Prep you Chapter 25 and 27
Which medication is classified as an antianxiety medication but is also used to treat muscle spasms?
Diazepam (Valium)
What is the primary purpose of nitrous oxide in the surgical setting?
It allows the anesthesia provider to administer lower doses of other anesthetics.
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 surgical client has developed malignant hyperthermia. Which medication can be used to treat this health emergency?
dantrolene
Which adverse effect should the nurse assess for when administering cyclobenzaprine?
drowsiness
What should the perinatal nurse anticipate will be the anesthetic of choice for a primiparous woman has been in the first stage of labor for 2 hours?
epidural anesthesia
When prescribed dantrolene, what is the most serious adverse effect the client should be instructed about?
hepatitis
After the administration of procaine to a client with a history that suggests a possible hypersensitivity to the drug, the nurse should prioritize what assessment?
respiratory
A clent has been admitted to the unit for treatment of a multiple sclerosis exacerbation. The admission order indicates that the client is taking baclofen (Lioresal). Which outcome would the nurse expect to be associated with use of this medication?
Decreased muscle spasms
Which medication is classified as an antianxiety medication but is also used to treat muscle spasms?
Diazepam
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
The nursing instructor is teaching the students about anesthesia and informs them that there are two types. What are those two types of anesthesia?
Local anesthesia General anesthesia
The nurse sprays the area with a medication to desensitize it. The nurse is administering which type of anesthesia?
Topical anesthesia
Muscle spasms are thought to arise from the flood of sensory impulses coming to the spinal cord from an injured area.
True
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
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 called the ambulatory clinic reporting headache, a "droopy eyelid" and malaise after receiving Botox injections at a friend's home the previous evening. The client is distressed, stating, "I had no idea that the injections could cause any problems." What is the nurse's best response?
"Come to the clinic so you can be assessed. You're likely having adverse reactions to the Botox injections."
The parents of a teething infant ask about over-the-counter (OCT) solutions to help minimize the pain. What assessment question has priority when preparing to provide suggestions?
"How old is your infant?"
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."
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 with spinal cord injury is experiencing muscle spasticity. Which agent would most likely be ordered?
Baclofen
Which medication would the nurse expect to administer if prescribed to achieve skeletal muscle relaxation?
Baclofen
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
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.
What is the most important nursing action when a client is admitted to the postanesthesia recovery unit (PACU)?
Ensure the client has adequate respirations.
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 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
Prior to administering morphine sulfate to a client in the postanesthesia recover unit (PACU), what information must the nurse obtain? (Select all that apply.)
Respirations Pulse Blood Pressure
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
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 for Injury related to CNS depression
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 nursing instructor is teaching students about anesthesia and instructs that general surgical anesthesia is divided into four different stages. In which stage would the nurse expect to see delirium?
Stage 2
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
Prior to elective hip replacement surgery, the nurse is explaining the basic characteristics of general anesthesia to the client. The nurse should perform this education in the understanding that general anesthesia is best understood as what result?
a state of reversible unconsciousness
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.
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
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 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."
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 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 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."
What is the most important teaching point for a client after surgery when the client had epidural anesthesia?
Ambulate with assistance.
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
Administration of which class of medications can decrease secretions of the upper respiratory tract?
Cholinergic antagonists
The nurse is caring for a client in the emergency department who will need sutures. The health care provider plans to use lidocaine. The nurse prepares the suture tray and places lidocaine and what other drug on the tray that helps prolong the local anesthetic effects?
Epinephrine
The nursing student makes the following statement during post conference in the clinical setting, "The difference between local and general anesthesia is very small. The client is unaware of his or her surroundings during both types." Is this true or false?
FALSE
The anesthesia care provider visits with the client prior to surgery. The choice of type of drugs to administer to the client during surgery are based on what factors? Select all that apply.
General physical condition of the client Area, organ, or system being operated on Anticipated length of the surgical procedure
During recovery from general anesthesia, what would be a priority?
Have emergency quitrent readily available
Dantrolene should be avoided in all patients who are 35 or older because of the increased risk of:
Hepatocelluar disease
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
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.
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
A client is most likely to experience respiratory adverse effects from which method of administration of a local anesthetic?
Nebulizer
The nurse is preparing a client who will receive intravenous anesthetic during a short surgical procedure. The nurse understands that this client is most likely to receive which medication?
Propofol
The client is undergoing surgery for a small bowel resection. At this time the client is experiencing complete respiratory paralysis and is in the most dangerous stage of general anesthesia. Which stage is this?
Stage 4
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
The client is having a kidney removed due to a tumor. The circulating nurse in the operating room knows that which stage of anesthesia will be most dangerous to the client?
Stage IV
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 37-year-old client has received procaine hydrochloride (Novocain) in the mouth for a dental procedure. How would the nurse evaluate that the outcome of reduced pain related to a dental procedure has been met?
The client's facial expressions are calm and relaxed.
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 client is scheduled to undergo craniofacial surgery, a procedure that will necessitate the use of propofol. The operating room nurse should be aware that alternative medications will be absolutely necessary in order to produce what effect in the client?
analgesia
A surgical client's balanced anesthesia includes the use of vecuronium. What nursing action should the operating room nurses prioritize?
assessing and protecting the client's airway
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
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
Spinal reflexes are the simplest nerve pathways that monitor movement and posture. (true or false)
True
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.
A client's migraines are not being adequately controlled by triptans and so the client is preparing to begin treatment with onabotulinumtoxin A. What should the nurse teach the client about this treatment?
Treatment will involve a series of injections every three months
