Nokea
A client is receiving carbidopa/levodopa (Sinemet). When assessing this client for possible adverse reactions, which of the following might the nurse note? Select all that apply.
- A. Choreiform movements
- B. Hyperglycemia
- C. Hypotension
- D. Dry mouth
- E. Anorexia
Correct Answer: A,D,E
Rationale: The most common adverse reactions associated with carbidopa/levodopa include anorexia, nausea, vomiting, abdominal pain, dysphagia, dry mouth, mental changes, headache, dizziness, increased hand tremor, and choreiform and dystonic movements.
You may also like to solve these questions
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.
A nurse is assigned to care for a client who is to receive a cholinergic blocking drug. The nurse obtains the history from the client. Which of the following would alert the nurse to the need for cautious administration?
- A. The client has a decreased liver function.
- B. The client has a history of hallucinations or psychosis.
- C. The client has a cardiovascular disease.
- D. The client has a pulmonary disease.
Correct Answer: A
Rationale: It is important for the nurse to know if the client has decreased liver or kidney function so that the cholinergic blocking drug can be administered cautiously in the client. Other conditions in clients that require cautious use include tachycardia, cardiac arrhythmias, hypertension, hypotension, tendency toward urinary retention, and obstructive disease of the urinary system or gastrointestinal tract. The cholinergic blocking drugs are given with caution to older adults. The nurse should use dopamine receptor agonist drugs with caution in clients with a history of hallucinations or psychosis or cardiovascular disease. The nurse should use dopaminergic drugs with caution in clients with pulmonary diseases.
A nurse is assigned to care for a 40-year-old client with a hepatic injury that has occurred due to the administration of tolcapone. Which of the following interventions should the nurse perform when caring for this client?
- A. Monitor the client for signs of tactile hallucinations.
- B. Monitor the client for signs of dystonic movements.
- C. Perform regular blood tests of the client.
- D. Perform serum transaminase level testing every day.
Correct Answer: C
Rationale: A serious and potentially fatal adverse reaction to tolcapone is hepatic injury. The nurse should, therefore, perform regular blood testing to monitor liver function of the client as prescribed. The testing of serum transaminase levels may be ordered at frequent intervals such as every 2 weeks for the first year and every 8 weeks thereafter. The nurse need not perform serum transaminase level testing every day. The nurse should monitor for signs of dystonic movements when caring for a client receiving carbidopa and levodopa, not tolcapone. The nurse should monitor for signs of tactile hallucinations when caring for an elderly client receiving tolcapone.
A nurse is caring for a client who requires antiparkinson drug therapy. The nurse confirms that which of the following conditions is absent because it would contraindicate the use of the COMT inhibitor?
- A. Pregnancy
- B. Achalasia
- C. Peptic ulcers
- D. Glaucoma
Correct Answer: A
Rationale: The nurse should confirm that the client is not pregnant or lactating and that the client does not have a hypersensitivity to the drug to ensure that the use of COMT inhibitors is not contraindicated. Achalasia, peptic ulcers, and glaucoma are not conditions that are contraindications to the use of COMT inhibitors. The use of cholinergic blocking drugs is contraindicated in clients with achalasia, peptic ulcers, and glaucoma.
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.