Neurological System: Part 1

which lab tests should you monitor for a client who is taking interferon beta-1b to treat MS?

C. thyroid hormones D. Liver function tests E. CBC Interferon beta-1b, an immunosuppressant, may cause hepatotoxicity and myelosuppression. Monitor liver studies and complete blood counts. This drug is unlikely to alter serum osmolality or glucose or thyroid hormone levels, but it can elevate serum creatinine and alter serum electrolytes.

A nurse is teaching a client who is taking levodopa/carbidopa to treat Parkinson's disease. Which of the following nursing interventions should the nurse include?

Change position slowly to prevent orthostatic hypotension

The client is taking oral contraceptives for birth control. Which of the following instructions should the healthcare professional include?

additional birth control methods may be needed

a nurse is teaching a client who received a prescription for intereeron beta-1a for the treatment of multiple sclerosis. Whcoh of the following information should the nurse include?

administer the drug in your thigh or upper arm Interferon beta-1a is administered via the Subcutaneous route. Therefore, the nurse should instruct the client how to perform subQ injections for self administration.

while obtaining a client's medical history, you find that the client is taking levodopa/carbidopa for Parkinson's disease. Which information in the client's health history alerts you to take further action?

glaucoma

a nurse is teaching a client who has a prescription fo rbaclofen. Which of the following instructions should the nurse include?

avoid driving until the drug's effects are evident Baclofen, a centrally-acting muscle relaxant, causes CNS depression. Clients taking the drug should avoid alcohol and other CNS depressants, and should not drive a vehicle until they know how the drug will affect them. Abrupt withdrawal of baclofen can cause seizures, fever, & hypotension. A better alternative is to treat the headache, which can have many other causes, and see if it resolves as drug therapy with baclofen continues. Clients typically take baclofen daily at regular doses. Clients should start with a low does and titrations up as tolerated. Clients may take Baclofen with food to help prevent nausea. They should take antacids 1 hour before or 2 hours after other drugs, including baclofen.

a nurse is teaching a client who has Alzheimer's disease and their caregiver about memantine. Which of the following instructions should the nurse include?

avoid taking OTC antacids Antacids that contain sodium bicarbonate increase urine alkalinity and can decrease drug excretion, ultimately leading to toxicity

a nurse is teaching the family of a client who has a new diagnosis of Alzheimer's disease about donepezil. Which of the following information should the nurse include?

avoid the use of NSAIDS for pain combining NSAIDS can cause GI bleeding

a nurse is teaching a client who has a prescription for carbamazepine. Which of the following instructions should the nurse include to help the client avoid adverse effects of this drug?

begin taking the drug at a low dosage Visual disturbances, vertigo, and ataxia can result from taking carbamazepine, a drug that treats seizure disorders. Dosages should be low to minimize or prevent these adverse effects.

a nurse is teaching a client who is about to begin sumatriptan therapy to treat migraine headaches. The nurse should instruct the client to monitor for which of the following adverse effects?

chest pain Sumatriptan, a serotonin agonist, can cause coronary vasospasm and chest pain. Clients should report any pressure, pain, or tightness in the jaw, chest, or back. Sumatriptan is not an appropriate choice for clients who have a history of coronary artery disease.

a nurse is preparing to administer memantine to a client who has Alzheimer's disease. Which of the following findings in the clients medical history indicated a need to withhold the drug and notify the provider?

cirrhosis Memantine should be used cautiously in clients who have severe hepatic impairment. The nurse should contact the provider about the client's history of cirrhosis to see if laboratory testing is required before starting the drug or if the dosage needs to be adjusted.

a nurse is caring for a client who has a new prescription for pramipexole to treat Parkinson's disease. The nurse should recognize that which of the following lab tests requires monitoring?

creatinine clearance Pramipexole, a direct-acting dopamine receptor agonist, should be used with caution for clients who have renal disease. Therefore, the nurse should monitor the client's renal function.

a nurse is caring for a client who has a prescription for dantrolene to treat skeletal muscle spasms. The nurse should instruct the client to report which of the following adverse effects?

diarrhea prolonged diarrhea can cause dehydration and other serious effects

a nurse is teaching a client who has a new prescription for valproic acid to treat a seizure disorder. The hurse should instruct the client to monitor for which of the following adverse effects (Select all that apply)

drowsiness headache rash

a nurse is caring for a client who is taking interferon beta-1b. The nurse should identify that which of the following finding indicated a potential serious adverse effect of this drug?

fatigue The nurse should identify that potential serious adverse effects of interferon beta-1b includes unexplained bruising, bleeding, and fatigue. Clients should report these adverse effects to their provider immediately because they can indicate bone marrow suppression and decreased platelet count.

a nurse is teaching a client who has a new diagnosis of Parkinson's disease about how levodopa/carbidopa can help control symptoms. The nurse should identify that the drug has which of the following pharmacologic effects?

increases available dopamine in the brain Levodopa/carbidopa, a dopaminergic agent, can increase dopamine in the extrapyramidal center of the brain, reducing involuntary motion, or tremors, associated with Parkinson's disease.

The health care professional is about to administer a loading dose of phenytoin IV. Which of the following is essential for the health care professional to do before administering phenytoin IV?

infuse phenytoin slowly

a nurse is providing teaching for a client who has a new prescription for valproic acid to treat a seizure disorder. The nurse should instruct the client to monitor woich of the following adverse effects?

jaundice Valproic acid can cause hepatic toxicity, characterized by jaundice, abdominal pain, & nausea. Clients taking the drug should report these manifestations, and the nurse should monitor liver function studies prior to treatment and periodically during therapy.

A nurse is caring for a client who has a new prescription for dantrolene to treat skeletal muscle spasms. The nurse should identify that which of the following laboratory tests requires monitoring?

liver function liver toxicity is a serious adverse effect. The nurse should monitor the client's liver function prior to treatment and at regular intervals and advise the client to report jaundice or abdominal pain

a nurse is caring for a client who has been taking selegiline to treat Parkinson's disease. The provider is considering the use of analgesics for the client but should be aware that a drug interaction between selegiline and meperidine can result in which of the following?

muscle rigidity A drug interaction between selegiline and opioids, especially meperidine, can result in rigidity, stupor, agitation, hypertension, and fever.

a nurse is administering fentanyl to a client to reduce pain. Which of the following drugs should the nurse have available to reserve the effects of fentanyl?

naloxone Naloxone is an opioid antagonist that reverse the effects of opioids. Fentanyl, an opioid agonist, can cause severe respiratory depression. The nurse should also have resuscitation equipment available when administering fentanyl to a client.

a nurse is caring for a patient who is taking donepezil to treat Alzheimer's disease. For which of the following adverse effects should the nurse monitor?

nausea The most common adverse effects of donepezil, a cholinesterase inhibitor, are nausea, vomiting, and diarrhea. taking donepezil with food can help minimize adverse effects.

the healthcare provider is now assessing the client. Which of the following finding can be an early indication of phenytoin toxicity?

nystagmus

a nurse is reviewing the medical record of a client who has a newly diagnosed seizure disorder and a new prescription for valproic acid and phenytoin. The nurse should include that which of the following can occur as a result of an interaction between these drugs?

phenytoin toxicity Valproic acid can cause an increase in phenytoin blood levels, resulting in phenytoin toxicity. The nurse should monitor serum phenytoin levels and notify the provider if levels begin to exceed the therapeutic range. Hyperammonemia is unlikely to result form a drug interaction between valproic acid and phenytoin. Taking valproic acid with topiramate, however, can increase the risk of excess ammonia in the blood. Hypertension is unlikely to result from a drug interaction between valproic acid and phenytoin. Phenytoin does not have CNS depressive effects and can cause hypotension, especially when administered via IV. Peptic ulcer disease is unlikely to result from a drug interaction valproic acid and phenytoin. Taking cimetidine with phenytoin, however, can increase phenytoin levels.

a nurse is teaching a client about interferon beta-1a. Which of the following instructions should the nurse give to help the client avoid the adverse effects of this drug?

premedicate with acetaminophen interferon beta drugs can cause fever, chills, headaches, and muscle aches

a nurse is preparing to administer sumatriptan to a client for the first time. The nurse should instruct the client that sumatriptan is indicated for which of the following conditions?

presence of a migraine headache

a nurse is caring for a client who is receiving methohexital sodium. The nurse should monitor the client for which of the following adverse effects?

respiratory depression Methohexital, a short-acting barbiturate, can cause cardiovascular depression. Mechanical ventilation and continuous monitoring are essential for clients receiving the drug.

Which of the following assessments of this client is most important immediately following the administration of IV Diazepam?

respiratory rate

a nurse is caring for a client who has a new prescription for amphetamine sulfate. The nurse should monitor the client for which of the following adverse effects?

tachycardia Amphetamine sulfate is an amphetamine stimulant. It can cause tachycardia and dysthymias. The client should notify the nurse if they develop palpitations or chest pain.

a nurse is teaching a client who has a prescription for modafinil to treat narcolepsy. Which of the following instructions should the nurse include?

take the drug in the morning Modafinil is a nonamphetamine stimulant. Taking it in the morning helps improve wakefulness for clients who have narcolepsy. Clients taking the drug for shift work sleepiness should take it 1 hour before work.

the healthcare professional is talking with the client who is soon to be discharged to home, about the adverse effects of phenytoin. Which of the following instructions may help minimize the adverse effects of phenytoin?

use good oral hygiene

a nurse is caring for a client who has been taking amphetamine/dextroamphetamine sulfate for the treatment of AHDH for 2 weeks. The nurse should report which of the following findings to the provider?

weight loss of 2.3 kg (5 lbs) Amphetamine/dextroamphetamine sulfate can cause a decreased appetite and weight loss. The nurse should instruct the client to weight themselves twice weekly and report unintended weight loss.