Deck 23: Pharmacotherapy of Muscle Spasms and Spasticity

Question 1

The operating room (OR)nurse is scheduled as the circulator in a case that involves a client with a family history of malignant hyperthermia.The nurse checks to see that dantrolene is readily available.What other medication should the nurse check for availability in case dantrolene must be administered?

A)Dilantin
B)Romazicon
C)Regitine
D)Lovenox

Answer 1

Regitine

Question 2

A client scheduled for surgery has a family history of malignant hyperthermia.The circulating nurse will be responsible for seeing that which medication is immediately available for administration?

A)Dantrolene sodium (Dantrium)
B)Baclofen (Lioresal)
C)Tizanidine (Zanaflex)
D)Orphenadrine (Myophen)

Answer 2

Dantrolene sodium (Dantrium)

Question 3

The nurse is providing care to a client who is diagnosed with muscle spasticity.The client wants to know the difference between muscle spasticity and muscle spasm.Which response by the nurse is most appropriate?

A)"A muscle spasm causes certain muscle groups to remain in a continuous state of contraction."
B)"Muscle spasms include scissoring movements of the lower extremities."
C)"Muscle spasticity causes pain that is more intense than muscle spasm and produces greater impairment of mobility."
D)"Muscle spasticity is a chronic neurologic disorder that is characterized by involuntary muscle contraction that forces body parts into abnormal,painful movements or postures."

Answer 3

"Muscle spasticity causes pain that is more intense than muscle spasm and produces greater impairment of mobility."

Question 4

The client tells the nurse,"The doctor is going to start me on Botox for the muscle spasms in my neck.I've always wanted to try that.It will make me look younger." Which information should the nurse provide to this client regarding onabotulinumtoxinA (Botox)? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"Once you start on the medication,it may take a week or so before you notice a change in your skin."
B)"Be certain you take the medication with a full glass of water because it can be hard on your kidneys."
C)"There are many different uses for that drug,depending on how it is administered."
D)"You may have to have additional treatments with the medication in a few months."
E)"You should be aware that side effects of the medication can occur hours or weeks after your treatment."

Question 5

The parents of a toddler client who has cerebral palsy are only now beginning to accept that their child will have permanent disability.The nurse has been instructing the parents about the treatment for the spasticity their child is experiencing.Which statements by the parents indicate that the nurse should plan additional teaching sessions? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"At some point,our child may require surgery to correct this spasticity."
B)"As long as we continue our child's medications,the spasticity can be controlled."
C)"Our physical therapy sessions should focus on flexing our child's muscles."
D)"We should repeat the exercises several times with each muscle group."
E)"It is best to give our child a rest from physical therapy by skipping 1 week a month."

Question 6

An adult client is prescribed dantrolene sodium ((Dantrium)for spasms related to progression of multiple sclerosis.Which intervention is most important for the nurse to include in this client's care plan?

A)Teach the client the importance of using sunscreen when taking this medication.
B)Assess the client for pain using the pain scale and range of motion.
C)Monitor the client for sedation.
D)Monitor liver function tests.

Question 7

The nurse is caring for a client who is prescribed cyclobenzaprine (Flexeril)for lower back pain following a work injury.The client has been quite drowsy,and dozes off and on throughout the day while taking the Flexeril.Which action by the nurse is the most appropriate for this client?

A)Notifying the health care provider that the client is experiencing extreme drowsiness
B)Providing the client caffeinated beverages to help the client stay awake
C)Holding the cyclobenzaprine until the client can be further evaluated
D)Continuing the medication as ordered

Question 8

A client tells the nurse,"I have been reading about using castor oil as a treatment for muscle cramping.Do you know anything about that?" How should the nurse respond to this question? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"Why don't you ask the doctor about whether it works or not?"
B)"I think you take a tablespoon twice a day."
C)"The castor oil should be warmed before use."
D)"Soak a flannel cloth with the castor oil and apply it to your muscle."
E)"You must wear gloves when handling castor oil."

Question 9

An adult client who prescribed the anticholinergic oxybutynin (Ditropan)for urinary incontinence is admitted to the unit with acute muscle spasms after twisting her back in a fall.Which medication used for muscle spasm relaxation would cause the nurse the most concern?

A)Ibuprofen 600 mg
B)Cyclobenzaprine (Flexeril)
C)Tizanidine (Zanaflex)
D)Chlorzoxazone (Parafon Forte)

Question 10

The nurse is providing discharge instructions for a client who has experienced pulled muscles in the back after lifting a heavy item at work.Which statement by the client indicates the need for further instruction?

A)"I should apply heat for 10 minutes,followed by cold for 10 minutes."
B)"I may sit in a warm whirlpool tub to help relax the back muscles."
C)"I may take 2 to 3 ibuprofen 200 mg each every 6 hours by mouth."
D)"I am to go home and stay on bed rest for the next 2 to 3 days."

Question 11

A client is seen for muscle spasms in the upper thigh.The nurse anticipates instructing the client on the use of which medication?

A)Nonsteroidal anti-inflammatory drugs
B)Muscle relaxants
C)Both nonsteroidal anti-inflammatory drugs and muscle relaxants
D)Nonsteroidal anti-inflammatory drugs,muscle relaxants,and narcotic pain relievers

Question 12

The client's health care provider prescribed dantrolene sodium (Dantrium)25 mg daily for the treatment of neck spasms secondary to spinal cord injury.The client reports that the medication is "not working," even though it has been 45 days since the medication was started.What changes in this client's plan of care would the nurse anticipate? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Increase in the dosage frequency to twice a day
B)Discontinuation of the medication
C)Increase in the frequency of hepatic function tests
D)Change to a different medication
E)Addition of succinylcholine (Anectine)to the client's medications

Question 13

The client is prescribed collagenase (Xiaflex)for Dupuytren contracture.When developing this client's care plan,which nursing diagnoses will the nurse include? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Body Image,Disturbed
B)Fatigue
C)Pain,Chronic
D)Falls,Risk for
E)Tissue Perfusion: Peripheral,Risk for Ineffective

Question 14

A client is admitted to the unit from surgery for insertion of pins for traction due to a compound fracture to the left femur.The client has a Foley catheter for gravity drainage.Chlorzoxazone (Parafon Forte)is ordered for the client.The next day,it is noted that the urine has a reddish-orange discoloration.How should the nurse respond to this development?

A)Call the health care provider for an order for a urinalysis.
B)Check the urine for bacteria with a urine chemstick.
C)Continue to monitor I & O.
D)Notify the health care provider about the discoloration in the urine.

Question 15

A client who was discontinued from using an MAOI 1 week ago has injured his back and is in pain from severe muscle spasms.The client is prescribed cyclobenzaprine (Flexeril)for the muscle spasms.Which nursing action is the most important?

A)Inform the client to watch for added CNS depression.
B)Warn the client not to operate a motorized vehicle until the effects of the medication are known.
C)Hold the Flexeril and notify the health care provider.
D)Give the Flexeril as prescribed.

Question 16

The nurse's neighbor says,"My son has been waking up with bad cramps in his calf for the last two nights.He has been working out with his football team,and it has been so hot." Which additional statement would indicate to the nurse that the neighbor needs more information concerning muscle spasms?

A)"I have my son take a multivitamin every day to help replenish calcium and other minerals."
B)"I think I will give him one of my muscle relaxers before practice today."
C)"I've told my son to point his toes upward and gently massage the calf muscle."
D)"I send three 64-ounce bottles of Gatorade and water with my son to practice every day."

Question 17

A client who suffers from frequent calf muscle cramping asks the nurse about using nonprescription capsaicin for pain relief.What information should the nurse provide this client?

A)Capsaicin is seldom effective in the treatment of cramping in calf muscles.
B)The client should plan to use the medication two times each day.
C)This medication should be taken with a full glass of water.
D)The client should wear gloves when handling this medication.

Question 18

A client is prescribed cyclobenzaprine for muscle spasms.Which nursing diagnosis should the nurse add to this client's care plan?

A)Infection,Risk for
B)Urinary Elimination,Impaired
C)Tissue Perfusion: Peripheral,Risk for Ineffective
D)Injury,Risk for

Question 19

A client who has cerebral palsy is beginning to experience spasticity of the muscles in the upper arm.Which medications would the nurse prescribed for this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Metaxalone (Skelaxin)dosed three times a day
B)Chlorzoxazone (Parafon Forte)dosed four times a day
C)Carisoprodol (Soma)dosed three times a day
D)Intrathecal baclofen (Lioresal)
E)Tizanidine (Zanaflex)dosed twice a day