Pharmacology PrepU Chapter 30 Skeletal Muscle, Bone, and Joint Disorder Drugs
A client with spastic hypertonia resulting from cerebral palsy has not responded appreciably to oral baclofen. During the client's care conference, the nurse should anticipate a discussion about what possible treatment?
Intrathecal baclofen infusion
A 44-year-old warehouse worker experienced a painful lower back injury that has not responded to treatment with nonsteroidal anti-inflammatory drugs. Consequently, the man's care provider is considering the short-term use of cyclobenzaprine (Flexeril). Which of the following assessment questions would inform the clinician's decision to prescribe this drug?
"Are you taking antidepressant medications these days?"
A client asks the nurse about herbal therapies for osteoarthritis. What is the nurse's best response?
"Glucosamine and chondroitin are generally well tolerated and not considered harmful."
After teaching a client about alendronate, the nurse determines that the teaching was successful when the client states which of the following?
"I need to stay upright for 30 minutes after taking the drug."
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 nurse is caring for a 36-year-old male client who is having back muscle spasms after falling from a ladder. The health care provider has prescribed cyclobenzaprine to relieve the muscle spasms. For which medical condition would the nurse want to hold the medications because of the increased risk of adverse effects?
A history of supraventricular tachycardia
The nurse is working in collaboration with a nurse anesthetist to assess a preoperative client. When addressing the client's risk for malignant hyperthermia as a result of neuromuscular junction blockers, what assessment should be prioritized?
Assessing for a family history of malignant hyperthermia
A nurse understands that which skeletal muscle relaxants should not be administered to a client with skeletal muscle spasms caused by systemic lupus erythematosus?
Baclofen
A female client has been experiencing increased muscle spasticity since being diagnosed with multiple sclerosis. What drug is most likely to meet this client's needs?
Baclofen (Lioresal)
A nurse would expect to administer which class of medication to treat osteoporosis?
Bisphosphonates
A client taking medication to treat an acute attack of gout should do which of the following?
Contact the health care provider if a mild skin rash appears.
The nurse is caring for a client with muslce spasms and who has been prescribed cyclobenzaprine (Amrix) 100 mg PO t.i.d. What is the nurse's best action?
Contact the prescriber to confirm the dose
When developing a teaching plan for a client who is to receive carisoprodol, which sign or symptom would the nurse include as the most common adverse reaction?
Drowsiness
A client sustained a musculoskeletal injury to his left leg that has resulted in occasional spasticity. What should the nurse expect the health care provider to prescribe?
Cyclobenzaprine
While lifting weights a patient suffered a severe back spasm, similar to the back spasms she experienced during her 2nd pregnancy. She asks the physician for the same drug she used before because it really helped decrease the pain. The nurse expects that the physician will prescribe what?
Cyclobenzaprine (Flexeril)
A nurse is caring for a client who has been prescribed alendronate for the treatment of postmenopausal osteoporosis. The client informs the nurse that she is also taking antacids for the relief of gastric upset. What effect of the interaction between the two drugs should the nurse anticipate in the client?
Decreased effectiveness of alendronate
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.
An older adult resident of a long-term care facility is experiencing muscle spasticity and has just been prescribed a centrally acting skeletal muscle relaxant. The client has comorbidities of early stage Alzheimer's disease and chronic obstructive pulmonary disease (COPD). What nursing action should the nurse prioritize for adding to the client's care plan?
Falls prevention measures
The nurse would administer alendronate cautiously to a client with which of the following?
Gastritis
A client is diagnosed with rheumatoid arthritis. Which medication would the nurse expect the primary health care provider to prescribe?
Hydroxychloroquine
Which of the following is an example of a bisphosphonate disease modifying antirheumatic drugs (DMARDs)? (Choose one)
Hydroxychloroquine (Plaquenil)
Baclofen is a prototype drug for the centrally acting skeletal muscle relaxants. What adverse effects do these drugs have? (Mark all that apply.)
Hypotension Weakness Dizziness
A client diagnosed with Crohn's disease is taking a disease-modifying antirheumatic drug (DMARD). What is this client's top priority of care?
Monitor for signs of infection.
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.
The nurse would expect to administer tiludronate to a client with which condition?
Paget disease
Certain bisphosphonates can be utilized in the treatment of which of the following conditions? (Choose one)
Paget's disease
A client with a spinal cord injury has developed central spasticity and the care provider wishes to administer a muscle relaxant intrathecally. What is the nurse's best action?
Prepare to administer baclofen (Lioresal)
The client has been prescribed medication to treat rheumatoid arthritis (RA). The nurse should tell the client to notify the healthcare provider if the client experiences which problems? Select all that apply.
Sore mouth Fever Itching Nausea
Baclofen (Lioresal) is used in the treatment of muscle spasticity associated with which disease processes? (Select all that apply.)
Spinal cord injury Muscle rigidity Multiple sclerosis
The circulating nurse in the operating room is aware that a client receiving enflurane (Ethrane) for abdominal surgery may require which additional medication for adequate muscle relaxation?
Succinylcholine (Anectine)
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
When reviewing the medical record of a client who is to receive dantrolene, which condition would alert the nurse to the need for close monitoring?
The client has respiratory depression from opioid analgesia
The nurse on a medical floor is preparing to receive a client transfer from the intensive care unit. The client's health record documents the ongoing use of pancuronium until two days earlier. What is the nurse's best interpretation of this data?
The client was likely intubated until recently
The nurse can determine that the client taking uric acid inhibitors is drinking enough fluids when which of the following occurs?
The daily urine output is about two liters.
For which patient would cyclobenzaprine not be prescribed for muscle spasms?
The patient who is having muscle spasms because of cerebral palsy
After teaching a group of nursing students about drugs used to treat osteoporosis, the instructor determines that the teaching was successful when the group identifies which drug as an example of a bisphosphonate?
Zoledronic acid
A history of what medical condition would contraindicate the use of cyclobenzaprine for acute muscle spasms?
cardiac dysrhythmias
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
