Neurological Medications

617. Ibuprofen (Advil) is prescribed for a client. the nurse tells the client to take the medication:

Answer: 1---with 8 oz of milk Rationale: Ibuprofen is a non steroidal anti-inflammatory drug (NSAID). NSAIDs should be given with milk or food to prevent gastrointestinal irritation.

616. A client is taking phenytoin (Dilantin) for seizure control and a sample for a serum drug level is drawn. Which of the following indicates a therapeutic. Serum drug range.

Answer: 2---10 to 20 mpg/mL Rationale: The therapeutic serum drug level range for phenytoin (Dilantin) is 10 to 20 mpg/dL.

612. A client with myasthenia gravis is receiving pyridostigmine (Mestinon). The nurse monitors for sign and symptoms of cholinergic crisis caused by overdose of the medication supply to ensure that which medication is available for administration if a cholinergic crisis occurs

Answer: 2---Atropine Sulfate Rationale: The antidote for cholinergic crisis is atropine sulfate.

618. A nurse is caring for a client who is taking phenytoin (dilantin) for control of seizure. During data collection, the nurse notes that the client is taking birth control pills. Which of the following information should the nurse provide to the client.

Answer: 3--- Potential for decrease effectiveness of the birth control pills exists while taking phenytoin (Dilantin) Rationale: Phenytoin (Dilantin) enhances the rate of estrogen metabolism, which can decrease the effectiveness of some birth control pills

619. A client with trigeminal Neuralgia is being treated with carbamazepine (Tegretol). Which laboratory result would indicate that the client is experiencing an adverse reaction to the medication?

Answer: 3---White blood cell count, 3000 cells/mm3 Rationale: Adverse effect of carbamazepine (tegretol) appear as blood dycrasias, including aplastic anemia, agranulocytosis, thrombocytopenia, leukopenia, cardiovascular disturbance, thrombophlebitis, dysrhythmias, and dermatological effect

611. A client with Myasthenia Gravis is suspected of having cholinergic Crisis. Which of the following indicate that this crisis exists?

Answer: 4--- Hypertension Rationale: Cholinergic crisis occurs as a result of an overdose of medication. Indication of cholinergic crisis include gastrointestinal disturbance, nausea, vomiting, diarrhea, abdominal cramps, increased salivation and tearing, mitosis, hypertension, sweating and increased bronchial secretion

613. A client with Myasthenia gravis becomes increasingly weak. The health care provider prepares to identify whether the client is reacting to an over dose of the medication (cholinergic crisis) or increasing severity of the disease (Myasthenic crisis). An injection of edrophonium (Enlon) is administered. Which of the following indicates that the client is in cholinergic crisis?

Answer: 4---A temporary worsening of the condition Rationale: An edrophonium (Enlon) injection makes the client in cholinergic crisis temporarily worse. This is known as a negative test. An improvement of weakness would occur if the experience Myasthenia gravis

614. Carbidopa-Levodopa (Sinemet) is prescribed for a client with parkinson disease, and the nurse monitors the client for adverse reactions to the medication. Which of the following indicate that the client is experiencing an adverse reaction?

Answer: 4---Impaired Involuntary Movements Rationale: Dyskinesia and impaired voluntary movement may occur with high levodopa dosages. Nausea, anorexia, dizziness, orthostatic hypotension, brady cardia, and akinesia (the temporary muscle weakness that last 1 minute to 1 hour, also known as the "On off phenomenon")

620. A client is receiving meperidine Hydrochloride (Demerol) for pain. Which of the following are side effect of this medication

Answer: Tremors, Drowsiness, Hypotension Rationale: Meperidine Hydrochloride is an opioid analgesic side effect include respiratory depression, drowsiness, hypotension, constipation, urinary retention, nausea, vomiting and tremors

Acetylcysteine (Mucomyst)

Antidote for Acetaminophen (Tylenol)

Atropine Sulfate

Antidote for Cholinergic Crisis

Protamine Sulfate

Antidote for HEPARIN

615.Phenytoin (Dilantin), 100 mg orally three times daily, has been prescribed for a client for seizure control. The nurse reinforces instruction regarding the medication to the client. Which statement by the client indicates an understanding of the instructions?

Answer: 1---"I will use a soft toothbrush to brush my teeth" Rationale: Phenytoin (Dilantin) is an anticonvulsant. Gingival hyperplasia, bleeding, swelling, and tenderness of the gums can occur with the use of this medication. The client needs to be taught good oral hygiene, gum massage, and the need for regular dentist visits. The client should not skip medication doses, because this could precipitate a seizure. capsules should not be chewed or broken and they must be swallowed. the client needs to be instructed to report a sore throat, fever, glandular swelling, or any skin reaction, because this indicates hematological toxicity

pyridostigmine (Mestinon)

Mestinon (pyridostigmine) is a cholinesterase inhibitor used to treat the symptoms of myasthenia gravis

Myasthenia Gravis

Myasthenia gravis (my-us-THEE-nee-uh GRAY-vis) is characterized by weakness and rapid fatigue of any of the muscles under your voluntary control. Myasthenia gravis is caused by a breakdown in the normal communication between nerves and muscles. There is no cure for myasthenia gravis, but treatment can help relieve signs and symptoms, such as weakness of arm or leg muscles, double vision, drooping eyelids, and difficulties with speech, chewing, swallowing and breathing.

Cholinergic Crisis

a pronounced muscular weakness and respiratory paralysis caused by excessive acetylcholine, often apparent in patients suffering from myasthenia gravis as a result of overmedication with anticholinesterase drugs.