Question

1. A patient presents with a “pulled muscle” in his back. The healthcare provider has prescribed cyclobenzaprine (Flexeril), 10 mg three times daily for 1 week. Before the patient leaves the healthcare provider’s office, what health teaching should you provide for the medication and temporary lifestyle changes?

Situation: After an extensive major surgical procedure, the patient is transferred to the postanesthesia recovery unit with an endotracheal tube in place. During the surgical procedure, the anesthesia record notes the administration of tubocurarine chloride.

2. Which criteria should be used to determine when to remove the endotracheal tube?

3. What patient assessments/evaluations should be completed to check for residual effects of the neuromuscular blocking agent?

4. Examine the drug monographs to identify premedication assessments used with musculoskeletal agents.

5. Review drug monographs to identify the specific use of direct-acting and centrally acting skeletal muscle relaxants.

Answer 1

Cyclobenzaparine is a medication used for muscle spasm.It will helps to relax the muscle.Here in this case patient had pulled back or spasm over the back so health care provider prescribed cyclobenzaprine commonly known as flexeril 10 mg thrice daily for 1 week.

Health teaching regarding this medication use:

1. Observe for side effects like dry mouth ,dizziness, headache, fainting, nervousness , diplopia, urinary retension. These side effects will change the life styles for temparory, so teach the patient how to cope up with these type of side effects
2. In over dose it may damage the liver severly so check liver enzymes periodically.
3. Should monitor the length of drug use, because over usage can rebound the spasm.

After the extensive surgical procedure patient shifted to post anasthesia room with endotracheal tube in place.

So need to assess the patient before extubation

1. Recheck all the vitals like heart rate, blood pressure , saturation level, respiratory rate.
2. Check for patient conscious level, whether patient is oriented to time , place
3. Check the sedation level by usine RASS scale
4. Do ABG to check paco2 lelvel

If everything is fine then extubate the patient