Chapter 25 Pharmacology Study NOTE

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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 is the drug of choice in children who need to be treated with tetanus?

Methocarbamol (Robaxin)

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

Liver function tests

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

dantrolene

Which adverse effect should the nurse assess for when administering cyclobenzaprine?

drowsiness

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 client with muscle spasticity following a back injury has been prescribed tizanidine (Zanaflex) 8 mg t.i.d. for use on an outpatient basis. When filling this prescription for a two-week supply, how many 4-mg tablets will the pharmacy provide the client with?

84

What client is most likely to benefit from Botox (incobotulinumtoxin A) injections?

A 54 year-old client who suffers debilitating migraines two to three days per week

A 3-year-old girl with a diagnosis of spasticity secondary to cerebral palsy has been admitted to the unit. The physician has ordered dantrolene to see if it relieves the spasticity in the child's arms and hands. What would be the priority nursing action?

Call the physician and challenge the order.

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

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 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 patient is being treated for intractable muscle spasticity with a peripherally acting spasmolytic. The nurse should anticipate administering which medication?

Dantrolene

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 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."

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.

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 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.

Which adverse effect of muscle relaxants is most pronounced when a client is prescribed tizanidine therapy?

hypotension

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

Signs and symptoms of what would necessitate discontinuation of dantrolene therapy?

Hepatic dysfunction

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 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 spinal cord injury is experiencing muscle spasticity. Which agent would most likely be ordered?

Baclofen

Which medication would the nurse expect to administer if prescribed to achieve skeletal muscle relaxation?

Baclofen

A female client has been taking dantrolene for several years and has now requested a prescription for oral contraceptives from her primary care provider. What is the nurse's best action?

Ensure all members of the care team are aware of the risk for hepatotoxicity

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 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.

Centrally acting skeletal muscle relaxants lyse or destroy the spasm.

True

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

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

hepatitis

Which skeletal muscle relaxant is also available in intrathecal form?

Baclofen (Lioresal)


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