P - Chapter 25 - Muscle Relaxants

Which instruction should the nurse specifically stress when administering drugs used for muscle spasm and cramping?

Avoid alcohol or other CNS depressants

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

Pyramidal tract

fibers within the CNS that control precise, intentional movement

When prescribed dantrolene, what is the most serious adverse effect the client should be instructed about?

hepatitis

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 client who is experiencing lower back pain has been prescribed cyclobenzapine. 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."

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 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 patient who is receiving chlorzoxazone reports that his urine is somewhat orange in color. Which response by the nurse would be most appropriate?

"This discoloration sometimes occurs with this drug."

The perioperative nurse is caring for a client who requires an umbilical hernia repair but who has a known family history of malignant hyperthermia. The client has been prescribed dantrolene 2.5 mg/kg IV one hour before surgery. The client weighs 121 lbs. The nurse reconstitutes a single-use vial as per the manufacture's instructions, yielding a solution with a concentration of 50 mg/mL. How many mL of the reconstituted dantrolene solution should the nurse add to the client's bag of intravenous fluid?

2.75 mL

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

Which medication is classified as an antianxiety medication but is also used to treat muscle spasms?

Diazepam (Valium)

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 should review a client's medical conditions prior to administering a dantrolene (Dantrium) as its use is contraindicated in clients with which issues? (Select all that apply.)

Hepatic disease Lactation

The nurse is caring for a client whose current medication regimen includes baclofen 60 mg PO daily. What assessment should the nurse nurse prioritize when assessing for therapeutic effects?

Inspection for muscle spasticity and range of motion assessment

A client has received a prescription for baclofen. The home care nurse would schedule which laboratory tests to monitor this client?

Liver function tests

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 male client routinely takes baclofen as a skeletal muscle relaxant for a neuromuscular disorder. His last lab results indicate that he is experiencing renal insufficiency. Based on these data, what would the nurse expect the health care provider to do?

Reduce the dose

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

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

The health care provider orders short-term skeletal muscle relaxants for an 11-year-old client. The nurse is responsible for the family education plan and teaches the parents that the medications should be used only under which condition?

When close supervision is available for monitoring drug effects

A client has been started on cyclobenzaprine. For the duration of treatment with cyclobenzaprine, the nurse should teach the client to eliminate:

alcohol

Basal ganglia

lower area of the brain, associated with coordination of unconscious muscle movements that involve movement and position

Cerebellum

lower portion of the brain, associated with coordination of muscle movements, including voluntary motion, as well as extra pyramidal control of unconscious muscle movements

Interneuron

neuron in the CNS that communicates with other neurons, not with muscles or glands

spindle gamma loop system

simple reflex arcs that involve sensory receptors in the periphery that respond to stretch and spinal motor nerves and cause muscle fiber contraction: Responsible for maintaining muscle tone and keeping an upright position against the pull of gravity

Extrapyramidal tract

cells from the cortex and subcortical areas, including the basal ganglia and the cerebellum, which coordinate unconsciously controlled muscle activity; allows the body to make automatic adjustments in posture or position and balance

A surgical client has developed malignant hyperthermia. Which medication can be used to treat this health emergency?

dantrolene

Hypertonia

state of excessive muscle response and activity

Spasticity

sustained muscle contractions

A client is receiving baclofen at 8 AM. The nurse would monitor the client for evidence of maximum effect at which time?

10 AM