PHARM. Chapter 25

Which of the following medications is classified as an antianxiety medication but is also used to treat muscle spasms?

Diazepam (Valium)

Patients receiving chlorzoxazone (Paraflex) should be cautioned that which of the following will occur with administration?

Discoloration of urine

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 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

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

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

Interference with calcium release from the muscles

In clients with spinal cord injury, spasticity requires treatment when:

It impairs safety, mobility, or the ability to participate in activities of daily living.

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

Liver function tests

An operating room nurse is assisting the anesthesiologist in the preparation of an intravenous dose of dantrolene. What emergent issue most likely prompted the need to give the patient dantrolene?

Malignant hyperthermia

Which agent would the nurse identify as also being used to treat tetanus?

Methocarbamol

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

Methocarbamol (Robaxin)

One of the adverse effects of dantrolene (Dantrium) includes:

Potentially fatal hepatitis.

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

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.

• Drowsiness • Insomnia • Dry mouth • Constipation

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

Centrally acting skeletal muscle relaxants lyse or destroy the spasm.

True

Muscle spasms are thought to arise from the flood of sensory impulses coming to the spinal cord from an injured area.

True

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

True

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

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 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

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

Dantrolene (Dantrium)

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 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 patient teaching should the nurse provide?

"Make sure to see your doctor 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 43-year-old woman was diagnosed with multiple sclerosis 2 years ago and has experienced a recent exacerbation of her symptoms, including muscle spasticity. Consequently, she has been prescribed Dantrolene (Dantrium). In light of this new addition to her drug regimen, what teaching point should the woman's nurse provide?

"You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity."

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

10 AM

A patient receives baclofen intrathecally at 8 AM. The nurse would expect the drug to peak at which time?

12 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?

3 PM

Which of the following would a nurse identify as increasing a client's risk for hepatic disease with dantrolene use?

Age over 35 years

An older client is to receive a centrally acting skeletal muscle relaxant. Which of the following would the nurse expect to be prescribed?

Carisoprodol

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

Dantrolene

Most muscle relaxants drugs are CNS depressants. Which of the following medications acts only on the muscle?

Dantrolene

A patient has been started on dantrolene (Dantrium). What is the most serious adverse effect on which the patient should be instructed?

Fatal hepatitis

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

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 the following is the action of the drug on the patient?

Reduction of muscle spasm

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

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 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

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

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 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.

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)

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

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

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