RN Muscle Relaxants and Antispasmodics Assessment American Career
College-Ontario VOCN 100 Questions with 100% Verified Answers Latest
Update
Question: Answer:
Laboratory Results A nurse is caring for a client who is undergoing knee surgery.
0900:Potassium 3.8 mEq/L (3.5 to 5.0 mEq/L)Sodium 138 mEq/L (135 History and Physical
to 145 37-year-old client Elective knee surgery under general
mEq/L)Chloride 98 mEq/L (98 to 106 mEq/L)Magnesium 1.5 mEq/L anesthesia. Anesthesia medications: Isoflurane and
(1.3 to 2.1 succinylcholine.
mEq/L)Creatine kinase 68 U/L (55 to 170 U/L)ABGs:pH 7.40 (7.35 to Vital Signs
7.45)PaCO2 35 mm 0900:Temp 37° C (98.6° F)Heart rate 80/minResp rate 12 BP
Hg (35 to 45 mm Hg)PaO2 100 mm Hg (80 to 100 mm 120/80 O2 sat 98% on 40% FiO2
Hg)0920:Potassium 5.5 mEq/L (3.5 0920:Tempe 38.5°C (101.3°F) Heart rate 110 Resp rate 20 BP
to 5.0 mEq/L)Sodium 139 mEq/L (135 to 145 mEq/L)Chloride 99 140/90 O2 sat 96% on 40% FiO2
mEq/L (98 to 106 0930: Temp 40°C(104°F) Heart rate 130 Resp rate 30 BP
mEq/L)Magnesium 1.6 mEq/L (1.3 to 2.1 mEq/L)Creatine kinase 175 160/100 O2 sat 94% on 100% FiO2
U/L (55 to 170 Assessment
U/L)ABGs:pH 7.30 (7.35 to 7.45)PaCO2 50 mm Hg (35 to 45 mm 0920:Masseter muscle spasm noted; increased muscle rigidity.
Hg)PaO2 90 mm Hg (80 0930:Severe muscle rigidity; tachypnea, tachycardia.
to 100 mm Hg) Decreased urine output (brown, red).
The nurse is reviewing the client's medical record and planning care
for the client as a
member of the interdisciplinary team. Which of the following
recommendations should
the nurse make for the client?
When generating solutions, the nurse should identify that dantrolene
should be
administered intravenously, and the client should receive ongoing
monitoring for
respiratory depression and evaluation of neuromuscular status.
Dantrolene is
administered intravenously for management of malignant
hyperthermia. As dantrolene
decreases muscle tone and increases muscle weakness, the client
should be monitored
for respiratory depression. The nurse should monitor the client's
neuromuscular status to
determine if the medication was effective.
, Question: Answer:
A nurse is caring for a client who has chronic back pain. Laboratory Results
History and Physical Day 1 1030:White blood cell 5,700/mm3 (5,000 to 10,000/mm3)Red
45-year-old client blood cell 4.7 x 1012/L
Medical history: Chronic back pain and mild depression. (4.2 to 5.4 x 1012/L)Hemoglobin 13 g/dL (12 to 16 g/dL)Hematocrit
Current medications: Carisoprodol for muscle relaxation for 41% (37 to 47%)
the last 2 weeks. St. John's wort for the last week. Platelets 310 x 109/L) (150 to 400 x 109/L)Alanine aminotransferase
Allergies: sulfonamides 24 U/L (4 to 36
Vital Signs U/L)Aspartate aminotransferase 23 U/L (0 to 35 U/L)Bilirubin 0.5
Day 1 1000:Temperature 37° C (98.6° F)Heart rate mg/dL (0.3 to 1.9
80/minRespiratory rate/minBP 120/80 mm HgDay 4 mg/dL)Day 4 0930:White blood cells 5,600/mm3 (5,000 to
0900:Temperature 37.3° C (99.1° F)Heart rate 10,000/mm3)Red blood cell
90/minRespiratory rate 18/minBP 130/90 mm HgDay 8 4.8 x 1012/L (4.2 to 5.4 x 1012/L)Hemoglobin 14 g/dL (12 to 16
1100:Temperature 38° C (100.4° F)Heart rate 100/minRespiratory g/dL)Hematocrit 40% (37 to
rate 20/minBP 140/100 mm Hg 47%) Platelets 320 x 109/L) (150 to 400 x 109/L))Alanine
AssessmentDay 1 1000:Mild improvement in mood and sleep aminotransferase 38 U/L (4 to 36
quality.Day 4 0900:Reports increased dizziness and U/L)Aspartate aminotransferase 36 U/L (0 to 35 U/L)Bilirubin 0.6
drowsiness. Skin rash noticed on arms and torso.Day 8 mg/dL (0.3 to 1.9
1100:Reports severe dizziness, confusion, and restlessness. mg/dL)Day 8 1130:White blood cells 5,300/mm3 (5,000 to
Worsened skin rash; signs of sunburn with minimal sun 10,000/mm3)Red blood cell 4.6
exposure. Reports vivid dreams, anxiety, and irritability. x 1012/L (4.2 to 5.4 x 1012/L)Hemoglobin 15 g/dL (12 to 16
g/dL)Hematocrit 42% (37 to
47%)Platelets 315 x 109/L) (150 to 400 x 109/L)Alanine
aminotransferase 52 U/L (4 to 36
U/L)Aspartate aminotransferase 45 U/L (0 to 35 U/L)Bilirubin 0.4
mg/dL (0.3 to 1.9 mg/dL)
The client is experiencing a (medication interaction)
as a result of (an allergic reaction).
When evaluating outcomes, the nurse should determine that this
client is experiencing a
medication interaction due to using carisoprodol in conjunction with
St. John's wort and
having a sulfonamide allergy. Using carisoprodol and St. John's wort
together is
contraindicated and can cause an increase in the sedative and
muscle relaxant effects.
Using carisoprodol and St. John's wort while having a sulfonamide
allergy can exacerbate
sensitivity.
College-Ontario VOCN 100 Questions with 100% Verified Answers Latest
Update
Question: Answer:
Laboratory Results A nurse is caring for a client who is undergoing knee surgery.
0900:Potassium 3.8 mEq/L (3.5 to 5.0 mEq/L)Sodium 138 mEq/L (135 History and Physical
to 145 37-year-old client Elective knee surgery under general
mEq/L)Chloride 98 mEq/L (98 to 106 mEq/L)Magnesium 1.5 mEq/L anesthesia. Anesthesia medications: Isoflurane and
(1.3 to 2.1 succinylcholine.
mEq/L)Creatine kinase 68 U/L (55 to 170 U/L)ABGs:pH 7.40 (7.35 to Vital Signs
7.45)PaCO2 35 mm 0900:Temp 37° C (98.6° F)Heart rate 80/minResp rate 12 BP
Hg (35 to 45 mm Hg)PaO2 100 mm Hg (80 to 100 mm 120/80 O2 sat 98% on 40% FiO2
Hg)0920:Potassium 5.5 mEq/L (3.5 0920:Tempe 38.5°C (101.3°F) Heart rate 110 Resp rate 20 BP
to 5.0 mEq/L)Sodium 139 mEq/L (135 to 145 mEq/L)Chloride 99 140/90 O2 sat 96% on 40% FiO2
mEq/L (98 to 106 0930: Temp 40°C(104°F) Heart rate 130 Resp rate 30 BP
mEq/L)Magnesium 1.6 mEq/L (1.3 to 2.1 mEq/L)Creatine kinase 175 160/100 O2 sat 94% on 100% FiO2
U/L (55 to 170 Assessment
U/L)ABGs:pH 7.30 (7.35 to 7.45)PaCO2 50 mm Hg (35 to 45 mm 0920:Masseter muscle spasm noted; increased muscle rigidity.
Hg)PaO2 90 mm Hg (80 0930:Severe muscle rigidity; tachypnea, tachycardia.
to 100 mm Hg) Decreased urine output (brown, red).
The nurse is reviewing the client's medical record and planning care
for the client as a
member of the interdisciplinary team. Which of the following
recommendations should
the nurse make for the client?
When generating solutions, the nurse should identify that dantrolene
should be
administered intravenously, and the client should receive ongoing
monitoring for
respiratory depression and evaluation of neuromuscular status.
Dantrolene is
administered intravenously for management of malignant
hyperthermia. As dantrolene
decreases muscle tone and increases muscle weakness, the client
should be monitored
for respiratory depression. The nurse should monitor the client's
neuromuscular status to
determine if the medication was effective.
, Question: Answer:
A nurse is caring for a client who has chronic back pain. Laboratory Results
History and Physical Day 1 1030:White blood cell 5,700/mm3 (5,000 to 10,000/mm3)Red
45-year-old client blood cell 4.7 x 1012/L
Medical history: Chronic back pain and mild depression. (4.2 to 5.4 x 1012/L)Hemoglobin 13 g/dL (12 to 16 g/dL)Hematocrit
Current medications: Carisoprodol for muscle relaxation for 41% (37 to 47%)
the last 2 weeks. St. John's wort for the last week. Platelets 310 x 109/L) (150 to 400 x 109/L)Alanine aminotransferase
Allergies: sulfonamides 24 U/L (4 to 36
Vital Signs U/L)Aspartate aminotransferase 23 U/L (0 to 35 U/L)Bilirubin 0.5
Day 1 1000:Temperature 37° C (98.6° F)Heart rate mg/dL (0.3 to 1.9
80/minRespiratory rate/minBP 120/80 mm HgDay 4 mg/dL)Day 4 0930:White blood cells 5,600/mm3 (5,000 to
0900:Temperature 37.3° C (99.1° F)Heart rate 10,000/mm3)Red blood cell
90/minRespiratory rate 18/minBP 130/90 mm HgDay 8 4.8 x 1012/L (4.2 to 5.4 x 1012/L)Hemoglobin 14 g/dL (12 to 16
1100:Temperature 38° C (100.4° F)Heart rate 100/minRespiratory g/dL)Hematocrit 40% (37 to
rate 20/minBP 140/100 mm Hg 47%) Platelets 320 x 109/L) (150 to 400 x 109/L))Alanine
AssessmentDay 1 1000:Mild improvement in mood and sleep aminotransferase 38 U/L (4 to 36
quality.Day 4 0900:Reports increased dizziness and U/L)Aspartate aminotransferase 36 U/L (0 to 35 U/L)Bilirubin 0.6
drowsiness. Skin rash noticed on arms and torso.Day 8 mg/dL (0.3 to 1.9
1100:Reports severe dizziness, confusion, and restlessness. mg/dL)Day 8 1130:White blood cells 5,300/mm3 (5,000 to
Worsened skin rash; signs of sunburn with minimal sun 10,000/mm3)Red blood cell 4.6
exposure. Reports vivid dreams, anxiety, and irritability. x 1012/L (4.2 to 5.4 x 1012/L)Hemoglobin 15 g/dL (12 to 16
g/dL)Hematocrit 42% (37 to
47%)Platelets 315 x 109/L) (150 to 400 x 109/L)Alanine
aminotransferase 52 U/L (4 to 36
U/L)Aspartate aminotransferase 45 U/L (0 to 35 U/L)Bilirubin 0.4
mg/dL (0.3 to 1.9 mg/dL)
The client is experiencing a (medication interaction)
as a result of (an allergic reaction).
When evaluating outcomes, the nurse should determine that this
client is experiencing a
medication interaction due to using carisoprodol in conjunction with
St. John's wort and
having a sulfonamide allergy. Using carisoprodol and St. John's wort
together is
contraindicated and can cause an increase in the sedative and
muscle relaxant effects.
Using carisoprodol and St. John's wort while having a sulfonamide
allergy can exacerbate
sensitivity.
