CHAPTER 25 Muscle Relaxants
The client is taking baclofen. What would be the most important safety instruction for the nurse to give to this client?
Discontinue the use of alcohol.
A client with a spinal cord injury is experiencing increasing muscle spasticity and the care team is considering the use of dantrolene. The nurse should identify what possible contraindication to the safe and effective use of this medication?
Do not drive or operate machinery until individual drug effects are known.
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 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 caring for a client who is receiving cyclobenzaprine for relief of muscle spasms. What adverse effect should the nurse assess for?
Drowsiness
When developing a teaching plan for a client who is to receive carisoprodol, which sign or symptom would the nurse include as a common adverse reaction?
Drowsiness
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."
A client got a cut on his hand while gardening one week ago and now shows signs and symptoms of tetanus. The nurse should anticipate the use of what medication?
Methocarbamol
An older adult is prescribed a skeletal muscle relaxant for reports of neck pain. What is the top priority of care for the nurse to teach the family?
Monitor the client before ambulating.
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.
An older adult client is to receive a centrally acting skeletal muscle relaxant. Which muscle relaxant would the nurse expect to be prescribed?
carisoprodol
The nurse instructs a client about the possibility of his urine turning orange to purple-red if the client were receiving:
chlorzoxazone.
The nurse is assessing a client for possible risk factors for the development of hepatotoxicity with the use of dantrolene. What situation(s) would the nurse identify as requiring cautious use of the drug?
female gender
The nurse instructs a client prescribed the muscle relaxant baclofen that the medication should be tapered slowly to prevent which adverse effect?
hallucinations
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.
hepatic disease lactation
The nurse is assessing the client's past medical history in preparation to administer dantrolene. The nurse will question this order if which condition(s) are noted in the client's medical record? Select all that apply.
hepatic disease lactation
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.
Which medication is classified as an antianxiety medication but is also used to treat muscle spasms?
Diazepam (Valium)
A surgical client has developed malignant hyperthermia. Which medication can be used to treat this health emergency?
dantrolene
The nurse is caring for a 59 year-old female client who was diagnosed with multiple sclerosis two years ago. In recent weeks, the client has developed increasing muscle spasticity and the care team is considering the use of dantrolene. What assessment question should the nurse prioritize?
"Are you on hormone replacement therapy?"
The nurse is preparing to administer cyclobenzaprine to a client. The nurse should question this order if which disorder(s) are noted in the client's history? Select all that apply.
recent myocardial infarction epilepsy
A 50-year-old woman has begun taking baclofen to treat her recently diagnosed multiple sclerosis (MS). What teaching point should the nurse provide to the patient about her new drug regimen?
"Make sure that you don't stop taking baclofen suddenly because it might cause your symptoms to rebound quite sharply."
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."
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."
The nurse who is a case manager is overseeing the care of several clients, both inpatient and community-dwelling. Which client is most likely to benefit from the administration of baclofen?
A client who is undergoing rehabilitation following a spinal cord injury at C7
The nursing instructor is teaching a group of students about drugs used for muscle spasms and cramping. The instructor determines the session is successful when the students correctly choose which instruction as relevant to skeletal muscle relaxants?
Avoid alcohol or other CNS depressants.
A client with spinal cord injury is experiencing muscle spasticity. Which agent would most likely be ordered?
Baclofen
Which skeletal muscle relaxant is also available in intrathecal form?
Baclofen (Lioresal)
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 with amyotrophic lateral sclerosis is experiencing muscle spasticity. Which drug would the nurse expect the physician to order?
Dantrolene
During surgery to repair a ruptured Achilles tendon, the client develops severe muscle contractions and a dramatic rise in body temperature. Which medication will be administered?
Dantrolene sodium
Signs and symptoms of what would necessitate discontinuation of dantrolene therapy?
Hepatic dysfunction
igns and symptoms of what would necessitate discontinuation of dantrolene therapy?
Hepatic dysfunction
The nurse is providing education to a client who has been prescribed tizanidine. What adverse effect should the nurse mention during teaching?
Hypotension
he nurse is providing education to a client who has been prescribed tizanidine. What adverse effect should the nurse mention during teaching?
Hypotension
A client with multiple sclerosis is experiencing painful muscle spasticity and has been prescribed a centrally acting skeletal muscle relaxant. What should the nurse include in the client's plan of care?
Implement non-pharmacologic pain relief measures as needed.
A client has told the nurse that she has been invited to a work colleague's house where she and some of her peers will be able to receive Botox injections. What is the nurse's best response?
It's safest to have these injections performed under medical supervision."
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 diagnosed with multiple sclerosis-induced spasticity asks why deep tissue massages do not relieve the associated pain. What facts about spasticity should be the basis of the nurse's response?
Spasticity is caused by nerve damage in the brain and spinal cord, and it is a permanent condition.
A client with a spinal cord injury is experiencing increasing muscle spasticity and the care team is considering the use of dantrolene. The nurse should identify what possible contraindication to the safe and effective use of this medication?
The client has hepatitis C
A 60 year-old female client has multiple sclerosis accompanied by muscle spasticity. The client has responded well to dantrolene 200 mg PO daily in divided doses. What assessment finding should the nurse prioritize for communication to the client's provider?
The client's most recent laboratory results show an upward trend in AST and ALT levels Explanation: An increase in liver enzyme levels could indicate the onset of hepatocellular damage, which is a high risk in female clients of this age. The provider must be made aware of this immediately. The client's lack of motivation and apparent despair should be addressed by the nurse, but may be able to be addressed independently by the nurse. As well, these issues are less time-dependent than a decrease in liver function. A weight gain of 1.5 lbs. over 48 hours is not outside the range of usual fluctuations in fluid balance.
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."
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 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 caring for a male patient who has a spinal cord injury due to a motorcycle accident. He has been taking dantrolene (Dantrium) for 2 weeks. The nurse will monitor:
alanine aminotransferase and total bilirubin levels. Explanation: The nurse will monitor alanine aminotransferase and total bilirubin levels, because a serious adverse effect of dantrolene is drug-induced hepatitis. The nurse will also educate the patient and family concerning signs and symptoms of hepatitis. Prothrombin time and partial thromboplastin time would be monitored for someone taking an anticoagulant, not for someone taking dantrolene. Urine specific gravity is part of a urinalysis and would be used to assess urinary function, which is not affected by dantrolene use. Follicle-stimulating hormone level is important to the female reproductive system and would not be assessed in a male.
