Neurological system part 2

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 Rationale: 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 providing teaching to a client who has a prescription for buspirone to treat anxiety. Which of the following instructions should the nurse include?

Take a missed dose as soon as you remember

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

A nurse is caring for a client who has a prescription for alprazolam. For which of the following adverse effects should the nurse monitor?

Tolerance- Tolerance and dependence can develop with benzodiazepines, such as alprazolam. Clients should use these drugs only as needed and for short periods of time. Anxiety- Paradoxical reactions, such as anxiety and insomnia, can develop when taking alprazolam, especially in older adults. Clients should report these findings. Sedation- CNS depression, manifested as sedation and drowsiness, is an adverse effect of benzodiazepines, such as alprazolam. Clients should take a benxodiazepine 30 min prior to bedtime. Respiratory depression- Benzodiazepines, such as alprazolam, can cause CNS depression when taken with other CNS depressants, especially for older adult clients. It is important to monitor for respiratory depression and recommend the lowest effective dose. Clients should avoid alcohol and other CNS depressants while taking a benzodiazepine.

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?

Apply gentle pressure to the nasolacrimal duct Do not touch the tip of the dropper Remove contact lenses

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

Asthma

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?

Avoid taking NSAIDS

A nurse is providing teaching for a client who has a new prescription for betaxolol eye drops. Which of the following effects should the nurse include in the teaching?

Bardycardia.

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 is correct.- Amitrptyline, a tricyclic antidepressant, can cause orthostatic hypotension. Clients should move slowly from sitting or lying to standing. Do not stop taking the drug abruptly- Relapse and withdrawal symptoms can occur with abrupt discontinuation of amitrptyline. When discontinuing the drug, it is important to reduce the dosage over a 2 week period to prevent or minimize withdrawal symptoms. Take the drug at bedtime to prevent daytime drowsiness- Clients should take the drug at bedtime and avoid activities that require alertness until they know how the drug will affect them. Increase fiber and fluid intake- causes anticholinergic effects, such as dry mouth, constipation and urinary retention, Clients should increase fiber and fluid intake during drug therapy and urinate before taking 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

A nurse is reviewing the 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 the prescription modification?

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

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

Wear sunscreen when exposed to sunlight. Clients should limit their exposure to sunlight and wear sunscreen and protective clothing while outdorrs.

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 Rationale: 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 caring for a client who recently began taking chlorpromazine to treat schizophrenia and who was 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 chlopromazine. Manifesations include muscle spasms of the back, neck, face, and tongue. Treatment include immediate adminstration of an anticholinergic drug, such as diphenhydramine.

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 a client to feel the drug's full therapeutic effects.

A nurse is assessing a client who has been alprazolam for several days. Which of the following findings should the nurse identify as an adverse drug reaction caused by alprazolam?

Anxiety

A nurse is caring for a client who has schizoaffective disorder and who has been prescribed chlorpromazine. Which of the following laboratory values should the nurse monitor during and immediately after IV administration of the drug?

Blood pressure

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- High ceiling loop diuretic, increases sodium loss and cause lithium reabsorption. The nurse should evaluate the client for lithium toxicity.

A nurse is caring for a client who has 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

A nurse is providing teaching for a client who has 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 Rationale:Tyramine-enriched foods, such as aged cheese and processed meat, can trigger severe hypertension in clients who are taking phenelzine. Manifestations include hypertension, headache and nausea.

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?

If I become pregnant, it is important to let my health care provider know.

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 a persistent headaches, let the provider know. Rationale: The client should report persistent headache, anxiety, or insomnia to the provider as an adverse drug reaction.

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

Seasonal affective disorder- Bupropion, an atypical antidepressant, helps prevent and treat seasonal affective disorder a type of depression associated with the reduction of natural light during winter months. Nicotine addiction- Bupropion, an atypical antidepressant, is an appropriate adjunct for clients who are trying to quit smoking. Depression- Bupropion, an atypical antidepressant, can help treat depression.

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 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- Confusion, slurred speech, and ataxia are indications of lithium toxicity that develop because of the drug's narrow therapeutic range. Nausea-Nausea, vomiting and diarrhea are early indications of lithium toxicity that develop because of the drug's narrow therapeutic range. clients should report any of these adverse effects Muscle weakness-Muscle weakness is an early indication of lithium toxicity that develops because of the drug's narrow therapeutic range. The nurse should monitor lithium levels periodically.

A nurse is providing teaching to a client about the effects of drug therapy. The nurse should include that orthostatic hypotension is a common adverse reaction of which of the following drugs.

Imipramine