ATI: Neurological System P2

a nurse is providing a teaching to a client who has a prescription for chlorpromazine. which of the following instructions should the nurse include?

wear sunscreen when exposed to sunlight - chlorpromazine is a conventional antipsychotic which can cause photosensitivity or increased susceptibility to a burn when exposed to sunlight - clients should limit their exposure to sunlight and wear sunscreen and protective clothing while outdoors

a nurse is providing a 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?

avoid taking with NSAIDs - they increase renal absorption of lithium and sodium

a nurse is caring for a client who has recently began taking chlorpromazine to treat schizophrenia and who has admitted to the emergency room with spasms of their face and back. which of the following adverse reactions should the nurse suspect?

acute dystonia - can develop during the first few days of treatment with chlorpromazine. manifestations include muscle spasms of the back, face, neck, and tongue. treatment includes immediate administration of an anticholinergic drug such as diphenhydramine

a nurse should identify that timolol is contraindicated for a client who has which of the following disorders?

asthma - timolol is a beta-adrenergic antagonist, can cause bronchospasm and difficulty breathing. clients who have asthma or any disorder that compromises respiratory function should not not use the drug

a nurse is caring for a client who has a schizoaffective disorder and who has been prescribed chlorpromazine IV. which of the following client findings should the nurse monitor after administering the medication?

blood pressure - chlorpromazine puts clients at risk for hypotension during and immediately after IV administration. the client should remain supine for 30 minutes while the nurse monitors their blood pressure. the nurse should instruct the clients to change positions slowly

a nurse is providing a teaching to a cleint who has a new prescription for betaxolol eye drops. which of the following AE should the nurse include in the teaching?

bradycardia - betaxolol and timolol can cause bradycardia bc of the blockade of cardiac B1 receptors. clients should check pulse regularly and report any sustained decreases

a nurse is reviewing the drug history of a client who is taking lithium carbonate for bipolar disorder. which of the following findings should indicate to the nurse to monitor for lithium toxicity?

furosemide for hypertension - furosemide is a high-ceiling loop diuretic which increases sodium loss and can cause lithium reabsorption

a nurse is providing teaching to a client who has a new prescription for diazepam for anxiety disorder. which of the following clients statements indicates an understanding of the teaching?

if i become pregnant it is important to let my health care provider know - diazepam can increase the risk of congenital malformation and is contraindicated for clients who are pregnant

a nurse is providing teaching to a client who has a new prescription for fluoxetine. which of the following instructions should the nurse include?

if you have persistent headaches, let the provider know. - the client should report persistent, anxiety, or insomnia to the provider as an adverse reaction of the drug

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

phenelzine - clients should not take venlafaxine, a serotonin norepinephrine reuptake inhibitor, within 14 days of taking phenelzine, other MAOIs, or serotonergic drugs. serotonin syndrome is a life-threatening complication characterized by anxieety, confusion, hallucination, and fever

a nurse is caring for a client who has a prescription for alprazolam. for which of the following AE should the nurse monitor?

tolerance - along with dependence, can develop with benzodiazepines like alprazolam. use them only PRN and for short periods of time anxiety - paradoxical rxns like anxiety and insomnia can develop when taking alprazolam, esp in older adults. sedation - CNS depression manifested as sedation and drowsiness can occur with benzos like alprazolam - take benzos 30 min before bedtime respiratory depression

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?

withdrawal symptoms - physical dependence can develop with extended use of alprazolam, a benzodiazepine. to prevent withdrawal symptoms, clients should taper the dose slowly over several weeks

a nurse is providing teaching to a client who has a prescription for buspirone. which of the following instructions should the nurse include?

allow 2-4 weeks for full therapeutic effects

a nurse is assessing a client who has been taking alprazolam for several days. which of the folloiwng findings should the nurse identify as an AE caused by the drug?

anxiety - clients can experience this paradoxical effect when taking benzos or buspirone, indicated by increased anxiety rather than relief of anxiety

a nurse is providing teaching to a client instilling pilocarpine for managing open-angle glaucoma. which of the following instructions should the nurse include in the teaching?

apply gentle pressure to the nasolacrimal duct for 1 min after instilling the drops - helps drug from entering systemic circulation do not touch the tip of the dropper - should remain sterile and should avoid touching it to the eye area remove contact lenses prior to instilling drops - can cause further irritation if left in place

a nurse is caring for a client who has a prescription for fluoxetine and who reports self-administering St. John's wort daily for the past 2 weeks. which of the following findings should the nurse report to the provider as an indication of serotonin syndrome?

hallucinations - an expected finding of serotonin syndrome - SSRI's are contraindicated with St. John's wort bc the combo can increase the risk of developing serotonin syndrome

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?

hypertensive crisis - tyramine enriched foods like aged cheeses and processed meat can trigger severe hypertension in clients taking phenelzine - manifestations: hypertension, headache, nausea

a nurse is reviewing medical history of a client who 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 prescription modification?

renal function impairment - alprazolam dosage should be decreased for clients who have renal or hepatic impairment

a nurse is providing teaching for a client about the AE of drug therapy. the nurse should include that orthostatic hypotension is a common AE of which of the following drugs?

imipramine - a TCA that can result in postural hypotension. clients should change positions slowly

a nurse is caring for a client who is taking lithium carbonate to treat bipolar disorder. which of the following diagnostic tests should the nurse recommend that the client undergo periodically?

thyroid function tests - hypothyroidism is an AE of lithium carbonate - clients should report neck enlargement, weight gain, lethargy, and constipation. they should also have their thyroid function checked before they begin taking lithium and annually thereafter

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?

seizure activity - bupropion, an atypical antidepressant, can cuase seizure activity when clients take high doses or have a seizure disorder, a CNS tumor, or a history of head trauma

a nurse is providing teaching to a client who has a prescription for buspirone to treat anxiety. which of the following instruction should the nurse include?

take a missed dose as soon as you remember - buspirone should be taken on a regular scheduled basis to be therapeutic. if a client misses a dose, then they should take one as soon as they remember, as long as it is not close to a time for the next scheduled dose

a nurse is providing teaching to a client who is about to begin amitriptyline therapy to treat major depressive disorder. which of the following instructions should the nurse include?

change positions slowly from sitting or lying to standing - amitriptyline is a TCA which can cause orthostatic hypotension do not stop taking the drug abruptly - relapse and withdrawal symptoms can occur with abrupt discontinuation of amitriptyline - reduce dosage over a 2-wk period to prevent or minimize withdrawal symtpoms take the drug at bedtime to avoid daytime drowsiness increase the fiber and fluid intake - this TCA causes anticholinergic effects like dry mouth, constipation, and urinary retention - increase fluid/fiber intake and urinate before taking the drug

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 for which of the following findings as indications of lithium toxicity?

tremors - a fine hand tremor is an early indication of lithium toxicity. a coarse tremor indicates advanced toxicity that can lead to seizure activity confusion - along with slurred speech and ataxia are indications of lithium toxicity that develop because of the drugs narrowed therapeutic range nausea - N/V/D are early indications of lithium toxicity that develop bc of the drug's narrow therapeutic range. clients should report any adverse effects muscle weakness - its an early indication of lithium toxicity that develops bc of the drug's narrow therapeutic range. the nurse should monitor lithium levels periodically

when reviewing the indications for various antidepressants, a nurse should identify that buproprion hydrochloride is an appropriate choice for clients who have which of the following?

season affective disorder - bupropion is an atypical antidepressant that helps prevent and treat seasonal affective disorder, a type of depression associated with the reduction of natural light during winter months nicotine addiction - bupropion is an appropriate adjunct for clients who are trying to quit smoking depression