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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.
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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.
A nurse is caring for a 70-year-old client who is receiving anticholinergic drug therapy for Parkinson's disease. The nurse would be alert for the development of which of the following in this client?
- A. Confusion and disorientation
- B. Choreiform movements
- C. Suicidal tendencies
- D. Psychotic episodes
Correct Answer: A
Rationale: The nurse should assess for confusion and disorientation when caring for this elderly client receiving anticholinergic drug therapy. Individuals older than 60 years frequently develop increased sensitivity to anticholinergic drugs and require careful monitoring. Lower doses may also be required in such cases. Choreiform movements, suicidal tendencies, and psychotic episodes are serious adverse reactions associated with the use of levodopa, which is a dopaminergic drug.
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 group of students are reviewing antiparkinson drugs. They demonstrate understanding when they identify which of the following as classified as dopaminergic drugs? Select all that apply.
- A. Amantadine (Symmetrel)
- B. Bromocriptine (Parlodel)
- C. Biperiden (Akineton)
- D. Carbidopa (Lodosyn)
- E. Benztropine (Cogentin)
Correct Answer: A,B,D
Rationale: Amantadine (Symmetrel), bromocriptine (Parlodel), and carbidopa (Lodosyn) are classified as dopaminergic drugs. Biperiden and benztropine are cholinergic blocking drugs used to treat Parkinson's disease.
A client tells the nurse that he takes the drug Stalevo. The nurse understands that this drug is a combination of which of the following? Select all that apply.
- A. Benztropine
- B. Levodopa
- C. Carbidopa
- D. Tolcapone
- E. Entacapone
Correct Answer: B,C,E
Rationale: Stalevo is a brand-name combination product that contains carbidopa, levodopa, and entacapone.