Nokea
A nurse administering carbidopa/levodopa (Sinemet) to a client should monitor the client for decreased effects of carbidopa/levodopa when which of the following medications are initiated? Select all that apply.
- A. Phenytoin (Dilantin)
- B. Amitriptyline (Elavil)
- C. Zonisamide (Zonegran)
- D. Ibuprofen (Motrin)
- E. Meperidine (Demerol)
Correct Answer: A,C
Rationale: A nurse administering carbidopa/levodopa (Sinemet) to a client should monitor the client for decreased effects of carbidopa/levodopa (Sinemet) when anticonvulsants, like phenytoin and zonisamide, are initiated.
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After administering an antiparkinson drug to a client, the nurse assesses the effectiveness of the drug. The nurse notes that the clients slow movements have improved. The nurse documents this as an improvement in which of the following?
- A. Akathisia
- B. Bradykinesia
- C. Achalasia
- D. Choreiform movements
Correct Answer: B
Rationale: Bradykinesia refers to the slow movements associated with Parkinson's disease. Akathisia refers to extreme restlessness and increased motor activity. Achalasia refers to the failure to relax, usually referring to the smooth muscle fibers of the GI tract. Choreiform movements refer to the involuntary muscular twitching of the limbs or facial muscles.
After administering tolcapone (Tasmar) to a client, the nurse would be alert for which of the following as a possible adverse reaction? Select all that apply.
- A. Orthostatic hypotension
- B. Renal failure
- C. Dyskinesia
- D. Dry mouth
- E. Anorexia
Correct Answer: A,C,E
Rationale: Adverse reactions associated with tolcapone (Tasmar) include orthostatic hypotension, dyskinesia, sleep disorders, dystonia, excessive dreaming, somnolence, dizziness, nausea, anorexia, muscle cramps, and liver failure.
A client is admitted to the health care facility with a diagnosis of Parkinson's disease. When assessing the client, which of the following would the nurse expect to find? Select all that apply.
- A. Slurred speech
- B. Erect posture
- C. Step-like gait
- D. Tremors
- E. Rapid, jerky movements
Correct Answer: A,D
Rationale: The cardinal signs of Parkinson's disease include tremors, rigidity, and slow movement (bradykinesia). Other symptoms of Parkinson's disease include slurred speech, a mask-like and emotionless appearance of the face, and difficulty chewing and swallowing. The patient assumes a rigid, bent-forward posture and the gait becomes unsteady and shuffled.
A group of students are reviewing antiparkinson drugs. They demonstrate understanding when they identify which of the following as classified as dopaminergic drugs? Select all that apply.
- A. Amantadine (Symmetrel)
- B. Bromocriptine (Parlodel)
- C. Biperiden (Akineton)
- D. Carbidopa (Lodosyn)
- E. Benztropine (Cogentin)
Correct Answer: A,B,D
Rationale: Amantadine (Symmetrel), bromocriptine (Parlodel), and carbidopa (Lodosyn) are classified as dopaminergic drugs. Biperiden and benztropine are cholinergic blocking drugs used to treat Parkinson's disease.
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.