Nokea
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.
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A nurse reviews a client's medical record for possible conditions that would contraindicate the use of carbidopa/levodopa (Sinemet). Which of the following would the nurse identify as a contraindication? Select all that apply.
- A. Narrow-angle glaucoma
- B. Renal disease
- C. Hepatic disease
- D. Diabetes
- E. Use of MAOI antidepressants
Correct Answer: A,E
Rationale: Carbidopa/levodopa (Sinemet) is contraindicated in clients who have known hypersensitivity to the drug or narrow-angle glaucoma or who use MAOI antidepressants.
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.
The nurse would be alert for a client taking benztropine (Cogentin) to have increased anticholinergic effects if which of the following medications are also started? Select all that apply.
- A. Amantadine (Symmetrel)
- B. Quetiapine (Seroquel)
- C. Glycopyrrolate (Robinul)
- D. Perphenazine (Trilafon)
- E. Tiotropium (Spiriva)
Correct Answer: A,D
Rationale: A client taking benztropine (Cogentin) will have increased anticholinergic effects if amantadine or phenothiazines such as perphenazine are given together.
A nursing instructor is describing parkinsonism to a group of nursing students. The instructor determines that the teaching was successful when the students identify which of the following as a possible cause? Select all that apply.
- A. Drugs
- B. Stroke
- C. Myocardial infarction
- D. Encephalitis
- E. Epilepsy
Correct Answer: A,D
Rationale: Parkinsonism may result from the use of certain drugs, head injuries, and encephalitis.
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.