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A nurse is caring for a client who has been prescribed pramipexole for the treatment of Parkinson's disease. From the client's medical records, the nurse understands that the client is taking verapamil. The nurse understands that the client is at increased risk for which effect from the interaction of the two drugs?
- A. Cardiac symptoms
- B. Agonist effectiveness
- C. Toxicity of both drugs
- D. Psychotic behavior
Correct Answer: B
Rationale: The nurse should assess for an increased risk of agonist effectiveness in the client. Increased risk of cardiac symptoms and increased risk of toxicity of both drugs are the effects of the interaction of COMT inhibitors with MAOI antidepressants and adrenergic drugs. Increased risk of psychotic behavior is the effect of the interaction of cholinergic blocking drugs with haloperidol.
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A nurse is caring for a client who has been prescribed amaritadine for the treatment of the influenza A virus. After administration of the drug, the client complains of dry mouth. Which of the following instructions should the nurse offer the client to help relieve dry mouth?
- A. Instruct the client to take ice chips frequently.
- B. Encourage the client to take small, frequent meals.
- C. Instruct the client to avoid protein-rich foods.
- D. Stop the use of the antiparkinsonism drug by the client.
Correct Answer: A
Rationale: The nurse should instruct the client to suck on ice chips or hard candy (if allowed). The nurse should also instruct the client to take frequent sips of water throughout the day and between meals. The nurse encourages the client to have small, frequent meals when the client experiences a GI disturbance and not when the client complains of dry mouth. The nurse also need not instruct the client to avoid protein-rich foods because this will not reduce the client's discomfort due to dry mouth. The nurse should stop the use of the antiparkinsonism drug when the client complains of severe nausea or vomiting and not when the client is experiencing dry mouth. If dry mouth is so severe that there is difficulty in swallowing or speaking, or if loss of appetite and weight loss occur, the dosage of the antiparkinsonism drug may be reduced but not stopped completely.
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.
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.
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.
After teaching the family of a client with Parkinson's disease about possible adverse reactions, the nurse determines that the teaching was successful when the family states they will withhold the drug if the client experiences which of the following? Select all that apply.
- A. Facial grimacing
- B. Exaggerated chewing motions
- C. Protruding tongue
- D. Constipation
- E. Lack of appetite
Correct Answer: A,B,C
Rationale: The nurse should teach the client and family how to describe movements and to be alert for those such as facial grimacing, protruding tongue, exaggerated chewing motions and head movements, and jerking movements of the arms and legs. If these occur, the client should not take the next drug dose and should notify the primary health care provider immediately.