Nokea
A nurse is caring for a 70-year-old client undergoing antiparkinsonism drug therapy. The client is prescribed pramipexole by the physician. The nurse should monitor the client's condition for the development of which of the following adverse reactions associated with the use of this drug?
- A. Blurred vision
- B. Memory loss
- C. Visual hallucinations
- D. Muscular rigidity
Correct Answer: C
Rationale: The nurse should monitor the elderly client who is administered a dopamine receptor antagonist for signs of visual, auditory, or tactile hallucinations. Hallucinations occur more often in older adults than in younger adults receiving the antiparkinsonism drugs, especially when taking the dopamine receptor agonists. The incidence of hallucinations appears to increase with age. The nurse need not monitor the clients condition for signs of blurred vision, memory loss, and muscular rigidity as these conditions are not known to occur in elderly clients due to the use of dopamine receptor agonists.
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A client with Parkinson's disease is undergoing treatment in a health care facility. Which of the following nursing interventions should the nurse perform as part of the client's ongoing assessment?
- A. Assess the client for ability to perform the daily activities.
- B. Observe the current mental condition of the client.
- C. Observe the client for various neuromuscular signs.
- D. Prepare a baseline for future evaluations of the client's drug therapy.
Correct Answer: C
Rationale: The nurse should evaluate the client's response to drug therapy by observing the client for various neuromuscular signs to compare these observations with the data obtained during the initial physical assessment. The nurse should assess the clients ability to perform daily activities and observe the client's current mental condition before the drug is administered to the client as part of the preadministration assessment. During the preadministration assessment, before starting the drug therapy, the nurse also performs a physical assessment of the client to provide a baseline for future evaluations of drug therapy.
A nurse is caring for a 55-year-old client with Parkinson's disease who is prescribed entacapone. The nurse would monitor this client for which adverse reaction?
- A. Increased hand tremor
- B. Constipation
- C. Urinary retention
- D. Dyskinesia
Correct Answer: D
Rationale: The nurse should monitor for dyskinesia, which is an adverse reaction of the COMT inhibitors, in the client. The other adverse reactions include dizziness, hypersinesia, nausea, anorexia, diarrhea, orthostatic hypotension, sleep disorders, excessive dreaming, somnolence, and muscle cramps. A serious, and possibly fatal, adverse reaction that can occur with the administration of tolcapone, one of the COMT inhibitors, is liver failure. Increased hand tremor and constipation are adverse effects associated with the use of dopaminergic drugs. Urinary retention is an adverse reaction associated with the administration of cholinergic blocking drugs.
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 nurse is caring for a client who has received carbidopa/leyodopa. After administration of the first dose of the drug, the client has developed gastrointestinal disturbances. Which of the following nursing interventions would be most appropriate?
- A. Administer the next drug dose with milk.
- B. Withhold the next drug dose.
- C. Observe for alterations in blood pressure.
- D. Administer the next drug dose with meals.
Correct Answer: D
Rationale: The nurse should administer the next drug dose with meals to manage gastrointestinal disturbances in a client who has been administered antiparkinsonism drugs. Withholding the next drug dose, administering the next drug dose with milk, or observing alterations in the client's blood pressure are not appropriate interventions when caring for a client who is experiencing GI disturbances with the first dose of antiparkinsonism drugs.
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.