Author Question: A client who was discontinued from using an MAOI 1 week ago has injured his back and is in pain from ... (Read 59 times)

WhattoUnderstand · **on:** Jul 23, 2018

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?

1. Inform the client to watch for added CNS depression.
2. Warn the client not to operate a motorized vehicle until the effects of the medication are known.
3. Hold the Flexeril and notify the health care provider.
4. Give the Flexeril as prescribed.

Question 2

A client who is taking baclofen (Lioresal) for muscle spasms due to a spinal cord injury that occurred 5 years ago is hospitalized with pyelonephritis 2.

The client is receiving ciprofloxacin IV for the infection and phenazopyridine (Pyridium) for the bladder discomfort. None of the medications the client takes at home have been continued during the hospitalization. The nurse should monitor this client for which condition?
1. Contractures of the hands and feet
2. Irritable tendon reflexes and scissoring movement of the lower extremities
3. Diminished kidney function
4. Fever and seizures, or hallucinations

strudel15 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 3
Rationale 1: Added CNS depression is not the important concern here.
Rationale 2: Although the client should not operate a motorized vehicle until effects of the drug are known, this is not the most important issue.
Rationale 3: A potentially fatal hypertensive crisis could occur if cyclobenzaprine is used within 14 days of an MAOI.
Rationale 4: The health care provider needs to be notified that the client has not been off the MAOI for the required minimum of 14 days before the Flexeril was prescribed.
Global Rationale: A potentially fatal hypertensive crisis could occur if cyclobenzaprine is used within 14 days of an MAOI. Added CNS depression is not the important concern here. Although the client should not operate a motorized vehicle until effects of the drug are known, this is not the most important issue. The health care provider needs to be notified that the client has not been off the MAOI for the required minimum of 14 days before the Flexeril was prescribed.

Answer to Question 2

Correct Answer: 4
Rationale 1: There is no indication that contractures of the hands and feet might occur.
Rationale 2: There is no indication that irritable tendon reflexes or scissoring of the lower extremities might occur.
Rationale 3: While it is important to monitor for urine output, there is nothing in the scenario to indicate that there is diminished kidney function.
Rationale 4: Abrupt discontinuation following prolonged therapy with baclofen can cause high fever, seizures, severe rebound muscle spasticity, and hallucinations.
Global Rationale: Abrupt discontinuation following prolonged therapy with baclofen can cause high fever, seizures, severe rebound muscle spasticity, and hallucinations. There is no indication that contractures of the hands and feet might occur or that irritable tendon reflexes or scissoring of the lower extremities might occur. While it is important to monitor for urine output, there is nothing in the scenario to indicate that there is diminished kidney function.