The Neurological System (part 2)

A nurse is assessing a client who has been taking alprazolam for several days. Which of the following findings should the nurse assess a fight as an adverse drug reaction caused by alprazolam? A. Anxiety B. Ringing in the ears C. Increased appetite D. Muscle spasms

A. Anxiety RATIONAL: The client can experience paradoxical effects when taking benzodiazepine or buspirone indicates by increased anxiety rather than relief of anxiety. The nurse should report this to the provider who might consider a different medication.

A nurse is providing teaching to a client about instilling pilocarpine for managing open angle glaucoma. Which of the following instructions should the nurse include in the teaching? (Select all that apply) A. Apply gentle pressure to nasolacrimal duct for one minute after installing the drops B. Do not touch the tip of the dropper C. Wash hands after instilling the drops D. Rub and gently After instilling the drops E. Remove contact lenses prior to instilling the drops

A. Apply gentle pressure to the nasal lacrimal duct for one minute after instilling the drops B. Do not touch the tip of the dropper E. Remove contact lenses prior to instilling the drops RATIONAL: Apply gentle pressure to the nasal lacrimal duct for 1 to 2 minutes of installation helps keep the drug from entering the systemic circulation The tip of the dropper should remain sterile it is important to clients avoid touching the droppers tip or touching it to the eye area Can you remove contact lenses before studying eyedrops because it can cause further irritation if left in place

A nurse should identify the timolol is contradicted for a client who has which of the following disorders? A. Asthma B. Seizure disorder C. Diabetes mellitus D. Rheumatoid arthritis

A. Asthma RATIONAL: Timolol. A beta-ádrenergic antagonist can cause bronchospasm and difficultly breathing. Clients who have asthma or any disorders that compromises respiratory function should not use the drug

A nurse is providing teaching to a client who is about to begin amitriptyline therapy to treat major depressive disorder. Which of the following instruction should the nurse include? (Select all that apply) A. Change position slowly from sitting or lying to standing B. Do not stop taking a drug abruptly C. Avoid crashing the tablet D. Take the drug a bedtime to prevent daytime drowsiness E. Increase fiber and fluid intake

A. Change position slowly from sitting or lying to standing B. Do not stop taking a drug abruptly D. Take the drug a bedtime to prevent daytime drowsiness E. Increase fiber and fluid intake RATIONAL: Amitriptyline A tricyclic antidepressant can cause orthostatic hypotension. Client remove slowly from sitting or lying to standing Relapse and withdrawal symptoms can occur with abrupt discontinuation of amitriptyline when discontinuing the drug it is important to reduce the dosage over in a two week period to prevent or minimize withdrawal symptoms amitriptyline a tricyclic antidepressant can cause drowsiness. Client should take the drug at bedtime and avoid activities that require alertness until they know how the drug will affect them amitriptyline tricyclic Anti-depressant causes anti-cholinergic effects such as dry mouth constipation and urinary retention plan should increase fiber and fluid intake during drug therapy and urinate before the taking a drug

A nurse is reviewing the drug history of a client who is taking lithium carbonate for my polar disorder. Which of the following findings should indicate the nurse to monitor for lithium toxicity? A. furosemide for hypertension B. Acetaminophen for headaches C. Ciprofloxacin for urinary tract infection D. Montelukast for asthma

A. Furosemide for hypertension RATIONAL: Furosemide A high ceiling loop diuretic increases sodium loss and can cause a lithium reabsorption. The nurse should evaluate the client for lithium toxicity

A nurse is caring for a client who has a prescription for fluoxetine and who reports of administering St. johns wort daily for the past two weeks. Which of the following findings should the nurse report to the providers as an indication of serotonin syndrome? A. Hallucinations B. Decrease temperature C. Hyper sexual behavior D. Constipation

A. Hallucinations RATIONAL: hallucinations are expected findings of serotonin syndrome. SSRIs are contradicted with St. John's wort because the combination can increase the risk of developing serotonin syndrome

A nurse is reviewing the medical history book playing has a new prescription for a reduced dosage of alprazolam for anxiety. Which of the following findings should indicate to the nurse the reason for the prescription modification? A. Renal function impairment B. Cataracts C. Recent weight loss D. Smoking

A. Renal function impairment RATIONAL: Alprazolam dosage should be decreased for clients who have Renal or hepatic impairment

A nurse is providing teaching to a client who has a prescription for buspirone to treat anxiety. Which is a funny instructions should the nurse include? A. Take I miss those as soon as you remember B. Take the drug as needed at the first sign of anxious feelings C. Take the drug in the morning with a glass of grapefruit juice D. Drink a cup of Chamomile tea at night with the drug

A. Take A missed dose as soon as you remember RATIONAL: Buspirone should be taken on a regular schedule basis to the therapeutic. If a client misses a dose then they should take one as soon as he remembered as long as it is now close to time for the next scheduled dose

A nurse is caring for a client who is about to begin taking lithium carbonate to treat bipolar disorder. The nurse should instruct the client to monitor for which of the following findings as an indication of lithium activity select (all that apply) A. Tremors B. Confusion C. Bronchospasm D. Nausea E. Muscle weakness

A. Tremors B. Confusion D. Nausea E. Muscle weakness RATIONAL: A fine hand tremor is an early indication of lithium toxicity. A coarse tremor indicates advance toxicity that can lead to seizure activity. Confusion slurred speech and ataxia are indications of lithium toxicity that develop because of drug narrow therapeutic range Nausea vomiting and diarrhea are early indications of lithium toxicity that develop because of the drug near therapeutic range clients to report any of these adverse effects. Muscle weakness as an early indication of lithium toxicity to develop because of the drugs narrow therapeutic range the nurse should monitor lithium levels periodically

A nurse is caring for a client who has schizoaffective disorder and who has been prescribed chlorpromazine. Which of the fine laboratory values should a nurse monitor during that immediately after IV administration of the drug? A. Cardiac output B. Blood pressure C. Urine specific gravity D. Oxygen saturation

B. Blood pressure RATIONAL: Glad to receive chlorpromazine are at risk for hypertension during and immediately after IV a ministration. They should remain supine for 30 minutes while the nurse monitors their blood pressure. It is essential to infuse a chlorpromazine solution slowly and not to mix it with other drugs

A nurse is providing teaching for a client who has a prescription for phenelzine The nurse should instruct the client to avoid tyramine enriched foods because of an increased risk for which of the following adverse reactions? A. Respiratory depression B. Hypertensive crisis C. Neuroleptic malignant syndrome D. Serotonin syndrome

B. Hypertensive crisis RATIONAL: Tyramine enriched foods such as cheese and processed meat can trigger severe hypertension and clients who are taking phenelzine. Manifestations include hypertension headache and nausea

A nurse is providing teaching to a client who has a prescription of Chlorpromazine. Which of the following instructions should the nurse include? A. Stop taking a drug immediately with the first signs of sore throat B. Where sunscreen when exposed to sunlight C. Take a joke with food to reduce gastrointestinal distress D. Take the drug in the morning to prevent nocturia

B. Wear sunscreen when exposed to sunlight RATIONAL: Chlorpromazine a conventional antipsychotic can cause photosensitivity or increase susceptibility to sunburn when exposed to sunlight. Client should limit the exposure to sunlight and wear sunscreen and protective clothing while outdoors.

A nurse providing teaching to a client who has a prescription for buspirone. Which of the following instruction should the nurse include? A. Take the drug with grapefruit juice to increase absorption B. Use the drug as needed for anxiety C. Allow 2 to 4 weeks for full therapeutic effects D. Take the drug on an empty stomach

C. Allow 2 to 4 weeks for full therapeutic effects RATIONAL: It can take up to four weeks for client to feel the drugs full therapeutic effects

A nurse is providing teaching to a client who has a prescription for lithium carbonate about reducing the risk for lithium toxicity. Which of the following instructions should the nurse include? A. Consume low sodium diet B. Reduce fluid intake C. Avoid taking an NSAIDs D. Take the drug with food

C. Avoid taking NSAIDs RATIONAL: NSAIDs increase Rena reabsorption of lithium and sodium. Clients who take lithium should not take NSAIDs.

A nurse providing teaching to a client about the adverse affects of drug therapy. The nurse should include a orthostatic hypotension is a common adverse reaction of which of the following drugs? A. Venlafaxine B. Bupropion C. Imipramine D. Valproic acid

C. Imipramine RATIONAL: imipramine a tricyclic Antidepressants can result in orthostatic (postural) hypotension. Client who take this drug should change position slowly from sitting or lying to standing

A nurse is caring for a client who is taking venlafaxine to treat major depressive disorder. The nurse should identify that which of the following drugs can cause serotonin syndrome when taken concurrently with venlafaxine? A. Alprazolam B. Phenytoin C. Phenelzine D. Pilcoarpine

C. Phenelzine RATIONAL: Client should take venlafaxine hey serotonin norepinephrine Reuptake inhibitor within 14 days of taking phenelzine other MAOIs or serotonergic drugs. Serotonin syndrome is a life-threatening complication characterized by anxiety confusion hallucinations and fever.

A nurse is caring for a client who is taking lithium carbonate to treat bipolar disorder. Which is the final diagnostic test should the nurse recommend that the client undergo periodically? A. Chest x-rays B. Tonometry C. Thyroid function test D. Endoscopic retrograde cholangiopancreatography (ERCP)

C. Thyroid function test RATIONAL: Hypothyroidism is an adverse affects of lithium carbonate. Client reports neck enlargement weight gain lethargy and constipation. They should also have their thyroid function checked before they begin taking lithium and annually thereafter

And you're just came for a client who recently began taking chlorpromazine to treat schizophrenia and who has admitted to the emergency room with spasms other face and back. Which is the adverse of reactions should the nurse suspect? A. Cholinergic crisis B. Serotonin syndrome C. Stevens Johnson syndrome D. Acute dystonia

D. Acute dystonia RATIONAL: Acute dystonia can Develop during the first few days of treatment with chlorpromazine. Manifestations include muscle spasms of the back neck face and song. Treatment includes immediate administrations of a anticholinegeric drug, such as diphenhydramine

A nurse is providing teaching for a client who has a new prescription for betaxolol eye drops. Which of the following adverse affects sure the nurse include in the teaching? A. Constricted pupils B. Discoloration of the iris C. Hypertension D. Bradycardia

D. Bradycardia RATIONAL: Betaxolol and trimolol Can cause bradycardia because of the blockade of cardiac beta 1 receptors. Client should check their pulse rate regularly and report any sustained decreases.

A nurse is providing teaching to a client who has a new prescription for diazepam for anxiety disorders. Which of the following client statements indicates an understanding of the teaching? A. It is not a big deal if I forget my pills for a couple of days B. I should limit alcohol intake to one drink daily while taking this medication C. I will avoid salt because this medication can increase my blood pressure D. If I become pregnant it is important to let my healthcare provider know

D. If I become pregnant it is appointed at my healthcare provider know RATIONAL: Diazepam can increase the risk of congenital malformation and it's contraindicated for clients who are pregnant

A nurse is caring for a client who was admitted to the emergency department with a head injury. The nurse notes that the client has an existing prescription for bupropion hydrochloride to treat depression. For which of the following adverse effects is the client at increased risk? A. Ischemic strike B. Drowsiness C. Respiratory depression D. Seizure activity

D. Seizure activity RATIONAL: Bupropion an atypical antidepressant can cause seizure activity when clients take high doses or have a seizure disorder a CNS tumor or a history of head trauma.

A nurse is caring for a client who has been taking alprazolam for an extended period of time to treat anxiety. The nurse should identify that abruptly stopping alprazolam therapy can result in which of the following adverse effects? A. Anterograde amnesia B. Respiratory depression C. Paradoxical reaction D. Withdrawal symptoms

D. Withdrawal symptoms RATIONAL: Physical dependence can develop with extended use of alprazolam, a benzodiazepine. to prevent withdrawal symptoms clients should taper the dose slowly over several weeks