Chapter 25 Prep-U Questions
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 older adult is prescribed a skeletal muscle relaxant for reports of neck pain. What is the top priority of care for the nurse to teach the family?
Monitor the client before ambulating
Baclofen is used to treat what?
Muscle spasticity associated with neuromuscular diseases.
The nursing instructor is discussing cholinergic drugs. The nursing students understand what system is acted upon by this family of drugs?
PSNS
The client has been prescribed a cholinergic agonist. Which nervous system to they stimulate?
PSNS is stimulated by these meds
Bethanechol subcutaneous injections are used to do what?
Relax the bladder so a client with urinary retention can void.
The nurse is developing a teaching plan for an outpatient receiving cholinergic drugs. What should be the role of the nurse when developing a teaching plan?
Review the purpose of the drug therapy with the patient and family
A client with a neurogenic bladder secondary to a spinal tumor has been taking bethanechol. When the nurse finds the client anxious, diaphoretic, and visibly flushed, what action should the nurse take to best assure the client's safety?
Contact the health care provider as the client may be experiencing a cholinergic crisis
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
Dantrolene should be avoided in all patients who are 35 or older because of the increased risk of?
Hepatocellular disease
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
The pharmacology instructor is discussing the drug therapy for Alzheimer's disease with a group of nursing students and states that indirect-acting cholinergic drugs do what to improve symptoms?
Improved cholinergic neurotransmission to the brain
How long does it take for Baclofen to reach it's peaks?
2 hours after administration
A nurse caring for a client receiving bethanechol for urinary retention should advise the client that voiding usually occurs how long after oral administration?
30-90 mins
A nurse has administered a drug that will have a therapeutic effect on the client's parasympathetic nervous system. The nurse understands the drug will primarily affect what neurotransmitter?
ACH
A nurse is preparing to administer a cholinergic medication. To prepare to administer the medication, the nurses is assessing the client for anticholinergic effects. Cholinergic medications act like which neurotransmitter?
ACH
When describing the parasympathetic nervous system to a group of students, which substance would the nursing instructor discuss as being responsible for transmission of nerve impulses across this system?
ACH
When providing client teaching on taking anticholinesterase drugs, the nurse would include which caution in regards to how the patient should take the drug?
Anticholinesterase drugs should be taken with food or milk to decrease the risk of gastric distress and ulceration.
Cholinergic agents like bethanechol are contraindicated for clients having which medical diagnosis?
Asthma, peptic ulcer, sick sinus syndrome, GI obstruction
A client with spinal cord injury is experiencing muscle spasticity. Which agent would most likely be ordered?
Baclofen
Which skeletal muscle relaxant is also available in intrathecal form?
Baclofen
The client has been diagnosed with urinary retention. The nurse expects the client to receive which medication for this condition?
Bethanechol
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
The nurse is assessing a patient with glaucoma. What therapeutic effect will the health care provider expect from the cholinergic agonist administered?
Decreased intraocular pressure
Cyclobenzaprine is used for the treatment of what?
Discomfort of acute musculoskeletal conditions.
Which agent would be most appropriate to administer to a client with Alzheimer's disease?
Donepezil
A 29-year-old client who experienced a lower back injury has seen his range of motion decrease and his pain increase over the past several weeks. As a result, he has been prescribed cyclobenzaprine. What nursing diagnosis should the nurse prioritize in light of the client's drug regimen?
Risk of injury related to CNS depression
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
Botulinum toxin type B is used to reduce what?
The severity of abnormal head position and neck pain associated with cervical dystonia.
T/F Centrally acting skeletal muscle relaxants lyse or destroy the spasm.
True
The health care provider orders short-term skeletal muscle relaxants for an 11-year-old client. The nurse is responsible for the family education plan and teaches the parents that the medications should be used only under which condition?
When close supervision is available for monitoring drug effects
What is a side effect regarding the eyes and skin of dantrolene?
Yellowish skin or eyes
A nurse should review a client's medical conditions prior to administering a dantrolene (Dantrium) as its use is contraindicated in clients with which issues?
Hepatic disease, and lactation
When prescribed dantrolene, what is the most serious adverse effect the client should be instructed about?
Hepatitis
Which adverse effect should the nurse assess for when administering cyclobenzaprine?
Drowsiness
Is donepezil best used for early AD patients or ones in the late stages of the disease?
Early because they slow the progression of the disease
What are common adverse effects of methocarbamol by injection
Fainting, incoordination and hypotension
T/F Muscle spasticity is the result of damage to peripheral structures rather than to injured neurons.
False
It is important for a nurse to understand which body systems are affected by cholinergic drug adverse reactions, as this will determine how the nurse should assess the client. Which body systems are affected by cholinergic drug adverse reactions?
GI, CNS, Circulatory, respiratory
A patient with dementia of Alzheimer's disease is administered donepezil HCL. What are the actions associated with cholinesterase inhibitors?
Increase in the level of acetylcholine in CNS
The nurse administers a drug that will increase micturition. What should the nurse assess for a therapeutic effect?
Increased voiding
While Dantrolene (Dantrium) relieves spacisticity what symptom of MS can it exacerbate?
Muscle weakness
T/F Spinal reflexes are the simplest nerve pathways that monitor movement and posture.
True
Dantrolene is used to treat what?
Upper motor neuron-associated muscle spasticity.
The client is ordered bethanechol subcutaneously. After giving the client the injection of bethanechol, the nurse should make sure that what is available?
Urinal, bed pan and call light
When assessing a client for possible adverse effects of direct-acting cholinergic agents, what might the nurse find?
Urinary urgency
A nurse is caring for a 49-year-old client who has been taking bethanechol for treatment of neurogenic bladder. After one week, the client develops sweating, heavy salivation, and bronchospasm. What would the nurse suspect is happening with this client?
Cholinergic crisis
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 due to adverse effect of photosensitivity