Nokea
After administering an antiparkinson drug to a client, the nurse assesses the effectiveness of the drug. The nurse notes that the clients slow movements have improved. The nurse documents this as an improvement in which of the following?
- A. Akathisia
- B. Bradykinesia
- C. Achalasia
- D. Choreiform movements
Correct Answer: B
Rationale: Bradykinesia refers to the slow movements associated with Parkinson's disease. Akathisia refers to extreme restlessness and increased motor activity. Achalasia refers to the failure to relax, usually referring to the smooth muscle fibers of the GI tract. Choreiform movements refer to the involuntary muscular twitching of the limbs or facial muscles.
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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.
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.
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 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 reviewing the medical record of a client who is exhibiting Parkinson-like adverse reactions due to drug therapy. Which drugs might the nurse note in the client's record? Select all that apply.
- A. Antidepressants
- B. Conventional antipsychotics
- C. Lithium
- D. Opioids
- E. NSAIDs
Correct Answer: A,B,C
Rationale: Drugs such as antidepressants, antiemetics, first-generation antipsychotics, lithium, and stimulants can cause symptoms similar to Parkinson's disease. Opioids and NSAIDs are not associated with Parkinson-like symptoms.