Nokea
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.
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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.
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 assigned to care for a client who is to receive a cholinergic blocking drug. The nurse obtains the history from the client. Which of the following would alert the nurse to the need for cautious administration?
- A. The client has a decreased liver function.
- B. The client has a history of hallucinations or psychosis.
- C. The client has a cardiovascular disease.
- D. The client has a pulmonary disease.
Correct Answer: A
Rationale: It is important for the nurse to know if the client has decreased liver or kidney function so that the cholinergic blocking drug can be administered cautiously in the client. Other conditions in clients that require cautious use include tachycardia, cardiac arrhythmias, hypertension, hypotension, tendency toward urinary retention, and obstructive disease of the urinary system or gastrointestinal tract. The cholinergic blocking drugs are given with caution to older adults. The nurse should use dopamine receptor agonist drugs with caution in clients with a history of hallucinations or psychosis or cardiovascular disease. The nurse should use dopaminergic drugs with caution in clients with pulmonary diseases.
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.
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.