Pharmacology Prep U Ch. 25 Muscle Relaxants
A nurse is preparing a teaching plan for a client who is to receive botulinum toxin type A for frown lines. What adverse effects should the nurse inform the client could possibly occur? Select all that apply.
Headache Respiratory infections Drooping eyelids
Signs and symptoms of what would necessitate discontinuation of dantrolene therapy?
Hepatic dysfunction
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 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?
Notify the physician.
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
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
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
Which skeletal muscle relaxant is also available in intrathecal form?
Baclofen (Lioresal)
A 56-year-old woman with a diagnosis of multiple sclerosis has begun taking dantrolene. What client teaching should the nurse provide?
"Make sure to see your health care provider promptly if you develop yellowish skin or eyes."
A client 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"
"This drug causes your urine to change color, so it's not likely blood that you're seeing."
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 will likely make you drowsy, so don't take it before doing anything that would require alertness."
A 43-year-old woman was diagnosed with multiple sclerosis 2 years ago and has experienced a recent exacerbation of her symptoms, including muscle spasticity. Consequently, she has been prescribed Dantrolene (Dantrium). In light of this new addition to her drug regimen, what teaching point should the woman's nurse provide?
"You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity."
The perioperative nurse is caring for a client who requires an umbilical hernia repair but who has a known family history of malignant hyperthermia. The client has been prescribed dantrolene 2.5 mg/kg IV one hour before surgery. The client weighs 121 lbs. The nurse reconstitutes a single-use vial as per the manufacture's instructions, yielding a solution with a concentration of 50 mg/mL. How many mL of the reconstituted dantrolene solution should the nurse add to the client's bag of intravenous fluid?
2.75 mL
Which patient would likely have the highest risk for hepatotoxicity from dantrolene?
A 57-year-old female who is on hormone replacement therapy
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
A client with spinal cord injury is experiencing muscle spasticity. Which agent would most likely be ordered?
Baclofen
A nurse understands that which skeletal muscle relaxants should not be administered to a client with skeletal muscle spasms caused by systemic lupus erythematosus?
Baclofen
Which medication would the nurse expect to administer if prescribed to achieve skeletal muscle relaxation?
Baclofen
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
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?
Dantrolene sodium
Which medication is classified as an antianxiety medication but is also used to treat muscle spasms?
Diazepam (Valium)
The client is taking baclofen. What would be the most important safety instruction for the nurse to give to this client?
Discontinue the use of alcohol.
The nurse is providing education to a client who has been prescribed tizanidine. What adverse effect should the nurse mention during teaching?
Hypotension
the nurse is providing education to a client who has been prescribed tizanidine. What adverse effect should the nurse mention during teaching?
Hypotension
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.
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
A surgical client has developed malignant hyperthermia. Which medication can be used to treat this health emergency?
dantrolene
Dantrolene should be avoided in all patients who are 35 or older because of the increased risk of:
hepatocellular disease.
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.
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 nurse is providing education to a client who has been prescribed dantrolene. What serious adverse effect should the nurse mention during teaching?
Hepatitis
A client with a history of malignant hyperthermia is scheduled for surgery. Which agent would the nurse most likely expect to administer?
Dantrolene
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 client has been prescribed baclofen and will be taking the drug on an outpatient basis. The client asks the nurse if it is still okay to drink wine with meals or end the day with a "nightcap." What is the nurse's best response?
"The combination of baclofen and alcohol could depress your nervous system to a dangerous level."
A 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?
Decreased muscle spasms
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?
Inspection for muscle spasticity and range of motion assessment
A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which instruction?
Wear appropriate clothing and sunscreen whenever he is in direct sunlight.
The health care provider orders short-term skeletal muscle relaxants for an 11-year-old client. The nurse is responsible for the family education plan and teaches the parents that the medications should be used only under which condition?
When close supervision is available for monitoring drug effects
