A client who has cerebral palsy is beginning to experience ...

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A client who has cerebral palsy is beginning to experience spasticity of the muscles in the upper arm. Which medications would the nurse question if prescribed for this client?
 
  Standard Text: Select all that apply.
  1. Metaxalone (Skelaxin) dosed three times a day
  2. Chlorzoxazone (Parafon Forte) dosed four times a day
  3. Carisoprodol (Soma) dosed three times a day
  4. Intrathecal baclofen (Lioresal)
  5. Tizanidine (Zanaflex) dosed twice a day

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?
 
  1. Dantrolene sodium (Dantrium)
  2. Baclofen (Lioresal)
  3. Tizanidine (Zanaflex)
  4. Orphenadrine (Myophen)

[SomethingSomething]

Answer to Question 1

Correct Answer: 1,2,5
Rationale 1: Metaxalone (Skelaxin) is ineffective in the treatment of spasticity-related neurologic disorders.
Rationale 2: Chlorzoxazone (Parafon Forte) is ineffective in the treatment of spasticity related to neurodegenerative disorders.
Rationale 3: Carisoprodol (Soma) is effective in relieving the pain, muscle spasms, and spasticity associated with cerebral palsy and is dosed three times a day.
Rationale 4: Baclofen (Lioresal) is effective in reducing muscle spasticity and can be delivered intrathecally.
Rationale 5: Tizanidine (Zanaflex) is used for muscle spasticity but has a short half-life and must be dosed every 68 hours.
Global Rationale: Metaxalone (Skelaxin) is ineffective in the treatment of spasticity-related neurologic disorders. Chlorzoxazone (Parafon Forte) is ineffective in the treatment of spasticity related to neurodegenerative disorders. Carisoprodol (Soma) is effective in relieving the pain, muscle spasms, and spasticity associated with cerebral palsy and is dosed three times a day. Baclofen (Lioresal) is effective in reducing muscle spasticity and can be delivered intrathecally. Tizanidine (Zanaflex) is used for muscle spasticity but has a short half-life and must be dosed every 68 hours.

Answer to Question 2

Correct Answer: 1
Rationale 1: Dantrolene is a direct-acting skeletal muscle relaxant that interferes with the release of calcium ions that produce hypermetabolism and intense muscle rigidity in malignant hyperthermia.
Rationale 2: Baclofen is a centrally acting muscle relaxant.
Rationale 3: Tizanidine is a centrally acting muscle relaxant.
Rationale 4: Orphenadrine is a centrally acting muscle relaxant.
Global Rationale: Dantrolene is a direct-acting skeletal muscle relaxant that interferes with the release of calcium ions that produce hypermetabolism and intense muscle rigidity in malignant hyperthermia. Baclofen is a centrally acting muscle relaxant. Tizanidine is a centrally acting muscle relaxant. Orphenadrine is a centrally acting muscle relaxant.

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