurse is providing education to a client who has been prescribed tizanidine. What adverse effect should the nurse mention during teaching?
Hypotension
A patient comes to the clinic for a botox injection around her eyes. While making an assessment, the nurse finds that the patient is taking polymyxin for an infection. What would the nurse do first?
Notify the physician.
A 40-year-old client with a diagnosis of fibromyalgia has been prescribed cyclobenzaprine (Flexeril) as an adjunct to her existing drug regimen. What nursing diagnosis should the nurse prioritize for the nursing care plan for this client?
Risk for Injury related to CNS depressant effects
A 29-year-old client who experienced a lower back injury has seen his range of motion decrease and his pain increase over the past several weeks. As a result, he has been prescribed cyclobenzaprine. What nursing diagnosis should the nurse prioritize in light of the client's drug regimen?
Risk for Injury related to CNS depression
When does a client with spinal cord injury-associated spasticity require treatment for this condition?
Safety, mobility, and activities of daily living are impaired.
A client's health care provider has prescribed baclofen in an effort to treat neuropathic cancer pain. What education should the nurse prioritize when teaching the client about this new medication?
The importance of ensuring safety related to possible sedation
Spinal reflexes are the simplest nerve pathways that monitor movement and posture.
True
A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which instruction?
Wear appropriate clothing and sunscreen whenever he is in direct sunlight.
A 32-year-old female client is taking tizanidine (Zanaflex) for spasticity related to her multiple sclerosis. The nurse will inform the client and her husband that the adverse effect that poses the greatest safety risk to the client is:
hypotension.
A patient has been prescribed methocarbamol for fibromyalgia. The nurse has spent an hour educating the patient on the use of methocarbamol for muscle pain. Which statement by the patient indicates that the patient has an understanding of at least one of the significant side effects of methocarbamol?
"My urine could be discolored while I take this drug."
A 43-year-old woman was diagnosed with multiple sclerosis 2 years ago and has experienced a recent exacerbation of her symptoms, including muscle spasticity. Consequently, she has been prescribed Dantrolene (Dantrium). In light of this new addition to her drug regimen, what teaching point should the woman's nurse provide?
"You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity."
A nurse is preparing a teaching plan for a client who is to receive botulinum toxin type A for frown lines. What adverse effect(s) should the nurse inform the client could possibly occur? Select all that apply.
1. Headache 2. Respiratory Infections 3. Drooping Eyelids
A client with a family history of malignant hyperthermia is to have bowel resection surgery and has been prescribed dantrolene 2.5 mg/kg IV one hour before surgery. The client weighs 185 lbs. The nurse reconstitutes dantrolene to a concentration of 50 mg/mL and should add how many mL to the IV minibag? Provide your answer to one decimal place.
4.2
Which would a nurse include when describing the action of dantrolene?
Interference with calcium release from the muscles
A surgical client has developed malignant hyperthermia. Which medication can be used to treat this health emergency?
dantrolene
Which patient would likely have the highest risk for hepatotoxicity from dantrolene?
A 57-year-old female who is on hormone replacement therapy
