Ch 25 ttteeer
While most muscle relaxants drugs are central nervous system (CNS) depressants, which medication acts only on the muscle?
dantrolen
excessive eating
does not decease reproductivity
Baclofen should be tapered slowly to prevent
hallucinations
A 30-year-old debilitated client is receiving anabolic steroids. Which might the client experience?
Priapism
What is responsible for controlling precise intentional movement?
Pyramidal tract
Hepatic dysfunction
Signs and symptoms of which of the following would necessitate discontinuation of dantrolene therapy?
Define 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
Define hypertonia
State of excessive muscle response and activity
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 nurse should review a client's medical conditions prior to administering a dantrolene (Dantrium) as its use is contraindicated in clients with which of the following? Select all that apply:
• Hepatic disease • Lactation
Baclofen (Lioresal) is used in the treatment of muscle spasticity associated with which of the following disease processes?
• Spinal cord injury • Muscle rigidity • Multiple sclerosis
Patients receiving chlorzoxazone (Paraflex) should be cautioned that which of the following will occur with administration?
Discoloration of urine
A patient is administered cyclobenzaprine (Flexeril). Which adverse effect can you expect with this medication?
Drowsiness
Which of the following is the most common adverse reaction to carisoprodol (Soma) that the nurse should discuss with the patient? (Choose one)
Drowsiness
The pyramidal tract is located primarily within the basal ganglia.
False
What occurs during andropause?
Atrophy of the seminiferous tubules
True or False: Centrally acting skeletal muscle relaxants lyse or destroy the spasm.
True
True or False: Spinal reflexes are the simplest nerve pathways that monitor movement and posture.
True
The nurse knows there are certain effects with the use of epidural anethesia. When a client is receiving epidural anesthesia, which will help to reduce the potential for a headache caused by the epidural? Select all that apply.
IV hydration Lying supine
Define basal ganglia
Lower area of the brain, associated w/ coordination of unconscious muscle movements that involve movement and position
Define cerebellum
Lower portion of the brain, associated w/ coordination of muscle movements, including voluntary motion, as well as extrapyramidal control of unconscious muscle movements
A muscle spasm often results from: A) Damage to the basal ganglia B) CNS damage C) Injury to the musculoskeletal system D) Chemical imbalance within the CNS
C
A patient sustained a musculoskeletal injury to his left leg. What would the nurse expect the health care provider to order?
Cyclobenzaprine
Which cells in the testes produce testosterone?
Leydig cells
A nurse should monitor a client receiving oxytocin for which adverse effects?
cardiac arrhythmias
A client needs further teaching about medication prescribed for muscle spasms and cramping when making which of the following statements?
"I take my medicine with three to four beers each evening."
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."
female client's seizure disorder has been successfully controlled by AEDs for years. She and her husband decide that it is time to start a family. She asks the nurse if it is safe for the fetus for her to continue her AEDs as prescribed. What is the nurse's best response?
"They are considered teratogenic."
Risk for Injury related to CNS depressant effects
A 40-year-old woman 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 when updating the nursing care plan for this patient?
"Make sure that you don't stop taking baclofen suddenly because it might cause your symptoms to rebound quite sharply."
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?
Carisoprodol
An older patient with a history of renal dysfunction is to receive a centrally acting skeletal muscle relaxant. Which agent would be most appropriate?
Malignant hyperthermia
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?
The nurse instructs a client to use benzocaine to soothe the itching and pain related to an insect bite. Benzocaine is considered to be what type of dermatologic agent?
Anesthetic
Immediately before starting an IV infusion of oxytocin (Pitocin), what should the nurse assess? (Select all that apply.)
Client's blood pressure Fetal heart rate Client's respiratory rate
A client is taking androgens and warfarin (Coumadin). What effect will these two medications have on the client's coagulation?
Coagulation will be decreased
Fertilization of the ovum and implantation in the uterine wall result in the production of what hormone?
Human chorionic gonadotropin
Which of the following would a nurse include when describing the action of dantrolene?
Interference with calcium release from the muscles
When caring for a patient receiving estrogen therapy, which action would be an appropriate part of the evaluation process?
Interviewing the patient and observing for therapeutic and adverse effects
In clients with spinal cord injury, spasticity requires treatment when:
It impairs safety, mobility, or the ability to participate in activities of daily living.
Gonadotropin-releasing hormone (GnRH) stimulates the anterior pituitary to release which hormones?
LH, FSH
Damage to what component of the male reproductive system would result in a lack of testosterone?
Leydig cells
The nurse at an urgent care clinical is reviewing local anesthetics. What drug should the nurse recognize as an amide?
Lidocaine
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 male client is prescribed sildenafil for the treatment of erectile dysfunction. What mechanism of action of sildenafil causes a sustained erection?
The drug inhibits phosphodiesterase (PDE) type 5, consequently decreasing the metabolism of cGMP.
An alpha-adrenergic agonist and is thought to increase inhibition of presynaptic motor neurons in the CNS
Tizanidine
Centrally acting skeletal muscle relaxants lyse or destroy the spasm.
True
Spinal reflexes are the simplest nerve pathways that monitor movement and posture
True
Spinal reflexes are the simplest nerve pathways that monitor movement and posture.
True
True or False: Muscle spasms are thought to arise from the flood of sensory impulses coming to the spinal cord from an injured area.
True
Which vitamin supplements should the nurse recommend while a postmenopausal client is taking alendronate (Fosamax)?
Vitamin D and calcium
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 of the following instructions?
Wear appropriate clothing and sunscreen whenever he is in direct sunlight
What should a nurse's pre-administration assessment for a client about the receive oxymetholone (Anadrol-50) include? (Select all that apply.)
Weight Fasting lipid panel Hepatic function tests
Do not drive or operate machinery until individual drug effects are known.
What is the most important teaching point to emphasize from the plan of care when a client is prescribed a skeletal muscle relaxant?
Dinoprostone can be used to terminate a pregnancy after 20 weeks.
false
Testosterone is injected directly into the corpus spongiosum.
false
The anesthesiologist has informed the operating room nurse that opioids will be used to supplement anesthesia for a client undergoing a partial mastectomy. What opioid is most likely to be utilized?
fetanyol
An ovum is allowed to mature and is exposed to estrogen and progesterone in which endocrine gland like storage structure?
follicle
A client with multiple sclerosis asks the nurse to explain why deep tissue massages do not relieve spasticity. The nurse should explain that spasticity is caused by:
nerve damage in the brain and spinal cord, and it is a permanent condition.
spinal motor neurons
nerves that regulate posture, balance, and movement are the result of a constantly fluctuating sequence of muscle contraction and relaxation
Interneuron
neuron in the CNS that communicates with other neurons, not with muscles or glands
A client has been prescribed vardenafil. Which medication in the client's history would the nurse be <b>most</b> concerned about?
nitroglycerin bc they affect smooth muscle
tyrosine is use to make what
norepinephrine
A nurse is reading a journal article about female hormones. Which would the nurse identify as a progestin?
norethindrone
A 16-year-old is prescribed estrogen therapy for hypogonadism. During therapy, what will the nurse monitor the client closely for?
normal sexual development and growth
A client is to receive ethotoin. The nurse would expect to administer this drug by which route?
oral
Methocarbamol is available in
oral and parenteral forms
Dantrolene is available in
oral or parenteral forms
Gas anesthetics such as nitrous oxide must be combined with what element before they can be administered to the client?
oxygen
A 26-year-old client who delivered a baby 24 hours prior, reports cramping pain while breast-feeding. The nurse caring for the client understands that breast-feeding causes the release of which hormone, which can cause uterine cramping?
oxytocin
The nurse is preparing an outline for a class on the physiology of the male sexual response. Which event would the nurse identify as occurring first?
penile vasodilation
The production of estrogen during pregnancy would be negatively affected if which structure was not functioning effectively?
placenta
When stimulation levels off during the human sexual response, the person is said to be in which of the following phases?
plateau
Pitocin is given to prevent what condition?
postpartum bleeding
The release of gonadotropin releasing hormone by the hypothalamus signals the onset of:
puberty
The post-anesthetic recovery unit nurse is caring for a client whose balanced anesthesia included midazolam. The nurse should prioritize assessments for what health problems?
respiratory depression and CNS suppression
The induction of a local anesthetic would decrease the permeability of the nerve cell membrane to which element?
sodium
The 35-year-old client has presented to the OB ward for her third delivery by cesarean section. The nurse who is caring for this client prepares for which type of anesthesia?
spinal
The nurse sprays the area with a medication to desensitize it. The nurse is administering which type of anesthesia?
spray is topical
A client is receiving general anesthesia and the client's skeletal muscles have begun to relax after being tense In what stage of anesthesia is this client?
stage 1
hallucination/delrium
stage II
The nurse is discussing the human response to sexual stimulation with a client experiencing an arousal problem. In which phase of sexual response should the client begin to feel the effects of the sympathetic nervous system?
stimulation
Spasticity
sustained muscle contractions
What is most important to tell the client who will be taking adrenergic blocking drugs for benign prostatic hypertrophy?
take at the same time every day
A nurse should administer skeletal muscle relaxants cautiously and monitor a client closely if they have which of the following medical conditions?
• Cerebrovascular accident • Epilepsy • Pregnancy • Parkinsonism
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 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 patient has been prescribed methocarbamol (Robaxin) for fibromyalgia. The nurse has spent an hour educating the patient on the use of methocarbamol for muscle pain. Which of the following statements by the patient indicates that she 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 patient has been prescribed methocarbamol (Robaxin) 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."
The nurse is educating a young adult client diagnosed with androgen deficiency about the prescribed testosterone transdermal system, apply two systems (dose of 5 mg) nightly. Which statement made by the client establishes the need for further clarification?
"One transdermal patch is applied to my back, upper arm, or abdomen to dry, clean skin, and the other to my groin."
A patient who is receiving chlorzoxazone reports that his urine is somewhat orange in color. Which response by the nurse would be the most appropriate?
"This discoloration sometimes occurs with this drug"
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 client with myasthenia gravis has been prescribed dantrolene for the treatment of muscle spasticity. What education should the nurse provide to the client?
"You might experience some urinary frequency and urgency. Tell me promptly if it becomes problematic."
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."
Muscle relaxants would be used in which of the following circumstances?
- To treat spasticity related to spinal cord injury - To treat spasticity that is related to toxins, such as tetanus - To treat spasticity that is a result of neuromuscular degeneration - To reduce the severity of head position associated with cervical dystonia - To reduce the appearance of frown lines (glabellar lines)
Baclofen is available in
- oral - intrathecal forms and can be administered via a delivery pump
A client is prescribed testosterone gel. Which would the nurse include in the teaching plan? Select all that apply.
-Allowing the application site to dry before getting dressed. -Applying the gel once daily in the morning. - Washing hands with soap and water after applying.
What adverse effects would a nurse more likely assess in a patient who is receiving a centrally acting skeletal muscle relaxant?
-Drowsiness -Dry mouth -Insomnia -Constipation
A nurse is preparing a teaching plan for a patient who is to receive botulinum toxin type A for frown lines. What adverse effects would the nurse inform the patient could occur?
-Respiratory infection -Headache -Drooping eyelids
The nurse reviews the patient's medical record before administering dantrolene. What factors would the nurse identify as placing the patient at risk for hepatocellular injury?
-She is 38 years old -She takes birth control pills containing estrogen
A patient receives baclofen intrathecally at 8 A.M. The nurse would expect teh drug to peak at what time?
12 P.M.
A patient receives baclofen intrathecally at 8 AM. The nurse would expect the drug to peak at which time?
12 PM
A client who is receiving phenytoin has a serum drug level drawn. Which result would the nurse interpret as within the therapeutic range?
12 mcg/mL
A 36-year-old man has been taking extended-release carbamazepine for 1 year. He is in the clinic every 3 months for follow-up visits, which include a drug blood level. Which of the following carbamazepine blood levels would indicate a potential risk for adverse effects?
15 mcg/mL
The nurse is monitoring the serum carbamazepine level of a client. Which result would lead the nurse to notify the prescriber that the client most likely needs an increased dosage?
2 mcg/mL
A patient receives intrathecal baclofen at 10 AM. The nurse would expect to see the maximum effect of this drug at approximately what time?
3 PM
A client is to have an intravenous line inserted, and the nurse prepares to apply a dermal patch to provide local anesthesia to the area. The nurse would apply the patch at which time before initiating intravenous access?
30 minutes
A nurse is instructing a client about vardenafil. The nurse would instruct the client to take the drug how many minutes before sexual stimulation?
60 min
A patient receives dantrolene via the oral route at 10 A.M. The nurse would expect the duration of action to extend until what time?
8 P.M.
A pt w/ spinal cord injury is experiencing muscle spasticity. Which agent would most likely be ordered? A) Baclofen B) Cyclobenzaprine C) Chlorzoxazone D) Carisoprodol
A
hypotension.
A 32-year-old female patient is taking tizanidine (Zanaflex) for spasticity related to her multiple sclerosis. The nurse will inform the patient and her husband that the adverse effect that poses the greatest safety risk to the patient is
"You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity."
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?
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
"Make sure to see your doctor promptly if you develop yellowish skin or eyes."
A 56-year-old woman with a diagnosis of multiple sclerosis has begun taking dantrolene. What patient teaching should the nurse provide?
Select all that apply: What adverse effects would a nurse most likely assess in a pt who is receiving a centrally acting skeletal muscle relaxant? A) Constipation B) Dry mouth C) Urinary retention D) Drowsiness E) Insomnia
A B D E
Select all that apply: Spasmolytics, or centrally acting muscle relaxants, block the reflexes in the CNS that lead to spasm. While a pt is taking one of these drugs, which of the following interventions should be implemented? A) Rest for the affected muscle B) Heat to the affected area C) Ice packs to the affected area D) Use of anti-inflammatory agents E) Body temp check every 2 hrs to watch for malignant hyperthermia F) Positioning to decrease pain and spasm
A B D F
Select all that apply: Muscle relaxants would be used in which of the following circumstances? A) To treat spasticity related to spinal cord injury B) To treat spasticity that contributes to locomotion, upright position, or increase in function C) To treat spasticity that is related to toxins, such as tetanus D) To treat spasticity that is a result of neuromuscular degeneration E) To reduce the severity of head position associated w/ cervical dystonia F) To reduce the appearance of frown lines (glabellar lines)
A C D E F
Select all that apply: The nurse reviews the pt medical record before administering dantrolene. What factors would the nurse identify as placing the pt at risk for hepatocellular injury? A) She is 39 yrs old B) She has been diagnosed w/ rheumatic arthritis C) She is married w/ 3 children under 10 yrs of age D) She visits the gym daily to ride a stationary bicycle E) She takes birth control pills containing estrogen
A E
Liver function tests
A client has received a prescription for baclofen. The home care nurse would schedule which laboratory tests to monitor this client?
A nurse who gives care on a neurological floor is working with several clients. Which client should the nurse prioritize for further assessment and possible interventions?
A client receiving pregablin who is not responsive to verbal stimuli
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
Dantrolene
A client with a history of malignant hyperthermia is scheduled for surgery. Which agent would the nurse most likely expect to administer?
Reduce the dose
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 physician to do?
Reduction of muscle spasm
A nurse is caring for a patient who is receiving cyclobenzaprine. Which of the following is the action of the drug on the patient?
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 of the following instructions?
• Drowsiness • Urinary frequency • Constipation
A nurse is preparing a teaching plan for a client who is receiving baclofen therapy. Which of the following would the nurse include as possible adverse effects?
increase self-care in activities of daily living.
A nurse is working with a 39-year-old patient who is experiencing muscle spasms associated with multiple sclerosis. The patient reports that she needs help with basic care and that her 15-year-old daughter has been helping bathe and dress her for a week. The patient's physician has prescribed baclofen (Lioresal). The nurse and the patient agree that an appropriate goal related to helping her maintain her self-worth would be to
Baclofen (Lioresal)
A nurse should not administer which of the following skeletal muscle relaxants to a patient with skeletal muscle spasms caused by systemic lupus erythematosus?
Decreased muscle spasms
A patient has been admitted to your unit for treatment of a multiple sclerosis exacerbation. The admission order indicates that the patient is taking baclofen (Lioresal). Which of the following outcomes would you expect to be associated with use of this medication?
"My urine could be discolored while I take this drug."
A patient has been prescribed methocarbamol (Robaxin) for fibromyalgia. The nurse has spent an hour educating the patient on the use of methocarbamol for muscle pain. Which of the following statements by the patient indicates that she has an understanding of at least one of the significant side effects of methocarbamol?
Fatal hepatitis
A patient has been started on dantrolene (Dantrium). What is the most serious adverse effect on which the patient should be instructed?
Drowsiness
A patient is administered cyclobenzaprine (Flexeril). Which adverse effect can you expect with this medication?
Hypotension
A patient is taking tizanidine (Zanaflex) to treat spasticity from multiple sclerosis. Which of the following adverse effects of muscle relaxants is most pronounced with this medication?
3 PM
A patient receives intrathecal baclofen at 10 AM. The nurse would expect to see the maximum effect of this drug at approximately what time?
Risk for Injury related to CNS depression
A patient who experienced a lower back injury while doing yard work 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 patient's drug regimen?
The nurse is aware that a client receiving which category of medication will not be prescribed vardenafil?
Antidysrhythmics
What is one of the registered nurse's primary roles in the administration of general anesthetic?
Assessing the client's status during recovery from anesthetic
A client has been administered phenobarbital during seizure activity. When assessing for adverse effects what should the nurse prioritize?
Assessment of orientation
Which agent would a client most likely be prescribed for penile erectile dysfunction if the client is very sexually active and the timing of sexual stimulation is not known?
Avanafil
Which of the following instructions should the nurse specifically stress when administering drugs used for muscle spasm and cramping?
Avoid alcohol or other CNS depressants
A client has a history of seizures of which the client takes phenytoin on a regular basis. What should the nurse teach the client in order to ensure safety?
Avoid ginkgo supplements
A pt receives baclofen intrathecally at 0800. The nurse should expect the pt serum levels of the drug to peak at what time? A) 1400 B) 1200 C) 1600 D) 1000
B
Dantrolene is being considered for the treatment to a pt w/ spasticity. Which aspect of the pt current health status is most likely to contraindicate the use of this med? A) The pt takes opioid analgesics regularly B) The pt spasticity is due to rheumatoid arthritis C) The pt adherence to drug therapy has been irregular D) The pt has type 1 diabetes and takes insulin regularly
B
The nurse is preparing to administer a pt scheduled dose of baclofen and notes that the pt most recent oral temp was 100.9. What is the nurse's best action? A) Perform a focused respiratory assessment B) Administer the med as prescribed and monitor the pt C) Hold the baclofen, administer antipyretics as prescribed, and reassess the pt in 1 hr D) Report this assessment finding promptly to the care provider
B
What pt is most likely to benefit from botulinum toxin type A injections? A) A 68 yr old pt who has chronic lumbar and thoracic pain following a workplace accident B) A 54 yr old pt who suffered debilitating migraines 2-3 days per week C) A 16 yr old pt w/ cerebral palsy whose upper body spasticity has worsened in recent months D) A 60 yr old pt who was diagnosed w/ myasthenia gravis 18 months ago
B
Select all that apply. The nurse is preparing a teaching plan for a pt who is to receive botulinum toxin type A for frown lines. What adverse effects should the nurse inform the pt that could possibly occur? A) Abnormal hair growth B) Drooping eyelids C) GI upset D) HA E) Respiratory infections
B D E
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 should not administer which of the following skeletal muscle relaxants to a patient with skeletal muscle spasms caused by systemic lupus erythematosus? (Choose one)
Baclofen (Lioresal)
Which of the following is an example of a skeletal muscle relaxant? (Choose one)
Baclofen (Lioresal)
The health care provider has prescribed testosterone for a 77-year-old client with a low testosterone level. The nurse will evaluate this client for what condition that may develop in this client in response to this medication?
Benign prostatic hypertrophy
A client with a foreign body embedded in her hand requires local anesthesia for removal. What drug would be most appropriate?
Benzocaine (it is local)
A client has begun treatment for penile erectile dysfunction. What explanation should the nurse provide regarding the primary effect a prescribed phosphodiesterase type 5 inhibitor will have on this condition?
Blood flow to the penis will be improved
After reviewing information about skeletal muscle relaxants, a group of students demonstrate understanding of the material when they identify which drug as a direct-acting muscle relaxant?
Botulinum toxin type A
After teaching a group of student about skeletal muscle relaxants, the instructor determines a need for additional teaching when the students identify what as a centrally acting skeletal muscle relaxant?
Botulinum toxin type A
After teaching a group of students about skeletal muscle relaxants, the instructor determines a need for additional teaching when the students identify which of the following as a centrally acting skeletal muscle relaxant?
Botulinum toxin type A
A patient has been diagnosed with cervical dystonia. The nurse would expect which of the following medications to be ordered for this patient?
Botulinum toxin type B
The nurse is aware that which medication will be used in the provision of local infiltrate anesthesia?
Bupivacaine (Marcaine)
The nursing instructor is teaching students about local anesthetics. The students demonstrate understanding when they identify which local anesthetics that can be given via epidural? Select all that apply.
Bupivacaine (Marcaine, Sensorcaine) Lidocaine (Dilocaine) Lidocaine (Xylocaine)
A pt has been prescribed baclofen and will be taking the drug on an outpatient basis. The pt asks the nurse if it's still okay to drink wine with meals or end the day with a margarita, the nurse should say what? A) "You're to permitted to drink alcohol while you are taking baclofen." B) "If you combine baclofen and alcohol, you could suffer a severe allergic-type rxn." C) "The combination of baclofen and alcohol could depress your nervous system to a dangerous level." D) "It's best to keep your alcohol intake to a low level when you're taking muscle relaxants."
C
A pt has been prescribed cyclobenzaprine for the treatment of injury-related muscle spasticity. The pt asks if it is safe to take ibuprofen while taking cyclobenzaprine. What should the nurse say? A) "Ask your care provider, but the combo might make you dangerously drowsy." B) "Confirm with your provider, but it would likely be quite hard on your liver." C) "Check w/ your care provider, but it's likely not a problem." D) "It would probably be unsafe because both drugs are from similar families."
C
Dantrolene is associated w/ potentially fatal cellular damage. If your pt condition is being managed w/ dantrolene, the pt should: A) Have repeated complete blood counts during therapy B) Have renal function tests done monthly C) Be monitored for signs of liver damage and have liver function tests done regularly D) Have a thorough eye examination before and periodically during therapy
C
The use of neuromuscular junction blockers may sometimes cause a condition known as malignant hyperthermia. The drug of choice for prevention or treatment of this condition is: A) Baclofen B) Diazepam C) Dantrolene D) Methocarbamol
C
An older client is to receive a centrally acting skeletal muscle relaxant. Which of the following would the nurse expect to be prescribed?
Carisoprodol
Define 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
The extra pyramidal tract is made up of cells from which of the following areas?
Cerebral cortex
May discolor the urine, becoming orange to purple-red when metabolized and excreted
Chlorzoxazone
Administration of which class of medications can decrease secretions of the upper respiratory tract?
Cholinergic antagonists
A patient is receiving treatment for infertility and is receiving a drug that stimulates ovulation. Which drug would this most likely be?
Chorionic gonadotropin
A client is prescribed lamotrigine (Lamictal) for control of partial seizures. What is the most important medication teaching information the nurse should emphasize from the plan of care?
Contact the health care provider immediately if rash appears.
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
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
The patient is taking cyclobenzaprine for muscle spasms secondary to an injury to his lumbar spine that occurred while lifting a motor at work. He is being seen for a follow-up visit by the physician. He is complaining of dry mouth, blurred vision, and constipation. Why is the patient having these side effects from cyclobenzaprine?
Cyclobenzaprine produces an anticholinergic response, resulting in these side effects.
A pt presents to the clinic seeking info about having botulinum toxin type A injections to reduce eye wrinkles. What should the nurse teach the pt about this treatment? A) "You would need to be sedated so you're able to stay perfectly still during the injections." B) "Some pt have adverse effects of botulinum toxin type A involving muscle spasticity." C) "The effectiveness of botulinum toxin A injections has been greatly overstated in the media." D) "This isn't a permanent solution. It has to be repeated in 3 months."
D
A pt w/ a recent history of muscle spasticity has been prescribed baclofen. What finding on the pt most recent lab report should prompt the nurse to contact the care provider? A) Rise in blood urea nitrogen B) Decline in sodium C) Decline in neutrophils D) Rise in liver enzymes
D
Dantrolene differs from the other skeletal muscle relaxants because: A) It acts in the highest levels of the CNS B) It is used to treat muscle spasms as well as muscle spasticity C) It cannot be used to treat neuromuscular disorders D) It acts directly within the skeletal muscle fiber and not within the CNS
D
Muscle spasticity is the result of: A) Direct damage to a muscle cell B) Over-stretching of a muscle C) Tearing of a ligament D) Damage to neurons within the CNS
D
The nurse is assessing a pt for possible risk factors for the development of hepatotoxicity with the use of dantrolene. What situations would the nurse identify as requiring cautious use of the drug? A) Cirrhosis B) Spasticity contributing to locomotion or upright position C) Age less than 30 yrs D) Female gender
D
The nurse is caring for a pt w/ an intrathecal catheter in place to treat muscle rigidity. What centrally acting skeletal muscle relaxant could the nurse administer intrathecally? A) Chlorzoxazone B) Cyclobenzaprine C) Carisoprodol D) Baclofen
D
When reviewing the medical record of a pt who is to receive dantrolene, which condition would alert the nurse for the need of close monitoring? The client: A) Has an infected surgical wound B) Received a blood transfusion less than 24 hrs ago C) Is 67 yrs old D) Has respiratory depression from opioid analgesia
D
A client with amyotrophic lateral sclerosis is experiencing muscle spasticity. Which of the following drugs would the nurse expect the physician to order?
Dantrolene
Acts within skeletal muscle fibers, interfering with the release of calcium from the muscle tubules
Dantrolene
The nurse is reviewing the results of a hospital client's serum phenytoin level, which has just become available. The results indicate that the client's phenytoin level is 17.5 mcg/mL. What is the nurse's best action?
Document the fact that the nurse checked the client's phenytoin levels
A client is receiving botulinum toxin type A as treatment for her frown lines. The nurse would instruct the client about which of the following?
Drooping eyelids
A nurse administers carisoprodol to a patient for the treatment of an acute musculoskeletal condition. What adverse reaction of the administration of carisoprodol should the nurse monitor for in this patient?
Drowsiness
Which adverse effects would a nurse most likely assess in a client who is receiving a centrally acting skeletal muscle relaxant? (Select all that apply.)
Drowsiness Insomnia Dry mouth Constipation
A man with no significant medical history is being prepared for outpatient surgery under general anesthesia. As part of the preparation for surgery, the anesthesiologist administers atropine, a anticholinergic agent. What is the purpose of administering this medication at this time?
Dry up secretions in the respiratory tract.
A client alerts the nurse she has been in menopause for a couple of months. The nurse teaches the client how menopause occurs. Which statement reflects the teaching has been effective?
Estrogen and Progesterone diminish
After describing the process of spermatogenesis to a group of students, the instructor determines that the teaching was successful when the students identify what as being responsible?
FSH- follicle stimulating hormone
A client presents to the emergency department with severe pain and receives methocarbamol by injection. As part of the nurse's safety care plan, the nurse should instruct the client that she may experience which common adverse reaction?
Fainting, incoordination, and hypotension
Muscle spasticity is the result of damage to peripheral structures rather than to injured neurons.
False
The nurse is assessing a patient for possible risk factors for the development of hepatotoxicity with the use of dantrolene. What situations would the nurse identify as requiring cautious use?
Female gender
The pharmacology instructor is discussing the differences between monotherapy and therapy that includes AEDs. What would the instructor cite as an advantage of monotherapy?
Fewer drug-drug interactions
Define pyramidal tract
Fibers within the CNS that control precise, intentional movement
After describing the process of spermatogenesis to a group of students, the instructor determines that the teaching was successful when the students identify what as being responsible?
Follicle stimulating hormone
A 28-year-old patient has a history of malignant hyperthermia following anesthesia. Today, this patient is on the operating room schedule for a D&C;. Which method of anesthesia would not be acceptable for this patient?
General anesthesia with an inhalation agent
When reviewing a journal article about seizure disorders, the nurse would expect to find tonic-clonic seizures and myoclonic seizures being classified as which type of seizures?
Generalized seizures
Which type of seizures involves a loss of consciousness?
Generalized seizures
After teaching a group of students about hormonal secretion of the reproductive system, the instructor determines that the teaching was successful when the students identify what as initiating hormone secretion from the ovaries and testes?
Gonadotropin releasing hormone
Which hormone would be initially responsible for hormone secretion from the ovaries and testes?
Gonadotropin-releasing hormone
Signs and symptoms of which of the following would necessitate discontinuation of dantrolene therapy?
Hepatic dysfunction
Dantrolene should be avoided in all patients who are 35 or older because of the increased risk of which of the following?
Hepatocellular disease
What is the best position for the client after the administration of a bisphosphonate medication?
High Fowler's
The nurse is obtaining a history from a 23-year-old man. The nurse suspects that the client may be using DHEA if he displays which symptom?
Hirsutism
The nurse is obtaining a history from a 23-year-old man. The nurse suspects that the client may be using DHEA if he displays which symptom?
Hirtuism (hair growth)
A patient comes to a clinic for a botox injection around his eyes. While collecting admission assessment data, the nurse learns that the patient is taking a polymyxin antibiotic for a skin infection involving the eyes. What is the nurse's priority action?
Hold the injection and consult the provider
A patient is taking tizanidine (Zanaflex) to treat spasticity from multiple sclerosis. Which of the following adverse effects of muscle relaxants is most pronounced with this medication?
Hypotension
When teaching a group of high school students about using anabolic steroids, the nurse would include information that these drugs are classified as which class of controlled substances?
III
A female client is prescribed estradiol cypionate for treatment of severe vasomotor symptoms associated with menopause. The nurse would expect to administer this drug by which route?
IM
Which is associated with an increase in gonadotropin-releasing hormone secretion?
Increased light exposure
The client is about to undergo surgery. The circulating nurse knows that methohexital (Brevital) is used for which purposes? Select all that apply.
Induction of anesthesia Supplement to other anesthetics Depress the central nervous system to produce hypnosis
A male client informs his physician that sildenafil therapy is not working for him. What is most likely to be the reason for this and needs to be carefully assessed for by the nurse?
Ingestion of high-fat meal along with the drug
What represents routes in which general anesthesia is most commonly achieved? (Select all that apply.)
Inhalation, IV
What teaching points would a nurse include when describing the action of tizandine to peers?
Inhibition of presynaptic motor neurons in the CNS
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 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
What stimulates the production of testosterone by the Leydig cells located in the testes?
LH
When teaching an adolescent about ovulation, the nurse would include that ovulation is initiated by a surge in:
LH
A client comes to the emergency department. The client has a small wound that requires suturing. The nurse would anticipate which type of anesthesia?
Local infiltration anesthesia
Status epilepticus is a life-threatening condition that needs immediate treatment. What is the drug of choice in treating status epilepticus?
Lorazepam
A 30-year-old client is to receive tetracaine (Pontocaine) via spinal anesthesia for an abdominal procedure. What should the nurse do to prevent side effects of this type of anesthesia?
Maintain the client in a supine position following the procedure.
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
An otherwise healthy surgical client has developed sharply increased muscle tone and rapid increase in heart rate and core body temperature. The operating room (OR) team should proceed with assessments and interventions that address what health problem?
Malignant hyperthermia
A woman who has been prescribed high doses of anabolic steroids should be instructed on which effects?
Masculinization
Which of the following is the drug of choice in children who need to be treated with tetanus?
Methocarbamol (Robaxin)
A nurse may be asked to administer which drug prior to a colonoscopy in order to help the client relax?
Midazolam
A 22-year-old woman is in the clinic to end an early pregnancy. She takes three tablets of mifepristone (Mifeprex). Two days after she takes the medication, she returns to the clinic to see if she is still pregnant or if the medical abortion is complete. It is determined that she is still pregnant. The nurse will administer which drug?
Misoprostol
A client, newly diagnosed with a seizure disorder, has been prescribed valproic acid. When assessing for adverse effects, what assessment should the nurse prioritize?
Monitoring the client's liver enzyme levels
Dantrolene
Most muscle relaxants drugs are CNS depressants. Which of the following medications acts only on the muscle?
A client received fentanyl during a surgical procedure. The nurse will have what drug available to treat any possible respiratory depression associated with the use of fentanyl?
Naloxone: on hand to reverse the effects of the opioid that is causing respiratory depression.
Define interneuron
Neuron in the CNS that communicates w/ other neurons, not w/ muscles or glands
A client asks the nurse about the cause of idiopathic seizures. What is the nurse's best response?
No known cause
A client in the ambulatory care clinic is experiencing shortness of breath, and facial and throat edema, while receiving a pegloticase infusion. What is the nurse's best action?
Notify emergency personnel
Insufficient levels of oxytocin would affect what event related to pregnancy?
Onset of labor contractions
What centrally acting skeletal muscle relaxant could the nurse administer IV?
Orphenadrine (Banflex)
After teaching a group of students about anabolic steroids, the instructor determines that the teaching was successful when the students identify which agent as an example?
Oxandrolone
After teaching a group of students about the events that occur with fertilization and implantation of an ovum, the instructor determines that the teaching has been effective when the students identify what as an endocrine structure?
Placenta
One of the adverse effects of dantrolene (Dantrium) includes:
Potentially fatal hepatitis.
A client is started on terbutaline therapy. What would indicate that the therapy has been successful?
Premature birth is avoided for at least 24 hours.
If an ovum is fertilized and implants into the uterine wall, which would occur next?
Production of human chorionic gonadotropin
what follows fertilization and implantation
Production of human chorionic gonadotropin
The client in the intensive care unit (ICU) is intubated and on a respirator. What drug would the nurse be told to give so that the client receives continuous sedation while intubated
Propofol
The nurse in the intensive care unit prepares to administer a medication that is used for induction and maintenance of anesthesia, but may also be used to continuously administer sedation to clients who are intubated. Which medication is it?
Propofol
The nurse is caring for a client in the post-anesthetic care unit (PACU). The client is disoriented and agitated, with an increased heart rate and respiratory rate. What is the nurse's best action?
Provide reassurance to the client while providing close monitoring
The nurse prepares to receive a client after a cesarian section who received isoflurane during general anesthesia. Based upon the drug's adverse effects, which measures would the nurse provide postoperatively? Select all that apply.
Provide warm blankets. Administer prescribed antiemetic. Assess for increased bleeding. Monitor oxygenation and vitals frequently.
A client is receiving lamotrigine as treatment for partial seizures. Which assessment finding would lead the nurse to stop the drug immediately?
Rash
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 physician to do?
Reduce the dose
A nurse is caring for a patient who is receiving cyclobenzaprine. Which of is the action of the drug on the patient?
Reduction of muscle spasm
A nurse is caring for a patient who is receiving cyclobenzaprine. Which of the following is the action of the drug on the patient?
Reduction of muscle spasm
The nurse is aware that progestins will be prescribed with extreme caution in a client with which condition? (Select all that apply.)
Renal disease Epilepsy Asthma
While taking the vital signs of a hospitalized client admitted for seizure control due to epilepsy, the nurse notices a bloody toothbrush on the client's bedside table and scattered bruising over the client's extremities. What is the nurse's best action?
Report the findings to the primary health care provider immediately.
When reviewing the medical record of a patient who is to receive dantrolene, which condition would alert the nurse to the need for close monitoring?
Respiratory depression
A client has been prescribed phenytoin for the treatment of seizures. How should the nurse most accurately determine whether the client has therapeutic levels of the medication?
Review the client's laboratory blood work
When reviewing a client's history, which condition would the nurse identify as contraindicating the use of a centrally acting skeletal muscle relaxant?
Rheumatic disorder
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 40-year-old woman 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 when updating the nursing care plan for this patient?
Risk for Injury related to CNS depressant effects
A patient who experienced a lower back injury while doing yard work 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 patient's drug regimen?
Risk for Injury related to CNS depression
After teaching a class on the female reproductive system, the nurse determines that the teaching was successful when the class identifies what as a primary function of the ovaries?
Secretion of estrogen and progesterone
How will the addition of nitrous oxide or IV anesthetics affect the minimum alveolar concentration (MAC) of isoflurane?
The MAC will decrease
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 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
Dantrolene is being considered for the treatment of a client's spasticity. Which aspect of the client's current health status is most likely to contraindicate the use of this medication
The client's spasticity is due to rheumatoid arthritis
A client's health care provider has prescribed baclofen in an effort to treat neuropathic cancer pain. What education should the nurse prioritize when teaching the client about this new medication?
The importance of ensuring safety related to possible sedation
A patient's physician has prescribed baclofen in an effort to treat the patient's neuropathic cancer pain. What patient education should the nurse prioritize when teaching the patient about this new medication?
The importance of ensuring safety related to possible sedation
• "Rise carefully from a seated to a standing position." • "This medication may cause you to have to urinate more frequently." • "This medicine may give you a headache or make sleeping difficult."
The nurse's home care teaching for a client who takes baclofen will include which instructions?
Cyclobenzaprine produces an anticholinergic response, resulting in these side effects.
The patient is taking cyclobenzaprine for muscle spasms secondary to an injury to his lumbar spine that occurred while lifting a motor at work. He is being seen for a follow-up visit by the physician. He is complaining of dry mouth, blurred vision, and constipation. Why is the patient having these side effects from cyclobenzaprine?
Which of the following patients is at greatest risk for experiencing status epilepticus?
The patient who suddenly stops drinking after consuming large amounts of alcohol for the past 5 years
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?
The nurse is discussing infertility issues with a couple. What information should the nurse provide the couple concerning the effect of Sertoli cells of male sperm?
They produce inhibin a substance that in turn affects sperm production
When caring for a patient receiving estrogen replacement therapy for postmenopausal symptoms, the nurse documents a diagnosis related to impaired tissue perfusion. Which condition is the nurse referring to in the diagnosis?
Thromboembolism
When epinephrine is mixed with a local injectable anesthetic, it is done for what purpose?
To cause vasoconstriction
Muscle spasms are thought to arise from the flood of sensory impulses coming to the spinal cord from an injured area
True
Muscle spasms are thought to arise from the flood of sensory impulses coming to the spinal cord from an injured area.
True
Muscle spasms are thought to arise from the floor of sensory impulses coming to the spinal cord from an injured area.
True
A female client age 25 years is prescribed methotrexate to treat rheumatoid arthritis (RA). The nurse should teach the client to do which of the following?
Use an effective contraceptive.
What would a nurse attribute to the effect of testosterone? (Select all that apply.)
Vocal cord thickening Increased hematocrit Facial hair growth
A client has received lidocaine (Xylocaine) 2% for a skin laceration repair. Before the repair begins, how would the nurse assess this client for adequate pain relief?
Wait 2 to 5 minutes and assess the area for pain and sensitivity to touch or pressure.
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 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
Coordination of position and posture
When describing the function of the extrapyramidal system, which of the following would the instructor include?
Baclofen (Lioresal)
Which of the following is an example of a skeletal muscle relaxant?
Drowsiness
Which of the following is the most common adverse reaction to carisoprodol (Soma) that the nurse should discuss with the patient?
Dantrolene (Dantrium)
Which of the following medications can be used to treat or prevent malignant hyperthermia?
Baclofen (Lioresal)
Which of the following skeletal muscle relaxants is also available in intrathecal form?
Spasm due to rheumatoid arthritis
Which of the following would be a contraindication for the use of a methocarbamol?
Discontinue the use of alcohol
Which of the following would be the most important safety-related instruction for a nurse to give to a patient taking baclofen (Lioresal)?
A client who was prescribed vardenafil has a sustained erection and is being seen in the emergency department. What is the priority nursing diagnosis?
acute pain
where are the nicotinic receptors found
adrenal medulla
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
Before the drugs are prescribed, a complete medical history, physical examination, pap test, urinalysis, and weight and blood pressure measurements are recommended.
all this crap before getting a prescription for contraceptives
Spasticity may result from
an increase in excitatory influences or a decrease in inhibitory influences within the CNS.
secondary male characteristics remain due to what?
androgen
The nurse instructs a client to use benzocaine to soothe the itching and pain related to an insect bite. Benzocaine is considered to be what type of dermatologic agent?
anesthetic
An older adult client's current medication regimen includes tamsulosin and sildenafil. The combination of these two medications should prompt what action by the nurse?
assessing the client regularly for signs of orthostatic hypotension
The nurse is closely following a client who began treatment with testosterone several months earlier. When assessing the client for potential adverse effects of treatment, the nurse should prioritize which assessment?
assessment of calcium levels
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.
Sildenafil has been prescribed to a client in his 60s, and the nurse is providing health education about the safe and effective use of the drug. The nurse should teach the client to:
avoid taking more than 1x in a 24 hour period
The circulating nurse knows that what is the most important nursing intervention during Stage II of general anesthesia?
avoid unnecessary noise in the operating room
A client with impaired liver function secondary to hepatitis C requires a centrally acting skeletal muscle relaxant for temporary pain relief. What medication would put the least metabolic burden on the client's liver?
baclofen (not metabolized)
Dantrolene is associated with potentially fatal cellular damage. If your patient's condition is being managed with dantrolene, the patient should
be monitored for signs of liver damage and have liver function tests done regularly.
A woman experiencing menopausal symptoms asks the nurse about herbal products that might help. Which would the nurse include in the response?
black cohash
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
The extra pyramidal tract is made up of cells from which areas?
cerebral cortex
After 6 months of unsuccessfully trying to conceive, a 31-year-old woman and her husband have sought a referral to a fertility specialist in order to explore their options. A nurse at the clinic should recognize that the woman may benefit from:
chlophiene
After 6 months of unsuccessfully trying to conceive, a 31-year-old woman and her husband have sought a referral to a fertility specialist in order to explore their options. A nurse at the clinic should recognize that the woman may benefit from:
clomiphene
Cyclobenzaprine is available in
controlled release oral form for continual control of the discomfort without repeated dosings
The nurse determines that teaching about testosterone therapy via a transdermal patch is effective when the male client states that he will change the patch in which time frame?
daily
Muscle spasticity is the result of
damage to neurons within the CNS.
A surgical client has developed malignant hyperthermia. Which medication can be used to treat this health emergency?
dantrolene
Which medication will inhibit the release of calcium in skeletal muscle cells to minimize the development of muscle contractions?
dantrolene sodium
magnesium causes what?
depressed reflexes
The drug of choice for a patient experiencing severe muscle spasms and pain precipitated by anxiety is
diazepam
Patients receiving chlorzoxazone (Paraflex) should be cautioned that what will occur with administration?
discoloration of urine
A client is receiving botulinum toxin type A as treatment for frown lines. The nurse would instruct the client about:
drooping eyelids
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
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
What additional warnings or risks should the nurse include in the teaching plan of a client receiving estrogen?
endometrial cancer
Androgens may be prescribed to women to treat conditions related to the effects of the female sex hormones. Danazol is prescribed to prevent or treat fibrocystic breast disease and:
endometriosis
What is the most plausible rationale for a female client being prescribed danazol?
endometriosis
Menopause occurs when the the female body stops producing which hormones? (Select all that apply.)
estrogen and progesterone
What is the preferred treatment for the diagnosis of atrophic vaginitis?
estrogen preparations
A client on long term testosterone therapy is at risk for the development of hepatocellular cancer. The nurse explains to the client that a hepatic function test should be done and evaluated on what schedule during the therapy?
every 6 months
A female client began an infusion of oxytocin 2 hours ago and the nurse has been conducting regular assessments on her as well as monitoring the fetal heart rate closely. The nurse should prioritize which potential nursing diagnosis in the organization of the client's immediate care?
excess fluid volume...also water toxicity
What is a common risk for epileptic seizures during late infancy to early childhood?
fever
Pyramidal Tract
fibers within the CNS that control precise, intentional movement
Which is an example of an androgen that can be used to treat hypogonadism?
fluoxymesterone
A 66-year-old man has made an appointment with his primary care provider to discuss his recent erectile dysfunction (ED) and has requested a prescription for tadalafil (Cialis) based on television commercials he has seen. What characteristic of this client would contraindicate the use of tadalafil for his ED?
has unstable angina and uses a nitroglycerin patch
Which would the nurse include in a teaching plan about the signs and symptoms of thrombophlebitis and thromboembolism that should be reported by a client taking estrogen?
headaches
Signs and symptoms of what would necessitate discontinuation of dantrolene therapy?
hepatic dysfunction
A client prescribed dantrolene therapy requires monitoring for what serious adverse effect?
hepatitis
When prescribed dantrolene, what is the most serious adverse effect the client should be instructed about?
hepatitis
A 76-year-old woman has a complex medical history that includes emphysema, osteoporosis, malnutrition, and hypothyroidism. Recently, the woman fell outside her home as a result of weakness and suffered a fracture to her femoral head. The woman's subsequent hip-replacement surgery has been scheduled and the care team recognizes that the use of isoflurane will be most significantly influenced by
history of emphysema
What happens with the hormones associated with pregnancy once the fetus and the placenta have been expelled from the uterus?
hormone decreases
A 30-year-old pregnant woman has been prescribed administration of oxytocin. When assessing the patient's drug regimen, the nurse understands that the patient is taking vasopressors. Which risk is the patient most susceptible to if oxytocin is administered along with vasopressors?
hypertension
Which is NOT a common adverse effect of spinal anesthesia?
hypertension
A 30-year-old pregnant client is 5 cm dilated and has just received epidural anesthesia for pain relief. Which adverse effect is most likely?
hypotension
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 adverse effect of muscle relaxants is most pronounced when a client is prescribed tizanidine therapy?
hypotension
which adverse effect of muscle relaxants is most pronounced when a client is prescribed tizanidine therapy?
hypotension
A 63-year-old woman taking estrogen and progestin for several years has recently changed to estrogen alone. What medical event would prompt such a change in treatment?
hysterectomy
In older adult men, anabolic steroids may be prescribed for a deficiency condition. If hypertensive, what might be the cause for an increase in blood pressure?
increase fluid and sodium retention
A nurse administers methylergonovine (Methergine) to a client immediately after delivery of a normal, healthy baby boy. The nurse will advise her that she may experience which common adverse effect of the drug?
increase in BP
The increase in thickness of the endometrial layer during the first half of the menstrual cycle is controlled by the:
increase in level of estrogen
A nurse is working with a 39-year-old patient who is experiencing muscle spasms associated with multiple sclerosis. The patient reports that she needs help with basic care and that her 15-year-old daughter has been helping bathe and dress her for a week. The patient's physician has prescribed baclofen (Lioresal). The nurse and the patient agree that an appropriate goal related to helping her maintain her self-worth would be to
increase self-care in activities of daily living
Which would a nurse expect to occur with the administration of anabolic steroids?
increased red blood cell mass
What represents routes in which general anesthesia is most commonly achieved? (Select all that apply.)
inhalation and IV
A perioperative nurse is explaining the process of general anesthesia in anticipation of the adult client's imminent bowel resection. When describing the phase of induction, the nurse should explain that this is usually achieved by what means?
intravenous administration of anesthetics
Dantrolene (Dantrium) differs from the other skeletal muscle relaxants because
it acts directly within the skeletal muscle fiber and not within the CNS
In the male, interstitial cell stimulating hormone is released. The nurse identifies this as:
lh
When teaching an adolescent about ovulation, the nurse would include that ovulation is initiated by a surge in:
lh
The nurse at an urgent care clinical is reviewing local anesthetics. What drug should the nurse recognize as an amide?
lidocaine
Andropause
like menopause, but for men
A nurse is teaching a class at the local high school on the abuse of anabolic steroids. Which potential adverse reaction should the nurse cite regarding the long-term use of these hormones?
liver tumors
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 extrapyramidal control of unconscious muscle movements
The students are studying for an exam in pharmacology. They know several local anesthetics have been covered along with other forms. Which medication can they anticipate as being local anethetics on the exam? Select all that apply.
marcaine xylocaine novocain
If a child older than 12 years of age requires a skeletal muscle relaxant after an injury
metaxalone has an established pediatric dosage
Signs and symptoms of tetanus, which includes severe muscle spasm, are best treated with
methocarbamol.
A 22-year-old woman is in the clinic to end an early pregnancy. She takes three tablets of mifepristone (Mifeprex). Two days after she takes the medication, she returns to the clinic to see if she is still pregnant or if the medical abortion is complete. It is determined that she is still pregnant. The nurse will administer which drug?
mistoprolol
A nurse is caring for a 28-year-old patient who is taking exogenous testosterone for treatment of cryptorchidism. What statement by this patient would lead the nurse to believe that patient teaching has been ineffective?
my sperm count will increase
A client with multiple sclerosis asks the nurse to explain why deep tissue massages do not relieve spasticity. The nurse should explain that spasticity is caused by:
nerve damage in the brain and spinal cord, and it is a permanent condition
Medroxyprogesterone is an effective form of birth control. Long-term use can cause what serious adverse effect?
osteoprosis
Clotting of the uterine lining during the menstrual cycle is prevented by high levels of
plasminogen
A teenage client who is using testosterone to treat a hormone deficiency calls the clinic to report acne-like skin eruptions on the face. How should the nurse counsel this client?
practice frequent and through skin cleansing
hormone engages the rhythm of birth control
progesterone
When describing the menstrual cycle to a group of young women, the nurse explains that estrogen levels are highest during which phase of the endometrial cycle?
proliferative
A patient reports menstrual cramps. The nurse understands that this is due to:
prostaglandins
The nurse monitors a patient receiving oxytocin for water intoxication based on the understanding that this condition is the result of:
release of antidiuretic hormones
A nurse is caring for a client with trigeminal neuralgia at a health care facility. The health care provider has prescribed carbamazepine. In which case is the use of carbamazepine contraindicated in clients with:
renal impairment.
During fetal development, the descent of the testes into what structure helps prevent injury to the sperm-producing cells?
scrotum
Dysfunction of which structure in the male reproductive system would result in ineffective sperm production?
seminiferous vesicles
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
A group of students are reviewing the drugs available for treating penile erectile dysfunction. The students demonstrate understanding when they identify which drug as a PDE5 inhibitor?
slidenafil
A patient who has suffered a crushing injury to his thumb and two fingers in an accident at a factory is relieved to be administered a local anesthetic prior to treatment. The drugs that were administered decrease the permeability of the nerve cell membrane to:
sodium
There are different stages of anethesia the client will go through in surgery. The circulating nurse is aware that extra caution is needed during which stage of general anesthesia, when the client may experience brief periods of delirium and excitement?
stage II
A surgical nurse is documenting the different stages of anesthesia on a patient's chart. Which stage will the nurse describe in documentation just before the surgeon makes the incision?
stage III
Hypertonia
state of excessive muscle response and activity
A client is using a transdermal system for androgen administration. Which drug would the client most likely be using?
testosterone
Which would the nurse expect to administer as a depot injection?
testosterone
A nurse is providing care for a patient who suffered extensive burns to the extremities during a recent industrial accident. Topical lidocaine gel has been ordered to be applied to the surfaces of all the burns in order to achieve adequate pain control. When considering this order, the nurse should be aware that:
there is a risk of systemic absorption of the lidocaine through the patient's traumatized skin.
When caring for a patient receiving estrogen replacement therapy for postmenopausal symptoms, the nurse documents a diagnosis related to impaired tissue perfusion. Which condition is the nurse referring to in the diagnosis?
thromboembolism
When epinephrine is mixed with a local injectable anesthetic, it is done for what purpose?
to cause vasoconstriction
A client requires local anesthesia to be administered. The nurse identifies that the anesthetic may be administered by which route? Select all that apply.
topical, regionalized, local inflitration
Anabolic steroids are analogs of testosterone with increased protein-building effects.
true
Centrally acting skeletal muscle relaxants lyse or destroy the spasm
true
A nurse teaching a 57-year-old client about the factors that must be considered around the use of hormone replacement therapy (HRT) should discuss what increased risk associated with the therapy?
venous thromboembolism
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?
watching when ambulating
A young man has received a diagnosis of androgen deficiency and has been prescribed testosterone. At clinic follow-up appointments, the nurse should prioritize which assessment?
weight and BP
Premenopausal women are also at increased risk for the hepatotoxicity associated
with dantrolene
Which of the following adverse effects would a nurse most likely assess in a patient who is receiving a centrally acting skeletal muscle relaxant? Select all that apply.
• Constipation • Insomnia • Dry mouth • Drowsiness
A client is receiving baclofen at 8 AM. The nurse would monitor the client for evidence of maximum effect at which time?
10 AM
what day does ovulation occur?
DAY 14
A client with a history of malignant hyperthermia is scheduled for surgery. Which agent would the nurse most likely expect to administer?
Dantrolene
A 29-year-old female client in labor has just received epidural anesthesia. Before the procedure her blood pressure was 120/78 and her pulse was 60 bpm. Now her blood pressure is 100/60 and her pulse is 80 bpm. She reports a metallic taste in her mouth, hears a ringing in her ears, and appears confused. What is this client most likely experiencing?
Systemic toxicity from local anesthesia
A nurse is preparing a class on the various drugs used to treat erectile dysfunction. Which would the nurse include?
Tadalafil
A muscle spasm often results from
injury to the musculoskeletal system
True or False: The pyramidal tract is located primarily within the basal ganglia.
False; Located in the CNS
True or False: Muscle spasticity is the result of damage to peripheral structures rather than to injured neurons.
False; Muscle spasticity is the result of damage to neurons within the CNS rather than injury to peripheral structures
A patient has been started on dantrolene (Dantrium). What is the most serious adverse effect on which the patient should be instructed?
Fatal hepatitis
If pregnancy does not occur during the menstrual cycle, the corpus luteum involutes and becomes the:
corpus albicans
Which of the following would a nurse identify as increasing a client's risk for hepatic disease with dantrolene use?
Age over 35 years
A client with muscular dystrophy has recently begun taking dantolene for the treatment of muscle spasms. When assessing for adverse effects, what assessment questions should the nurse include? Select all that apply.
"Do you find that the medication gives you an upset stomach?" "Are you getting any sudden or frequent urges to urinate?" "Have you experienced any new or unusual aches and pains since starting the medication?"
A client sustained a severe laceration to the right thumb and index finger that will require local anesthetic to facilitate suturing. Which statement should prompt the nurse to provide further client health education?
"I'm feeling pretty queasy about getting stitches, so I'm glad they'll be knocking me out."
The nurse is educating an adult male client diagnosed with erectile dysfunction about the prescribed sildenafil. Which statement made by the client establishes the need for further clarification?
"If I eat a fatty meal I will need to take two pills instead of one, so the drug will take effect faster."
A male clent has been diagnosed with impotence and is started on a regimen of androgens. Which statement by the client indicates that he has understood the teaching?
"If my skin appears yellow or my urine turns dark, I will contact my health care provider."
A client has been diagnosed with partial seizures and has been prescribed carbamazepine. When providing health education about the safe and effective use of this medication, what should the nurse teach the client?
"It's safest if you avoid drinking alcohol while you're taking this drug."
A 56-year-old woman with a diagnosis of multiple sclerosis has begun taking dantrolene. What patient teaching should the nurse provide?
"Make sure to see your doctor promptly if you develop yellowish skin or eyes."
Spasmolytics, or centrally acting muscle relaxants, block the reflexes in the central nervous system that lead to spasm. While a patient is taking one of these drugs, which of the following interventions should be implemented?
- Rest for the affected muscle - Heat to the affected area - Use of anti-inflammatory agents - Positioning to decrease pain and spasm
Bind directly to the receptor sites of motor nerve terminals and inhibit the release of acetylcholine, leading to local muscle paralysis
- botulinum toxins A and B - incobotulinumtoxin A
Baclofen
A patient with spinal cord injury is experiencing muscle spasticity. Which agent would most likely be ordered?
he client is to have a spinal anethesisa for surgery. While educating the client, which statement by the nurse is correct regarding the insertion of the needle?
A small gauge needle will be inserted into the subarachnoid space and medication will be administered into the cerebrospinal fluid.
34-year-old man received a skin laceration while playing soccer that will require a few stitches. A local anesthetic will be used. Which medication would the nurse question for the use in this procedure?
A volatile liquid such as halothane or isoflurane (Fluothane)
A client in status epilepticus has been brought to the emergency department. The nurse should anticipate which treatment measures?
Administration of intravenous lorazepam
A pt sustained a musculoskeletal injury to his left leg that resulted in occasional spasticity. What should the nurse expect the health care provider to prescribe? A) Cyclobenzaprine B) Baclofen C) Botulinum toxin type B D) Dantrolene
A; Used to treat discomfort from acute conditions
After teaching a group of students about abortifacients, the instructor determines that the teaching was successful when students identify which condition as a contraindication to their use?
Active pelvic inflammatory disease
The nurse administers a pt scheduled dose of dantrolene P.O. at 10:00. The nurse should expect the duration of action to extend until approximately what time? A) 15:00 B) 20:00 C) 17:00 D) 13:00
B; Duration of action is 8-10 hours
What pt is using his or her pyramidal tract to the largest extent? A pt who is: A) Reaching to flush the toilet B) Filling out the dietary preferences card for the next day C) Walking to the dining room D) Rising from a sitting to a standing position
B; pyramidal tract controls precise intentional movement such as writing
estrogen
BLACK BOX WARNING: it increases risk of cancer, MI, and blood clots
When providing follow-up care for a client prescribed an oral contraceptive several months ago, the nurse must be certain to prioritize what assessment?
BP
The health care provider has prescribed testosterone for a 77-year-old client with a low testosterone level. The nurse will evaluate this client for what condition that may develop in this client in response to this medication?
BPH
A client with spinal cord injury is experiencing muscle spasticity. Which agent would most likely be ordered?
Baclofen
A patient with multiple sclerosis is admitted to the medical division for treatment of severe spasticity. What medication is used to treat spasticity and is administered intrathecally?
Baclofen
A patient with spinal cord injury is experiencing muscle spasticity. Which agent would most likely be ordered?
Baclofen
Centrally Acting Skeletal Muscle Relaxant Prototype
Baclofen
Often used to relieve the muscle spasticity associated with cerebral palsy
Baclofen
The nurse is caring for a patient with an intrathecal catheter in place to treat muscle rigidity. What centrally acting skeletal muscle relaxant could the nurse administer intrathecally?
Baclofen
What centrally acting skeletal muscle relaxant is not metabolized but is excreted in the urine?
Baclofen
Which medication would the nurse expect to administer if prescribed to achieve skeletal muscle relaxation?
Baclofen
Which of the following is an example of a skeletal muscle relaxant?
Baclofen (Lioresal)
When reviewing the med record of a pt who is to receive dantrolene, which condition would alert the nurse for the need of close monitoring? A) Has an infected surgical wound B) Is 67 years old C) Has respiratory depression from opioid analgesia D) Received a blood transfusion less than 24 hrs ago
C; It can increase muscular weakness and make respiratory depression worse
A pt w/ impaired liver function secondary to hepatitis C requires a centrally acting skeletal muscle relaxant for temporary pain relief. What med would put the lest metabolic burden on the pt liver? A) Orphenadrine B) Methocarbamol C) Baclofen D) Diazepam
C; It is not metabolized
A patient admitted to a health care facility for appendicitis surgery is administered methohexital as a general anesthesia. Which condition should the nurse observe in the patient as the effect of the administration of methohexital?
CNS depression
The nurse should review which lab result before advising a client about taking the first dose of ibandronate (Boniva)?
Calcium
An older adult patient with a history of renal dysfunction is to receive a centrally acting skeletal muscle relaxant. Which agent would be most appropriate?
Carisoprodol
The centrally acting skeletal muscle relaxant of choice for older patients and for those with hepatic or renal impairment
Carisoprodol
Direct-Acting Skeletal Muscle Relaxant Prototype
Dantrolene
Most muscle relaxants drugs are CNS depressants. Which of the following medications acts only on the muscle?
Dantrolene
Used to treat upper motor neuron spasticity in children
Dantrolene
Which of the following medications can be used to treat or prevent malignant hyperthermia?
Dantrolene (Dantrium)
A patient is having surgery to repair a ruptured Achilles tendon. The patient develops severe muscle contractions and hyperthermia. Which medications will be administered?
Dantrolene sodium (Dantrium)
The use of neuromuscular junction blockers may sometimes cause a condition known as malignant hyperthermia. The drug of choice for prevention or treatment of this condition is
Dantrolene.
A patient has been admitted to your unit for treatment of a multiple sclerosis exacerbation. The admission order indicates that the patient is taking baclofen (Lioresal). Which of the following outcomes would you expect to be associated with use of this medication?
Decreased muscle spasms
Which results with the administration of testosterone?
Decreased protein catabolism
he nurse is administering phenytoin to a client who is also receiving a continuous nasogastric enteral feeding and is aware of what possible effect?
Decreasing the absorption of the AED
When fluoxymesterone is administered to a 14-year-old male, what is the expected result?
Development of sexual organs
A client is brought to the emergency department in the midst of acute alcohol withdrawal accompanied by seizure activity. What drug is most likely to meet this client's needs?
Diazepam (Valium)
Which medication is classified as an antianxiety medication but is also used to treat muscle spasms?
Diazepam (Valium)
Which of the following medications is classified as an antianxiety medication but is also used to treat muscle spasms?
Diazepam (Valium)
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
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.
Baclofen is not
Metabolized
The drug of choice if a child needs to be treated for tetanus
Methocarbamol
What agent would the nurse identify as also being used to treat tetanus?
Methocarbamol
Which agent would the nurse identify as also being used to treat tetanus?
Methocarbamol
Which is the drug of choice in children who need to be treated with tetanus?
Methocarbamol (Robaxin)
What would be a contraindication for the use of a methocarbamol?
Spasm due to rheumatoid arthritis
True
Spinal reflexes are the simplest nerve pathways that monitor movement and posture.
Define spasticity
Sustained muscle contractions
The human sexual response involves the activation of which system?
Sympathetic nervous system -follows the phase of stimulation, plateau, climax, resolution
A client diagnosed with benign prostatic hypertrophy (BPH) is prescribe tamsulosin. The client communicates with the nurse about a friend that was prescribed sildenafil for his BPH. Which is the nurse's best response regarding the difference in the use of the two drugs for BPH?
Tamsulosin relaxes muscles in the prostate and bladder and increases ability to urinate.
A 74-year-old woman states that many of her peers underwent hormone replacement therapy (HRT) in years past. The woman asks the nurse why her primary care provider has not yet proposed this treatment for her. What fact should underlie the nurse's response to the woman?
The risks of stroke and breast cancer are unacceptably high in women taking HRT
The nursing students are learning about synergistic effects of combined medications. Which is a desired effect of combining epinephrine with a local anesthetic? Select all that apply.
There is a lower risk of systemic toxicity. The local anesthetic stays in the desired tissues longer
Which patient would likely have the highest risk for hepatotoxicity from dantrolene (Dantrium)?
a women on HRT
In describing the effects of progesterone, which would be appropriate to include?
increased body temp
A male taking anabolic steroids may experience which side effects?
jaundice
