Pharm Test Specific Neurodegenerative Disorders

The duration of action for transdermal rivastigmine is hours.

24 The duration of action of transdermal rivastigmine is 24 hours.

A nurse administers oral carbidopa-levodopa to a patient who has tremors from Parkinson's disease. What duration of action does the nurse expect to see for this medication?

5 hours Reason: The duration of action of carbidopa-levodopa is 5 hours.

Where does the excretion of carbidopa-levodopa occur?

Urine Reason: Carbidopa-levodopa is excreted in the urine as metabolites.

What information should the nurse include in patient teaching for a patient taking extended-release carbidopa-levodopa?

"Do not abruptly stop taking this medication." An increase in parkinsonism symptoms can occur if carbidopa-levodopa is stopped abruptly; therefore, the patient should not abruptly stop taking the medication. "You may continue to have symptoms for several weeks or months " It may take weeks or months for a therapeutic goal of carbidopa-levodopa to be reached and for symptoms to be controlled. "You may experience discolored urine or dark perspiration while taking this medication." Discolored urine or dark perspiration may occur when a patient is taking carbidopa-levodopa.

The nurse is providing education to a patient taking carbidopa-levodopa. Which statement by the nurse correctly explains why the patient should take this medication with low-protein foods?

"High-protein foods interfere with transportation of this medication to the central nervous system." Reason: High-protein foods interfere with the transportation of the medication to the central nervous system. Patients taking carbidopa-levodopa should limit their intake of dietary protein.

What correct statement should the nurse include in patient teaching related to carbidopa-levodopa and symptoms of dyskinesia?

"It may take weeks or months before your symptoms are controlled." Reason: Symptoms may take weeks or months to be controlled in patients taking carbidopa-levodopa.

A family member states, "My father complains of an upset stomach after taking rivastigmine." Which would be an appropriate response by the nurse?

"Make sure he takes the medication with food." Administering rivastigmine with food enhances absorption and reduces GI effects.

Which information related to rivastigmine should the nurse teach Mrs. Hill?

"Rise slowly from sitting or lying positions, as orthostatic hypotension can occur." Orthostatic hypotension is a potential side effect of rivastigmine.

During patient discharge, a family member states to the nurse, "My mother's Alzheimer's disease can be cured." How should the nurse respond?

"The symptoms may be treated, but the disease itself cannot be cured." There are many physiologic symptoms of Alzheimer's disease that can be treated with medication, but there is no cure for the disease.

A patient who is currently taking an antihypertensive drug for renal artery stenosis has also been prescribed carbidopa-levodopa for the beginning stages of Parkinson's disease. The patient states, "I'm applying for a job where I would be operating a backhoe." What teaching should the nurse provide for the patient?

"These medications together may increase your risk for hypotension, so you will need to use caution when operating heavy machinery." Reason: Taking an antihypertensive in combination with carbidopa-levodopa can result in hypotension. Patients using both medications should use caution when operating heavy machinery.

Which instruction ismost important for the nurse to include when teaching a patient who has been prescribed sustained-released carbidopa-levodopa?

"Watch for adverse effects such as dizziness and drowsiness." Reason: Adverse effects of carbidopa-levodopa include dizziness and drowsiness, which can lead to orthostatic hypotension and falls. Safety is the highest priority

Match the drug class with the mechanism of action.

Affect dopamine content of the brain: COMT inhibitors Stimulate dopamine receptors of nerve cells in the brain: Dopaminergics Inhibit activity of acetylcholine: Dopamine agonists Inhibit activity of monoamine oxidase: Anticholinergics

A nurse is providing a teaching plan for a patient who is taking carbidopa-levodopa and selegiline, an MAOI. Which foods should the nurse tell the patient to avoid?

Aged cheeses, red wines, and bananas Reason: Foods high in tyramine such as aged cheeses, red wines, and bananas should be avoided to prevent hypertensive crisis.

What baseline labs should be obtained for a patient who has been prescribed carbidopa-levodopa?

CBC Baseline labs for a patient who has been prescribed carbidopa-levodopa include CBC. LFT Baseline labs for a patient who has been prescribed carbidopa-levodopa include LFT. Prolactin level Baseline labs for a patient who has been prescribed carbidopa-levodopa include prolactin level. Pregnancy test Baseline labs for a patient who has been prescribed carbidopa-levodopa include a pregnancy test.

The nurse is preparing to administer rivastigmine to a patient who has been admitted with worsening symptoms of Alzheimer's disease. The order states to administer 8 mg bid, and the pharmacy sends four 2-mg tablets for the am dose. What should the nurse do first?

Call the health care provider for an order change Reason: The maximum dose of rivastigmine is 6 mg bid.

Which statement about the mechanism of action of carbidopa is true?

Carbidopa has no therapeutic effect on its own. Reason: Carbidopa has no therapeutic effect of its own; it is used to enhance the effects of levodopa.

Which statement correctly explains the action of carbidopa-levodopa?

Carbidopa prevents levodopa decarboxylation in the periphery, resulting in more levodopa being transported to the brain. Reason: With the use of carbidopa, less levodopa is needed. Carbidopa has no therapeutic effect of its own.

Which statement about carbidopa-levodopa is correct?

Carbidopa-levodopa should not be stopped abruptly. Reason: Discontinuing use of carbidopa-levodopa abruptly can result in rebound parkinsonism.

What potential side effect of carbidopa-levodopa should the nurse teach the patient and family to report to the health care provider?

Dyskinesia Dyskinesia (involuntary muscle movement) may occur with high levodopa dosages and should be reported.

Which nursing diagnosis is highest priority for a nurse who is caring for a patient taking carbidopa-levodopa for Parkinson's disease?

Impaired physical mobility related to dizziness Reason: Impaired physical mobility related to dizziness is the highest priority. Patients are at higher risk for falls when they are dizzy.

To evaluate the effectiveness of dopaminergic agents, the nurse should assess for which condition?

Improvement in balance, gait, and mobility Reason: The effectiveness of dopaminergic agents is evaluated by their control of parkinsonism symptoms. An improvement in balance, gait, and mobility indicates controlled parkinsonism symptoms.

A nurse is evaluating the effectiveness of an Alzheimer patient's drug regimen. Which assessment finding by the nurse would indicate that the medicine is effective?

Improvement in mental status Reason: Ongoing evaluation of controlled Alzheimer's disease symptoms helps determine if an increase in dosage or change in medication is needed. An improvement in mental status from the baseline assessment indicates the medication is having a therapeutic effect.

Which statement best explains the therapeutic effect of rivastigmine?

Improves memory Reason: Rivastigmine improves memory in patients with mild to moderate Alzheimer's disease.

A patient has been taking carbidopa-levodopa for many years. During assessment, the nurse finds that the patient presents with hand tremors, drooling, and a mask-like facial expression. What action by the health care provider should the nurse anticipate?

Increase in medication dosage Reason: Ongoing evaluation of controlled Parkinson's disease symptoms helps the health care provider determine if an increase in dosage or change in medication is needed. After many years of use, carbidopa-levodopa may lose its overall effectiveness.

The nurse is caring for a patient who has a history of COPD and a new diagnosis of Alzheimer's disease. The nurse knows that theophylline and rivastigmine have what effect on the patient when given together?

Increase the risk for theophylline toxicity Reason: Rivastigmine can increase the effects of theophylline and increase the patient's risk for theophylline toxicity.

Which intervention related to family members who are preparing to bring their mother with Alzheimer's disease home from the hospital would be the highest priority for the nurse?

Instruct the family members to remove obstacles from the patient's path to prevent falls and injuries if she should wander Reason: Instructing the family members to remove obstacles from the patient's path to prevent falls is the priority intervention; it will enable the family to provide a safe environment for the patient in the home.

Which statement about rivastigmine is correct?

It is contraindicated in patients with liver disease. Reason: Rivastigmine is contraindicated in patients with liver disease due to risk of hepatotoxicity.

Which factor in a patient's health history is most important for the nurse to consider with regard to the patient's treatment plan?

Liver disease A cumulative drug effect of rivastigmine is likely to occur in an older adult patient with liver disease or dysfunction; therefore, rivastigmine would be contraindicated for this patient.

Which side effects should the nurse teach Mrs. Hill to expect while taking rivastigmine?

Nausea Nausea is a potential side effect of rivastigmine. Diarrhea Diarrhea is a potential side effect of rivastigmine. Anorexia Anorexia is a potential side effect of rivastigmine. Headache Headache is a potential side effect of rivastigmine.

What statement is correct about the pharmacokinetics of topical rivastigmine?

Onset of action is 0.5 to 1 hour Reason: The onset of action for topical rivastigmine is 30 minutes to 1 hour.

Which statement correctly explains the action of rivastigmine?

Permits more acetylcholine in the neuron receptors Reason: Rivastigmine effectively penetrates the central nervous system (CNS) and increases cholinergic transmission. The result is improved cognitive function in patients with mild to moderate Alzheimer's disease.

When instructing patients and family members about rivastigmine, the nurse should teach that which adverse effect is considered life threatening and is a priority?

Suicidal ideation Reason: Suicidal ideation is life threatening and requires immediate attention.

Which is a correct therapeutic goal for treatment of Parkinson's Disease?

To improve the patient's ability to carry out activities of daily living Reason: A goal for all medication treatment plans used with Parkinson's disease is to improve the patient's ability to carry out activities of daily living.

Which route of administration for rivastigmine results in a peak concentration between 8 and 16 hours?

Transdermal Transdermal applications of rivastigmine peak between 8 and 16 hours.