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Nurse 123
Chapter 45
| Question | Answer |
|---|---|
| What are some causes of muscle spasms? | causes include overmedication with anitpsychotic drugs, epilepsy, hypocalcemia, pain and neurologic disorders |
| What are the characteristics of muscle spasms | When the muscle spasms it freezes in a contracted state,A single prolonged contraction is a tonic spasm,Multiple rapid repeated contractions are clonic spasms. |
| What are the pharmacologic treatments for muscle spasms? | Pharmacologic includes combination of analgesics, anti-inflammatory agents, and centrally acting muscle relaxants |
| What are the non-pharmacologic treatments for muscle spasms? | Non-pharmacologic treatments include heat or cold, hydrotherapy, ultrasound, massage, supervised exercises and/or manipulation. |
| What are the characteristics of Antispasmodic drugs (muscle relaxants)? | Relieve symptoms of muscular stiffness and rigidity,May be prescribed in combination with other meds to decrease pain and increase ROM.They don’t have any direct effect on muscles, nerve conduction or neuromuscular junctions. |
| What are other uses of Antispasmodic drugs (muscle relaxants)? | All of these muscle relaxants produce some degree of sedation.These are used in combo with physical therapy, rest and analgesics to relieve. muscle spasm associated with acute painful musculoskeletal. |
| What are the types of muscle relaxant medications? | Flexeril is recommended for short-term treatment- it is very sedating,Skelaxin use with caution in pts with liver disease,Baclofen is different and the coplete mechanism of activity is unknown. Not to be used in pts with muscle spasisity . |
| What are the side effects of muscle relaxants? | Drowsiness,Ataxia (lack of coordination),Dry mouth,Dizziness,Sleepiness,GI disturbances. |
| What are some nursing interventions for administerig muscle relaxants? | Can also cause HA and fatigue.Need to monitor pt for use of other CNS depressants (sleep aids, ETOH, analgesics and tranquilizers, barbiturates.Need to be sure the pt doesn’t drive or operate machinery until they know the effects of this. |
| What is spascity? | A condition where certain muscle groups remain in a continuous state of contraction,Usually caused by damage to the CNS, Cerebral palsy, severe head injury, spinal cord injury or lesions, and stroke. |
| What is Dystonia | chronic neurologic disorder,Characterized by involuntary muscle contractions that forces body parts into abnormal movements or postures. Meds and PT are used to treat disorder. |
| Which part of the body does Dystonia affects? | It affects the muscle tone of the arms, legs, trunk, neck, eyelids, face or vocal cords |
| What are some drugs used to treat dystonia? | Dantrolene (Dantrium),Botulinum toxin type A (Botox) |
| What is Dantrolene (Dantrium)? | Direct acting drug,Works by interfering with the release of calcium ions in skeletal muscle. |
| What are the sode effects of Dantrolene (Dantrium)? | Side effects include muscle weakness, drowsiness, dry mouth, dizziness, nausea, tachycardia, diarrhea, erratic blood pressure, photosensitivity, and urinary retention. |
| What is Dantrolene (Dantrium)used for? | Used to control spasticity of chronic disorders such as cerebral palsy, MS, spinal cord injury, and stroke syndrome. |
| What is Botulinum toxin type A (Botox)used for? | Also direct acting,Unusual drug because at high doses it acts as a poison,At lower doses it is a safe and effective muscle relaxant for pts with dystonia,It produces it effect by blocking the release of acetylcholine from nerve terminals |
| What are the side effects of Botulinum toxin type A (Botox)? | Can cause extreme weakness so its use may require additional therapies to improve muscle strength.It is often applied to small muscle groups to prevent major problems with mobility and posture. |
| What are some other characteristics of Botulinum toxin type A (Botox)? | Drawbacks to therapy are delayed and limited effects.May take 6 weeks for effectiveness to start and only lasts 3-6 months.Also it is an injection directly into the muscle.Uses local anesthetics to block the pain of injections. |
| What controls the calcium level? | PTH and calcitonin influence 3 major targets,1. the bones,2. the kidneys,3. the GI tract. |
| What is vitmain D in the skin synthesized from? | Vitamin D- in the skin it is synthesized from cholesterol, diet (fortified milk), dietary supplements and sunlight. |
| What is the primary function of calcitriol? | Causes more calcium to be absorbed from the GI tract. |
| What is the normal calcium range? | 9-11 mg/dl |
| What are the characteristics of Calcium levels? | Calcium ions influence the excitability of all neurons. Hypercalcemia interferes with nerve conduction. Hypocalcemia makes cells hyperexcitable. High calcium levels may cause seizures. Calcium is required for blood coagulation and muscle contraction. |
| What are the causes of hypocalcemia? | Causes include hypoparathyroid disease (removal of parathyroid glands or renal failure), digestive related malabsorption disorders and vitamin D deficiencies. |
| What are the characteristics of hypocalcemia? | Is not a disease but a sign of underlying pathology.Need to diagnose the cause of hypocalcemia.Can have many different causes.Need to look at dietary intake of calcium. |
| What are the signs and symptoms of hypocalcemia? | Muscle twitching,Tremor,Cramping,Numbness and tingling of extremities,Seizures with severe hypocalcemia,Confusion,Altered mental status. |
| What are the treatments of hypocalcemia? | Calcium can be given IV or oral,Increase amount in diet,Identify the cause and treat it |
| What are some side effects of hypocalcemia? | Hypercalcemia,Drowsiness,Lethargy,Weakness,HA,Anorexia,Nausea and vomiting,Increased urination,Thirst. |
| What are some side effects of recieving calcium by IV? | Hypotension,Bradycardia,Dysrhythmias,Cardiac arrest. |
| What are some common calcium supplements? | Calcium Carbonate (Bio-Cal),Calcium citrate (Citracal),Calcium gluconate (Kalcinate). |
| What are some common vitamin D supplements? (This is not the same as regular vitamin D- regular vitamin D needs to be activated in the kidney- these are active vitamin D) | Calcitriol (Rocaltrol),Paricalcitol (Zemplar) |
| What are some side effects of vitamin D? | Hypercalcemia,HA,Weakness,Dry mouth,Thirst,Increased urination,Muscle or bone pain. |
| What is osteoporosis? | The most common metabolic bone disease,Usually asymptomatic until bones become brittle and fracture |
| What are some risk factors of osteporosis? | Post-menopause,High alcohol or caffeine consumption,Anorexia,Tobacco use,Physical inactivity,Testosterone deficiency,Lack of vitamin D and/or calcium in the diet,Meds such as corticosteroids, immunosuppressant, and some anticonvulsants. |
| What is Hormonal Agents (first group) | It is an osteoporosis treatment. Includes Calcitonin and Selective Estrogen-Receptor Modulators (SERMs) |
| What are the characteristics of Hormonal Agents (first group)? | Approved for treatment in women 5 years postmenopausal,Nasal spray or SQ injection,Increases bone density,Reduces risk of vertebral fractures. |
| What are the side effects of Hormonal Agents (first group)? | Side effects- allergies are possible, nasal irritation (nose spray) and nausea and vomiting. |
| What are Selective Estrogen-Receptor Modulators (Hormonal Agent)? | It is an osteoporosis treatment. Meds is Raloxifene (Evista. |
| What does Raloxifene (Evista) do? | Blocks estrogen receptors in the uterus and breast andAlso increases bone density |
| What are the side effects of Raloxifene (Evista) | Side effects: hot flashes, migraine HA, flu-like symptoms, breast pain, vaginal bleeding |
| What are the characteristics of Bisphosphonate (second group)? (Osteoporosis treatment) | Inhibit bone reabsorption by suppressing osteoclast activity and This increases bone density |
| What are the side effects of Bisphosphonate (second group)? | Side effects include nausea, vomiting, abdominal pain, and esophageal irritation.These drugs are poorly absorbed so they need to be taken on an empty stomach |
| What are some common Bisphosphonate (second group)drugs? | Etidronate disodium (Didronel),Alendronate sodium (Fosamax),Risedronate sodium (Actonel). |
Created by:
smensah
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