Nokea
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.
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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 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 understands the need for cautious administration of the prescribed entacapone to a client with which of the following? Select all that apply.
- A. Hypotension
- B. Renal dysfunction
- C. Hepatic dysfunction
- D. Diabetes
- E. Hypertension
Correct Answer: A,B,C,E
Rationale: The nurse should cautiously administer entacapone (Comtan) to clients with hypotension, hypertension, and decreased hepatic or renal function.
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.
When reviewing the medication records of several clients, the nurse notes documentation of nonergot dopamine receptor agonists. Which of the following would the nurse most likely note? Select all that apply.
- A. Pramipexole (Mirapex)
- B. Entacapone (Comtan)
- C. Amuitadine (Symmetrel)
- D. Ropinirole (Requip)
- E. Benztropine (Cogentin)
Correct Answer: A,D
Rationale: Pramipexole (Mirapex) and ropinirole (Requip) are nonergot dopamine receptor agonists.