Prep-U: Chapter 30

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

What is the most important teaching point to emphasize from the plan of care 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

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 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 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 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."

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

Avoid alcohol or other CNS depressants

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

Avoid alcohol or other CNS depressants.

A patient has been diagnosed with cervical dystonia. The nurse would expect which medication to be ordered for this patient?

Botulinum toxin type B

The nurse is caring for a client who has a disorder of muscle contraction and relaxation. The nurse should prioritize the assessment of what laboratory value?

Calcium

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

Which medications can be used to treat or prevent malignant hyperthermia?

Dantrolene (Dantrium)

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.

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

When caring for a client taking dantrolene, for what adverse effects should the nurse monitor the client? Select all that apply.

Jaundice Fatigue Drowsiness

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 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 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

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 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

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

dantrolene

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

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

drowsiness

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

hepatitis

Adverse effects of dantrolene (Dantrium) include:

potentially fatal hepatitis.

Spinal reflexes are the simplest nerve pathways that monitor movement and posture.

true

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

10 AM

A client needs further teaching about medication prescribed for muscle spasms and cramping when making which statements?

"I take my medicine with three to four beers each evening."

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 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

A client with a history of malignant hyperthermia is scheduled for surgery. Which agent would the nurse most likely expect to administer?

Dantrolene

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

Dantrolene

General anesthetic has been administered to a surgical client and the client has begun to exhibit signs and symptoms of malignant hyperthermia. The operating room nurse should prepare to assist with the administration of:

Dantrolene

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

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

Hepatic dysfunction

Which would a nurse include when describing the action of dantrolene?

Interference with calcium release from the muscles

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

alcohol