Nokea
A client is prescribed carbidopa/levodopa. The nurse understands that this drug should be administered cautiously to clients with which condition? Select all that apply.
- A. Hyperthyroidism
- B. Seizure disorder
- C. Renal disease
- D. Asthma
- E. Peptic ulcer disease
Correct Answer: C,D,E
Rationale: Carbidopa/levodopa (Sinemet) is used cautiously in clients with cardiovascular or pulmonary disease (asthma), peptic ulcer disease, renal or hepatic disease, and psychosis.
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When reviewing the medication records of several clients, the nurse notes documentation of nonergot dopamine receptor agonists. Which of the following would the nurse most likely note? Select all that apply.
- A. Pramipexole (Mirapex)
- B. Entacapone (Comtan)
- C. Amuitadine (Symmetrel)
- D. Ropinirole (Requip)
- E. Benztropine (Cogentin)
Correct Answer: A,D
Rationale: Pramipexole (Mirapex) and ropinirole (Requip) are nonergot dopamine receptor agonists.
A nurse is reviewing the medication record of several clients with Parkinson's disease. The nurse identifies which drug if included in the client's record as being classified as a catechol-O-methyltransferase (COMT) inhibitor drug? Select all that apply.
- A. Amantadine (Symmetrel)
- B. Bromocriptine (Parlodel)
- C. Biperiden(Akineton)
- D. Entacapone (Comtan)
- E. Toleapone (Tasmar)
Correct Answer: D,E
Rationale: Entacapone (Comtan) and tolcapone (Tasmar) are classified as COMT inhibitors. Amantadine and bromocriptine are dopaminergic drugs. Biperiden is a cholinergic blocking drug.
A client tells the nurse that he takes the drug Stalevo. The nurse understands that this drug is a combination of which of the following? Select all that apply.
- A. Benztropine
- B. Levodopa
- C. Carbidopa
- D. Tolcapone
- E. Entacapone
Correct Answer: B,C,E
Rationale: Stalevo is a brand-name combination product that contains carbidopa, levodopa, and entacapone.
A client is prescribed ropinirole (Requip). The nurse would anticipate an increase in dopamine agonist effects if which of the following medications are initiated? Select all that apply.
- A. Ranitidine (Zantac)
- B. Verapamil (Calan)
- C. Estradiol (Estrace)
- D. Perphenazine (Trilafon)
- E. Lisinopril (Prinivil)
Correct Answer: A,B,C
Rationale: A client taking ropinirole (Requip) will have increased dopamine agonist effects if ranitidine, verapamil, or estrogens such as estradiol are initiated.
A nurse is caring for a 70-year-old client who is receiving anticholinergic drug therapy for Parkinson's disease. The nurse would be alert for the development of which of the following in this client?
- A. Confusion and disorientation
- B. Choreiform movements
- C. Suicidal tendencies
- D. Psychotic episodes
Correct Answer: A
Rationale: The nurse should assess for confusion and disorientation when caring for this elderly client receiving anticholinergic drug therapy. Individuals older than 60 years frequently develop increased sensitivity to anticholinergic drugs and require careful monitoring. Lower doses may also be required in such cases. Choreiform movements, suicidal tendencies, and psychotic episodes are serious adverse reactions associated with the use of levodopa, which is a dopaminergic drug.