Nokea
Before administering dantrolene to a client, the nurse checks the client's medical history for possible contraindications for use. Which condition would the nurse identify as problematic? Select all that apply.
- A. Hypertension
- B. Atrial fibrillation
- C. Hepatic disease
- D. Diabetes
- E. Lactation
Correct Answer: C,E
Rationale: The use of dantrolene is contraindicated during lactation and in clients with active hepatic disease and muscle spasm caused by rheumatic disorders.
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A client is receiving medication for gout. The nurse would include instructions about which of the following during the course of treatment?
- A. Taking drug on an empty stomach
- B. Using protection against sunlight
- C. Reporting any skin rash
- D. Wearing a brace to get out of bed
Correct Answer: C
Rationale: The nurse should instruct the client to report any skin rash. A rash should be monitored carefully because it may precede a serious adverse reaction, such as Stevens-Johnson syndrome. The nurse need not instruct the client to take the drug on an empty stomach, use protection against sunlight, or wear a brace to get out of bed. Clients with osteoporosis are asked to wear a brace to get out of bed. Clients taking medications for gout are asked to take it with food. These clients are also instructed to avoid driving or performing other hazardous tasks.
A nurse would monitor a client closely for increased CNS depressant effects when a skeletal muscle relaxant is used concomitantly with which of the following? Select all that apply.
- A. Antihistamine
- B. Oral contraceptives
- C. Alcohol
- D. Opiates
- E. Antidiabetic medications
Correct Answer: A,C,D
Rationale: The concomitant use of skeletal muscle relaxants and antihistamines, alcohol, opiates, or sedatives can result in increased CNS depressant effects.
After teaching a group of nursing students about the various drugs used to treat musculoskeletal conditions, the instructor determines that the teaching was successful when the students identify which of the following as being used to treat osteoporosis?
- A. DMARDs
- B. Bone resorption inhibitors
- C. Skeletal muscle relaxants
- D. Uric acid inhibitors
Correct Answer: B
Rationale: Bone resorption inhibitors are used to treat osteoporosis. Disease-modifying antirheumatic drugs (DMARDs) are used to treat rheumatoid arthritis. Uric acid inhibitors are used to treat gout. Skeletal muscle relaxants are used to alleviate muscle spasms and cramping.
The nurse should screen clients carefully for medical conditions involving which of the following prior to the administration of colchicine? Select all that apply.
- A. Gastrointestinal disorders
- B. Pulmonary disorders
- C. Cardiac disorders
- D. Blood disorders
- E. Central nervous system disorders
Correct Answer: A,C,D
Rationale: Colchicine is contraindicated in clients with serious GI, renal, hepatic, or cardiac disorders and those with blood dyscrasias.
A client with gout has not responded to the usual medications. The primary health care provider prescribes a pegloticase infusion. Based on the nurse's understanding of this drug, which nursing diagnosis would be most appropriate?
- A. Risk for Injury
- B. Acute Pain
- C. Impaired Comfort: Gastric Distress
- D. Risk for Allergic Response
Correct Answer: D
Rationale: When first-line treatments for gout are not successful, sometimes drugs that are more toxic may be prescribed, such as the pegloticase infusion. During the infusion the patient is closely monitored for the development of adverse reactions, in particular anaphylaxis. Should an anaphylactic reaction occur, the infusion center staff members are prepared to start resuscitative measures as emergency personnel are notified.