A client is receiving baclofen for the management of symptoms associated with multiple sclerosis. To evaluate the effectiveness of this medication, what does the nurse assess?

Muscle spasms

Mood and affect

Appetite

Sleep pattern

Answer and Explanation

The Correct Answer is A

Choice A reason:

Baclofen is primarily used to treat muscle symptoms caused by multiple sclerosis, including muscle spasms, stiffness, and pain1. It acts on the spinal cord nerves to decrease the number and severity of muscle spasms, thereby improving muscle movement2. The effectiveness of baclofen in managing multiple sclerosis symptoms is best evaluated by assessing the reduction in muscle spasms.

Choice B reason:

While mood and affect are important aspects of a patient’s overall well-being, they are not the primary indicators of baclofen’s effectiveness. Baclofen does not have a direct impact on mood and affect, as its main function is to relieve muscle spasms and improve muscle movement.

Choice C reason:

Appetite is not a primary concern when evaluating the effectiveness of baclofen. This medication is not known to significantly affect appetite. The main therapeutic goal of baclofen is to reduce muscle spasms and improve mobility in patients with multiple sclerosis.

Choice D reason:

Sleep pattern, although important for overall health, is not the primary measure of baclofen’s effectiveness. Baclofen’s primary role is to alleviate muscle spasms and improve muscle function. While it may have some impact on sleep due to its muscle-relaxing properties, this is not the main criterion for evaluating its effectiveness.

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Correct Answer is B

Explanation

Choice A reason: An increase in temperature is not a primary indicator of hypovolemic shock. While fever can occur due to infection or inflammation, it is not directly related to hypovolemic shock, which is primarily characterized by a significant loss of blood or fluids leading to decreased perfusion and oxygenation of tissues.

Choice B reason: A decrease in urinary output is a critical sign of hypovolemic shock. When the body loses a significant amount of blood or fluids, the kidneys receive less blood flow, leading to reduced urine production. This is a compensatory mechanism to conserve fluids and maintain blood pressure. Normal urine output is typically around 30 to 50 mL per hour, so a drop below this range is concerning.

Choice C reason: An increase in heart rate is a common response to hypovolemic shock as the body attempts to maintain cardiac output and blood pressure despite the loss of blood volume. Tachycardia (increased heart rate) is one of the early signs of shock, indicating that the heart is working harder to pump blood to vital organs.

Choice D reason: A decrease in respiratory rate is not typical of hypovolemic shock. In fact, hypovolemic shock often leads to an increased respiratory rate (tachypnea) as the body tries to compensate for decreased oxygen delivery to tissues. A decrease in respiratory rate could indicate other issues but is not a hallmark of hypovolemic shock.

A. Administer levetiracetam intravenously. B. Obtain a STAT electroencephalogram. C. Administer lorazepam intravenously. D. Obtain a STAT 12-lead electrocardiogram.

Correct Answer is C

Explanation

Choice A Reason:

Administering levetiracetam intravenously is not the first intervention. While levetiracetam is an antiepileptic drug used to control seizures, it is not the first-line treatment for an ongoing seizure, especially one lasting as long as 15 minutes. The priority in this situation is to stop the seizure activity immediately to prevent further complications, such as neuronal damage or status epilepticus. Levetiracetam may be used later for maintenance therapy, but it is not the initial emergency intervention.

Choice B Reason:

Obtaining a STAT electroencephalogram (EEG) is important for diagnosing and understanding the type of seizure activity, but it is not the first intervention. The immediate priority is to stop the seizure. An EEG can be performed after the seizure has been controlled to assess brain activity and guide further treatment. Delaying the administration of an anticonvulsant to perform an EEG could result in prolonged seizure activity and increased risk of complications.

Choice C Reason:

Administering lorazepam intravenously is the most appropriate first intervention. Lorazepam is a benzodiazepine that acts quickly to stop seizure activity. It is the drug of choice for treating status epilepticus and prolonged seizures because of its rapid onset and effectiveness. Administering lorazepam helps to quickly terminate the seizure, reducing the risk of complications and stabilizing the patient for further evaluation and treatment.

Choice D Reason:

Obtaining a STAT 12-lead electrocardiogram (ECG) is not the first intervention. While an ECG can provide valuable information about the patient’s cardiac status, it does not address the immediate need to stop the seizure. The priority is to administer an anticonvulsant to terminate the seizure. Once the seizure is controlled, an ECG can be performed to assess any potential cardiac issues, especially if the patient has a history of cardiac problems or if the seizure was triggered by a cardiac event.

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A client is receiving baclofen for the management of symptoms associated with multiple sclerosis. To evaluate the effectiveness of this medication, what does the nurse assess?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who returns to the nursing unit from the recovery room after a sigmoid colon resection for adenocarcinoma. The client had an episode of intraoperative bleeding. Which finding indicates to the nurse that the client may be developing hypovolemic shock?

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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