Pharmacology Chapter 25
Dantrolene sodium
During surgery to repair a ruptured Achilles tendon, the client develops severe muscle contractions and a dramatic rise in body temperature. Which medication will be administered?
Baclofen (Lioresal)
Which skeletal muscle relaxant is also available in intrathecal form?
The client has hepatitis C
A client with a spinal cord injury is experiencing increasing muscle spasticity and the care team is considering the use of dantrolene. The nurse should identify what possible contraindication to the safe and effective use of this medication?
Baclofen
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?
Drowsiness Urinary frequency Constipation
A nurse is preparing a teaching plan for a client who is receiving baclofen therapy. Which would the nurse include as possible adverse effects? (Select all that apply.)
Ensure all members of the care team are aware of the risk for hepatotoxicity
A female client has been taking dantrolene for several years and has now requested a prescription for oral contraceptives from her primary care provider. What is the nurse's best action?
Dantrolene
A client with amyotrophic lateral sclerosis is experiencing muscle spasticity. Which drug would the nurse expect the physician to order?
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?
drooping eyelids.
A client is receiving botulinum toxin type A as treatment for frown lines. The nurse would instruct the client about:
Dantrolene
A client with a history of malignant hyperthermia is scheduled for surgery. Which agent would the nurse most likely expect to administer?
True
Centrally acting skeletal muscle relaxants lyse or destroy the spasm.
Hepatic dysfunction
Signs and symptoms of what would necessitate discontinuation of dantrolene therapy?
True
Spinal reflexes are the simplest nerve pathways that monitor movement and posture.
When close supervision is available for monitoring drug effects
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?
2.75 mL
The perioperative nurse is caring for a client who requires an umbilical hernia repair but who has a known family history of malignant hyperthermia. The client has been prescribed dantrolene 2.5 mg/kg IV one hour before surgery. The client weighs 121 lbs. The nurse reconstitutes a single-use vial as per the manufacture's instructions, yielding a solution with a concentration of 50 mg/mL. How many mL of the reconstituted dantrolene solution should the nurse add to the client's bag of intravenous fluid?
A 54 year-old client who suffers debilitating migraines two to three days per week
What client is most likely to benefit from Botox (incobotulinumtoxin A) injections?
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?
Safety, mobility, and activities of daily living are impaired.
When does a client with spinal cord injury-associated spasticity require treatment for this condition?
The client has respiratory depression from opioid analgesia
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?
Baclofen
A client with spinal cord injury is experiencing muscle spasticity. Which agent would most likely be ordered?
Wear appropriate clothing and sunscreen whenever he is in direct sunlight.
A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which instruction?
2
As a result of a bicycle accident two years ago, an 11 year-old client has a spinal cord injury. In recent months, the client's muscle spasms have worsened and the client has been prescribed dantrolene for the first time at a dose of 0.5 mg/kg PO b.i.d. The client weighs 110 lbs. How many 25-mg capsules should the client receive each day?
Cyclobenzaprine produces an anticholinergic response
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?
Interference with calcium release from the muscles
Which would a nurse include when describing the action of dantrolene?
dantrolene
While most muscle relaxants drugs are central nervous system (CNS) depressants, which medication acts only on the muscle?
Dantrolene
A patient is being treated for intractable muscle spasticity with a peripherally acting spasmolytic. The nurse should anticipate administering which medication?
Diazepam (Valium)
Which medication is classified as an antianxiety medication but is also used to treat muscle spasms?
The client's most recent laboratory results show an upward trend in AST and ALT levels
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?
Baclofen
Which medication would the nurse expect to administer if prescribed to achieve skeletal muscle relaxation?
Decreased muscle spasms
A client has been admitted to the unit for treatment of a multiple sclerosis exacerbation. The admission order indicates that the client is taking baclofen. Which outcome would the nurse expect to be associated with use of this medication?
"The combination of baclofen and alcohol could depress your nervous system to a dangerous level."
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?
Monitor the client before ambulating.
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?
Falls prevention measures
An older adult resident of a long-term care facility is experiencing muscle spasticity and has just been prescribed a centrally acting skeletal muscle relaxant. The client has comorbidities of early stage Alzheimer's disease and chronic obstructive pulmonary disease (COPD). What nursing action should the nurse prioritize for adding to the client's care plan?
Hepatitis
The nurse is providing education to a client who has been prescribed dantrolene. What serious adverse effect should the nurse mention during teaching?
Intrathecal baclofen infusion
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?
Drowsiness
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?
Hypotension
The nurse is providing education to a client who has been prescribed tizanidine. What adverse effect should the nurse mention during teaching?
"I take my medicine with three to four beers each evening."
A nurse is teaching a client about musculoskeletal medication that has been prescribed. The client needs further teaching about the medication when making which statements?
Notify the physician.
A patient comes to the clinic for a botox injection around her eyes. While making an assessment, the nurse finds that the patient is taking polymyxin for an infection. What would the nurse do first?
"My urine could be discolored while I take this drug."
A patient has been prescribed methocarbamol for fibromyalgia. The nurse has spent an hour educating the patient on the use of methocarbamol for muscle pain. Which statement by the patient indicates that the patient has an understanding of at least one of the significant side effects of methocarbamol?
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?
hepatocellular disease.
Dantrolene should be avoided in all patients who are 35 or older because of the increased risk of:
Inspection for muscle spasticity and range of motion assessment
The nurse is caring for a client whose current medication regimen includes baclofen 60 mg PO daily. What assessment should the nurse prioritize when assessing for therapeutic effects?
Risk for Injury related to CNS depression
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?
"Are you on hormone replacement therapy?"
The nurse is caring for a 59 year-old female client who was diagnosed with multiple sclerosis two years ago. In recent weeks, the client has developed increasing muscle spasticity and the care team is considering the use of dantrolene. What assessment question should the nurse prioritize?
"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?
"It's safest to have these injections performed under medical supervision."
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?
"This will likely make you drowsy, so don't take it before doing anything that would require alertness."
A client who is experiencing lower back pain has been prescribed cyclobenzaprine. The nurse should provide what health education in order to ensure safe and effective treatment?
"This drug causes your urine to change color, so it's not likely blood that you're seeing."
A client with a lower back injury was recently prescribed chlorzoxazone 250 mg PO t.i.d. The client has phoned the clinic, telling the nurse, "My pain's better, but I'm worried that my bladder is bleeding because there's been blood in my urine." What is the nurse's best response"
nerve damage in the brain and spinal cord, and it is a permanent condition.
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:
"You might experience some urinary frequency and urgency. Tell me promptly if it becomes problematic."
A client with myasthenia gravis has been prescribed dantrolene for the treatment of muscle spasticity. What education should the nurse provide to the client?
dantrolene
A surgical client has developed malignant hyperthermia. Which medication can be used to treat this health emergency?
The client's spasticity is due to rheumatoid arthritis
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?
Discontinue the use of alcohol.
The client is taking baclofen. What would be the most important safety instruction for the nurse to give to this client?
Avoid alcohol or other CNS depressants.
Which instruction should the nurse specifically stress when administering drugs used for muscle spasm and cramping?