Pharm Chap 21 Neuromuscular Drugs

The nurse teaches a class about muscle movement to a group of patients who have neuromuscular disorders. What will the best plan of the nurse include? Select all that apply.

• Body movement depends on an intact spinal cord

• Body movement depends on proper functioning of muscles

• Body movement depends on intact nerves

• Body movement depends on proper endocrine functioning

• Body movement depends on the level of consciousness

Answer explanation

Body movement depends on proper functioning of muscles. Body movement does not depend on the level of consciousness. Body movement does not depend on an intact spinal cord as portions of the body move even if the spinal cord is damaged. Body movement does not depend on proper endocrine functioning.

The nurse teaches the patient with a neuromuscular disorder about nonpharmacological treatment of muscle spasms. What will the best information include? Select all that apply.

• Application of heat or cold

• Ultrasound

• Massage

• Relaxation techniques

• Guided imagery

Answer explanation

Nonpharmacological treatment of muscle spasms includes application of heat or cold, ultrasound, and massage. Guided imagery is not a nonpharmacological treatment for muscle spasms. Relaxation techniques are not a type of nonpharmacological treatment for muscle spasms.

The patient is started on a medication to treat a neuromuscular disorder. What does the nurse teach as the primary therapeutic goal of the medication?

• To stop the patient's muscle spasms

• To improve the patient's appearance

• To promote exercise in the patient

• To allow the patient increased independence

Answer explanation

The therapeutic goals of pharmacotherapy include minimizing pain and discomfort, increasing range of motion, and improving the patient's ability to function independently. Stopping muscle spasms can be achieved, but this is not the primary goal. Promoting exercise is not a goal. Improving the patient's appearance is not a goal.

The patient receives dantrolene (Dantrium) for muscle spasticity. Which lab result is a priority for the nurse to assess?

• Creatinine clearance

• Serum amylase

• Hemoglobin and hematocrit

• Aspartate aminotransferase (AST) and alanine aminotransferase (ALT)

Answer explanation

Dantrolene (Dantrium) can cause hepatitis; the aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are the priority laboratory tests for the nurse to assess. Dantrolene (Dantrium) does not affect hemoglobin or hematocrit; these laboratory tests are not a priority to assess. Dantrolene (Dantrium) does not significantly affect renal function; the creatinine clearance test isn't a priority laboratory test to assess. Dantrolene (Dantrium) does not affect pancreatic function; the serum amylase isn't a priority laboratory test to assess.

The physician has ordered dantrolene (Dantrium) for a patient. What is a priority assessment by the nurse prior to administering this medication?

• Does the patient have gastric ulcer disease?

• Does the patient have psoriasis?

• Does the patient have gallbladder disease?

• Is the patient pregnant or lactating?

Answer explanation

Dantrolene (Dantrium) is a Pregnancy Category C drug, so pregnancy should be assessed prior to administration. Gastric ulcer disease is not a contraindication to receiving dantrolene (Dantrium). Gallbladder disease is not a contraindication to receiving dantrolene (Dantrium). Psoriasis is not a contraindication to receiving dantrolene (Dantrium).

The physician prescribes cyclobenzaprine (Flexeril) for the patient. When doing medication education, what will the best information of the nurse include?

• Increase the intake of fiber while taking this medication

• Restrict the intake of sodium while taking this medication

• Increase the intake of protein while taking this medication

• Do not drink any caffeine while taking this medication

Answer explanation

Cyclobenzaprine (Flexeril) has anticholinergic properties and can cause constipation, so the patient should increase the intake of fiber while taking this medication. There is no need to limit sodium. There is no need to limit caffeine. There is no need to increase protein.

The patient is treated for muscle spasms following a spinal cord injury. What is the best outcome for this patient?

• Patient will have stabilized vital signs

• Patient will have an improved self-concept

• Patient will sleep without pain

• Patient will have increased bladder tone

Answer explanation

Decreasing muscle spasms will help prevent pain that can interfere with sleep. This medication relaxes muscles, but it will not increase bladder tone. Stabilization of vital signs is not an expected effect of this medication. Relief of muscle spasms may help with self-concept, but this is not a direct effect of the drug.

The patient tells the nurse that she awakens frequently during the night because of leg and foot cramps. What is the best response by the nurse?

• "Ask your physician for a muscle relaxant."

• "Increase your intake of vitamin B₆."

• "Take a warm bath before going to bed."

• "Apply heat to relieve the cramping."

Answer explanation

Oral therapy with vitamin B₆ may reduce the intensity and duration of leg muscle cramping. It is premature to ask the physician for a muscle relaxant. Applying heat will relax the muscles but will not prevent cramping. Taking a warm bath will relax the muscles but will not prevent cramping.

The patient receives dantrolene (Dantrium). Which medication would the nurse evaluate as being contraindicated with dantrolene (Dantrium)?

• Verapamil (Calan)

• Insulin

• Clarithromycin (Biaxin)

• Methylphenidate (Concerta)

Answer explanation

Verapamil (Calan) is a calcium channel blocker; combining this with dantrolene (Dantrium) could lead to cardiovascular collapse. There isn't any contraindication to the use of dantrolene (Dantrium) and insulin. There isn't any contraindication to the use of dantrolene (Dantrium) and methylphenidate (Concerta). There isn't any contraindication to the use of dantrolene (Dantrium) and clarithromycin (Biaxin).

Which list of treatment options would be considered optimal for treating a muscle spasm with an unknown cause?

• Anti-inflammatory agents, casting, and ultrasound

• Analgesics, antibiotics, and heat application

• Analgesics, muscle relaxants, and massage

• Anti-inflammatory agents, immobilization, and fluid and electrolyte replacement

Answer explanation

Muscle spasms can be treated with a variety of pharmacologic and nonpharmacologic methods. When the cause is unknown, a more general approach is indicated, such as analgesics, muscle relaxants, and massage. Antibiotics and casting are not indicated for muscle spasms. Fluid and electrolyte replacement can be indicated, if determined to be the cause; immobilization is not indicated.