The nurse is administering the muscle relaxant baclofen by mouth (PO) to a client diagnosed with multiple sclerosis. Which intervention should the nurse implement?

Advise the client to move slowly and cautiously when rising and walking.

Monitor intake and output every 8 hours.

Ensure the client knows to stop baclofen before using other antispasmodics.

Evaluate muscle strength every 4 hours.

Answer and Explanation

The Correct Answer is A

Choice A rationale: Baclofen is a muscle relaxant used to reduce muscle spasticity in conditions such as multiple sclerosis. One of the common side effects of baclofen is dizziness or orthostatic hypotension, which can increase the risk of falls. Therefore, the nurse should advise the client to move slowly and cautiously when rising and walking to prevent falls and injury.

Choice B rationale: Monitoring intake and output every 8 hours is not directly related to the administration of baclofen.

Choice C rationale: Ensuring the client knows to stop baclofen before using other antispasmodics is not the correct intervention. Baclofen should not be abruptly discontinued without medical advice, and its use should be discussed with the healthcare provider.

Choice D rationale: Evaluating muscle strength every 4 hours may be part of the client's overall care plan, but it is not directly related to the administration of baclofen. Muscle strength evaluation is more pertinent for assessing the progression of multiple sclerosis and its effects on muscle function.

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Correct Answer is D

No explanation

A. Two hours after completion of the IV dose and two hours before the next administration of the medication. B. One hour after completion of the IV dose and one hour before the next administration of the medication. C. Thirty minutes into the administration of the IV dose and 30 minutes before the next administration of the medication. D. Immediately after completion of the IV dose and 30 minutes before the next administration of the medication. E. None F. None

Correct Answer is D

Explanation

A. Two hours after completion is too late to accurately capture the peak serum concentration, and drawing a trough two hours before the next dose will result in an artificially elevated trough level, as the drug has not yet cleared to its lowest concentration.

B. One hour after completion may miss the true peak concentration for intravenous vancomycin, and drawing a trough one hour before the next dose does not represent the absolute lowest point of the medication's therapeutic window.

C. Thirty minutes into the infusion is too early to measure a peak because the entire dose has not yet been delivered into the bloodstream, which can lead to inaccurate clinical decision-making.

D. To capture the maximum concentration of the drug in the bloodstream, the peak level should be drawn immediately after completion of the intravenous infusion (or within 30 to 60 minutes depending on facility protocol and infusion duration). To capture the lowest concentration, the trough level must be drawn immediately prior to the next scheduled dose, typically 30 minutes before administration.

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