Nokea
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.
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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.
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 teaching a group of nursing students issues and problems commonly associated with antiparkinson drug therapy, the instructor determines that the teaching was successful when the students identify which nursing diagnosis as common? Select all that apply.
- A. Risk for Injury
- B. Risk for Infection
- C. Diarrhea
- D. Impaired Physical Mobility
- E. Imbalanced Nutrition: More Than Body Requirements
Correct Answer: A,D
Rationale: Common drug therapy-related nursing diagnoses include Risk for Injury, Constipation, Impaired Physical Mobility, Imbalanced Nutrition: Less Than Body Requirements, and Disturbed Sleep Pattern.
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.
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.