Pharmacology Neurological meds yx18d 3rd 4th

A client is receiving phenobarbital sodium (Luminal) for the treatment of a seizure disorder. Which finding on the nursing assessment would indicate that the client is experiencing a common side effect of this medication?

1. Drowsiness

18. The nurse is caring for a client with an exacerbation of multiple sclerosis. Which medication(s) will the nurse expect to be prescribed to hasten recovery from the exacerbation?

1. Methylprednisolone (Solu-Medrol) intravenously

c/o of back spams, Since aspirin intoxication is suspected, the nurse should assess the client for which manifestation?

1. Tinnitus

A client with myasthenia gravis becomes increasingly weaker. The health care provider (HCP) injects a dose of edrophonium (Enlon) to determine whether the client is experiencing a myasthenic crisis or a cholinergic crisis. The nurse expects that the client will have which reaction if in cholinergic crisis?

A temporary worsening of the condition

The health care provider (HCP) writes a prescription for carbamazepine (Tegretol) for a client who was admitted to the hospital. The nurse contacts the HCP to verify the prescription if which condition is noted in the assessment data?

Bone marrow depression

A client on the nursing unit has a prescription for dextroamphetamine (DextroStat) daily. The unit nurse collaborates with the dietitian to limit the amount of which item on the client's dietary trays?

Caffeine

A client with a diagnosis of Parkinson's disease began taking amantadine (Symmetrel) approximately 2 weeks ago. The client reports to the clinic for a follow-up evaluation. The nurse determines that the client is experiencing an adverse effect related to the use of this medication if which is noted?

Client complaints of urinary retention

Propofol (Diprivan) is prescribed to induce sedation in a client who is intubated and is being mechanically ventilated. The nurse prepares the medication and selects which solution to dilute the medication?

Lantus

A client with a history of simple partial seizures is taking clorazepate (Tranxene). The client asks the nurse if there is a risk of addiction with this medication. The nurse's response is based on which information about this medication?

Leads to physical and psychological dependence with prolonged high-dose therapy

A client is scheduled to begin medication therapy with valproic acid (Depakene). The nurse looks for the results of which laboratory test(s) before administering the first dose?

Liver function tests

Sumatriptan (Imitrex) is prescribed for a client. Based in this prescription, the nurse suspects that the client has which condition?

Migraine headache

A client with myasthenia gravis who is taking neostigmine (Prostigmin) is experiencing frequent exacerbations of myasthenic crisis and cholinergic crisis. The nurse teaches the client that it is most important that this medication be taken in which manner?

On time

The nurse has a prescription to give dexamethasone (Decadron) by the intravenous (IV) route to a client with cerebral edema. How should the nurse prepare this medication?

Preparing an undiluted direct injection of the medication

A client taking carbamazepine (Tegretol) asks the nurse what to do if a dose is inadvertently missed. The nurse responds that which action should be taken?

Take the dose as long as it is not close to the time for the next dose.

After review of the client's laboratory values, the nurse notes that a phenytoin (Dilantin) level for a client receiving phenytoin (Dilantin) is 7 mcg/mL. The nurse makes which interpretation regarding this laboratory result?

The level is lower than the expected therapeutic range.

A client reports frequent use of acetaminophen (Tylenol) for relief of headaches and other discomforts. The nurse should evaluate which diagnostic data to determine if the client is at risk for toxicity?

The liver function studies

The home health nurse visits a client who is taking phenytoin (Dilantin) for control of seizures. During the assessment, the nurse notes that the client is taking birth control pills. Which information should the nurse include in the teaching plan?

There is the potential of decreased effectiveness of birth control pills while taking phenytoin.

A client who was started on anticonvulsant therapy with clonazepam (Klonopin) tells the nurse of increasing clumsiness and unsteadiness since starting the medication. The client is visibly upset by these manifestations and asks the nurse what to do. The nurse's response is based on which understanding?

These symptoms are most severe during initial therapy and decrease or disappear with long-term use.

A nurse is collecting data from a client and notes that the client is taking carbamazepine (Tegretol). The nurse determines that this medication has been prescribed to treat which condition?

Trigeminal neuralgia

Meperidine hydrochloride (Demerol) is prescribed for a client with pain. What should the nurse monitor for as a side/adverse effect of this medication?

Urinary retention

client is taking trihexyphenidyl hydrochloride for the treatment of Parkinson's disease. The nurse should assess for which adverse effect of this medication?

Urinary retention

The nurse teaches the wife of a client who is receiving levodopa/carbidopa (Sinemet) to avoid pyridoxine (vitamin B6) medications. Which statement by the wife indicates an understanding of the instructions?

Vitamin B6 reverses the effectiveness of levodopa, meaning a higher dose is needed."

A client is experiencing impotence after taking guanfacine (Tenex). The client states, "I would sooner have a stroke than keep living with the effects of this medication." What is the most appropriate response by the nurse?

You are concerned about the effects of your medication."

The nurse is caring for a client receiving morphine sulfate for pain. Because this medication has been prescribed for this client, which nursing action should be included in the plan of care?

Encourage the client to cough and deep breathe.

A client who is taking phenytoin (Dilantin) for a seizure disorder is being admitted to the hospital because of an increase in seizure activity. The client reports severe vomiting for the last 24 hours and inability to take phenytoin during that time. The nurse anticipates that the health care provider will most likely prescribe which medication?

Fosphenytoin sodium (Cerebyx)

A client with narcolepsy has been prescribed dextroamphetamine (DextroStat). The client complains to the nurse that he cannot sleep well at night and does not want to take the medication any longer. Before making any specific comment, the nurse plans to investigate whether the client takes the medication at which proper time schedule?

At least 6 hours before bedtime

The nurse is providing instructions to an adolescent prescribed phenytoin (Dilantin) for the control of seizures. Which statement by the adolescent indicates a need for further teaching regarding the medication?

If my gums become sore and swollen I need to stop the medication."

The client with a head injury is experiencing signs of increased intracranial pressure (ICP), and mannitol (Osmitrol) is prescribed. The nurse administering this medication expects which as an intended effects of this medication? Select all that apply

◦1. Increased diuresis ◦2. Reduced intracranial pressure ◦3. Increased osmotic pressure of glomerular filtrate ◦4. Reduced tubular reabsorption of water and solutes

The nurse in the health care provider's office is reviewing the results of a client's phenytoin (Dilantin) level determination performed that morning. The nurse identifies that a therapeutic drug level has been achieved if which result is noted?

15 mcg/mL

client in ER with Bell's palsy. Acetaminophen (Tylenol) overdose is suspected. Which antidote should the nurse anticipate to be prescribed?

Acetylcysteine (Mucomyst)

The nurse is assisting in the care of a client with myasthenia gravis who is receiving pyridostigmine (Mestinon). Which medication should the nurse plan to have readily available should the client develop cholinergic crisis because of excessive medication dosage?

Atropine sulfate

The nurse who is caring for a client with myasthenia gravis has a prescription to perform an Enlon (Tensilon) test. After obtaining edrophonium (Enlon), the nurse should be certain that which also is available at the bedside?

Atropine sulfate

A client is receiving anticonvulsant therapy with phenytoin (Dilantin). To monitor for adverse effects of this medication, the nurse assesses the results of which laboratory test?

Complete blood count (CBC)

A client has been prescribed a cough formula containing codeine sulfate. The nurse has given the client instructions for its use. The nurse concludes that the client understands the instructions if the client verbalizes to self-assess for which side effect?

Constipation

A client is having the dosage of clonazepam (Klonopin) adjusted. The nurse should plan to perform which action?

Institute seizure precautions.

client with severe back pain. Codeine sulfate has been prescribed for the client. Specific to this medication, which intervention should the nurse include in the plan of care while the client is taking this medication?

Monitor bowel activity.

The nurse has given instructions for taking codeine sulfate to a client with a severe headache. Which statement by the client indicates the teaching has been effective?

"I should increase fluid intake."

Phenytoin (Dilantin), 100 mg to be given orally three times daily, has been prescribed to a client for seizure control. The home health nurse visits the client and provides instructions regarding the medication. Which statement, if made by the client, would indicate an understanding of the instructions?

"I will use a soft toothbrush to brush my teeth."

The nurse has a prescription to administer diazepam (Valium) 5 mg by the intravenous (IV) route to a client. The nurse should administer the medication over a period of at least how long?

1 minute

The nurse has given medication instructions to a client receiving phenytoin (Dilantin). Which statement indicates that the client has an adequate understanding of the instructions?

2. "Good oral hygiene is needed, including brushing and flossing."

The nurse in a long-term care facility is reviewing the health care provider's (HCP) prescriptions on an assigned client. The nurse notes that the HCP prescribed ropinirole hydrochloride (Requip). The nurse determines that this medication has been prescribed to treat which condition in the client?

4. Parkinsonian syndrome

A client is suspected of having myasthenia gravis. Edrophonium (Enlon) is administered intravenously to determine the diagnosis. Which indicates that the client may have myasthenia gravis?

An increase in muscle strength within 30 to 60 seconds following administration of the medication

A nurse is reviewing the results of a test on a sample drawn from a child who is receiving carbamazepine (Tegretol) for the control of seizures. The results indicate a serum carbamazepine level of 10 mcg/mL. The nurse analyzes the results and anticipates that the health care provider (HCP) will note which prescription?

Continuation of the presently prescribed dosage

Carbidopa-levodopa (Sinemet) adverse effect?

Impaired voluntary movements

The nurse is caring for a client with Parkinson's disease who is taking oral benztropine mesylate (Cogentin) daily. What is the priority nursing assessment for the client?

Intake and output

The nurse is caring for a client who underwent an open reduction internal fixation to the right hip. When administering opioid analgesics for pain, the nurse should instruct the client that which are side/adverse effects of opioid analgesics? Select all that apply.

◦1. Sedation ◦3. Constipation ◦5. Respiratory depression

A client with myasthenia gravis has difficulty chewing and has received a prescription for pyridostigmine (Mestinon). The nurse should check to see that the client takes the medication at what time?

30 minutes before meals

The nurse has a prescription to administer phenytoin (Dilantin) 100 mg by the intravenous (IV) route to a client. The nurse administers the medication after preparing it in which solution?

0.9% normal saline with an in-line filter

A client with Parkinson's disease has begun therapy with levodopa. The nurse determines that the client understands the action of the medication if he or she verbalizes that results may not be apparent for how long?

2 to 3 weeks

The nurse is administering medications to a client with trigeminal neuralgia. The nurse expects that which medication will be prescribed for pain relief?

3. Carbamazepine (Tegretol) and gabapentin (Neurontin)

A client with myasthenia gravis has become increasingly weaker. The health care provider prepares to identify whether the client is reacting to an overdose of the medication (cholinergic crisis) or an increasing severity of the disease (myasthenic crisis). An injection of edrophonium is administered. Which finding would indicate that the client is in cholinergic crisis?

4. A temporary worsening of the condition

A client has received a dose of dimenhydrinate (Dramamine). The nurse evaluates the effect of the medication by noting whether the client obtained relief from what symptom?

4. Nausea and vomiting

A client receiving therapy with carbidopa/levodopa (Sinemet) is upset and tells the home health nurse that his urine has turned a darker color since he started taking this medication. The client wants to discontinue its use. In formulating a response to his concerns, the nurse interprets that this change is indicative of which condition?

A harmless side effect of the medication

A client has a prescription to receive valproic acid (Depakene) daily. To maximize the client's safety, when is the best time for the nurse to schedule the administration of this medication?

Before bedtime

A client with insomnia has been started on zolpidem (Ambien). After instructing the client in how to obtain the maximal effect of zolpidem, the nurse determines that the client demonstrates understanding of correct administration of the medication by which statement?

I need to take the medication with a full glass of water."

Benztropine mesylate (Cogentin) is prescribed for a client with a diagnosis of Parkinson's disease. What statement by the client indicates that the client needs additional information about the medication?

I will sit in the sun for an hour a day to enhance medication effectiveness."

A nurse should question a prescription for which medication in the client concurrently receiving tramadol (Ultram)?

Monoamine oxidase inhibitors (MAOIs)

A client has been prescribed cyclobenzaprine (Flexeril) for the treatment of painful muscle spasms accompanying a herniated intervertebral disk. The nurse should withhold the medication and question the prescription if the client has a concurrent prescription for which medication?

Tranylcypromine (Parnate)

The nurse has given medication instructions to a client beginning anticonvulsant therapy with carbamazepine (Tegretol). The nurse determines that the client understands the use of the medication if he or she makes which statement?

Use sunscreen when outdoors.

A client with Parkinson's disease is taking benztropine mesylate (Cogentin) orally daily. In monitoring this client for medication side effects, the nurse should plan to focus the assessment on which item?

Voiding pattern

A nurse is reading the laboratory results for a client being treated with carbamazepine (Tegretol) for prophylaxis of complex partial seizures. When evaluating the client's laboratory data, the nurse determines that which value is consistent with an adverse effect of this medication?

White blood cell count, 3200 cells/mm3

The health care provider is preparing to administer edrophonium (Enlon) to the client with myasthenia gravis. In planning care, the nurse understands which about the administration of edrophonium? Select all that apply.

◦2. Atropine is used to reverse the effects of edrophonium. ◦3. If symptoms worsen following administration of edrophonium, the crisis is cholinergic. ◦4. Edrophonium is used to distinguish between a myasthenic crisis and a cholinergic crisis. ◦5. An improvement in symptoms following administration of edrophonium indicates worsening of myasthenia gravis.

Meperidine hydrochloride (Demerol) has been prescribed for a client to treat pain. Which are side/adverse effects of this medication? Select all that apply. 1. Diarrhea 2. Tremors 3. Drowsiness 4. Hypotension 5. Urinary frequency 6. Increased respiratory rate

◦2. Tremors ◦3. Drowsiness ◦4. Hypotension

A home health nurse visits a client who suffered a back injury. On review of the health care provider's prescriptions, the nurse notes that codeine sulfate has been prescribed for the client, and the nurse provides instructions to the client regarding the medication. Which statement, if made by the client, indicates an understanding of health measures related to the medication?

"I should increase my fluid intake while taking this medication."

A client with a diagnosis of trigeminal neuralgia is started on a regimen of carbamazepine (Tegretol). The nurse provides instructions to the client about the side/adverse effects of the medication. Which client statement indicates an understanding of the side/adverse effects of the medication?

. "I will report a fever or sore throat to my health care provider."

The nurse is preparing to give a postcraniotomy client medication for incisional pain. The family asks the nurse why the client is receiving codeine sulfate and not "something stronger." In formulating a response, the nurse incorporates which information about codeine sulfate?

. Does not alter respirations or mask neurological signs as do other opioids

Carbamazepine (Tegretol) has been prescribed for a client. The nurse should tell the client that which blood test will be done periodically while the client is taking this medication?

Complete blood cell (CBC) count

A client is scheduled to begin therapy with carbamazepine (Tegretol). The nurse should assess the results of which test(s) before administering the first dose of this medication to the client?

Complete blood cell count

A client began taking amantadine (Symmetrel) approximately 2 weeks ago. The nurse determines that the medication is having a therapeutic effect if the client exhibits which finding?

Decreased rigidity and akinesia

A client has a medication prescription for phenytoin (Dilantin) to be administered by the intravenous route. After drawing up the medication, the nurse notes the presence of precipitate in the syringe. Which action should the nurse take

Discard the syringe and begin again.

A client with Parkinson's disease has been prescribed benztropine (Cogentin). The nurse should assess for which gastrointestinal (GI) problems as a side effect of this medication?

Dry mouth

A nurse is providing instructions to a client beginning medication therapy with divalproex sodium (Depakote) for treatment of absence seizures. The nurse instructs the client that which represents the most frequent side effect of this medication?

Nausea and vomiting

The nurse is observing a new nursing graduate who is preparing an intermittent intravenous (IV) infusion of phenytoin (Dilantin) for a client with a diagnosis of seizures. Which solution used by the nursing graduate should indicate to the nurse an understanding of proper preparation of this medication?

0.9% sodium chloride (normal saline)

The nurse notes that a client taking ergotamine tartrate (Cafergot) is having the intended effects of therapy if the client states relief from which symptom?

Headaches

The nurse is caring for a client with myasthenia gravis who has received edrophonium (Enlon) by the intravenous route to test for myasthenic crisis. The client asks the nurse how long the improvement in muscle strength will last. The nurse's response is based on the understanding that the effects have a duration of approximately how long

30 minutes

A client is taking phenytoin (Dilantin) for seizure control. A blood sample is drawn to determine the serum drug level, and the nurse reviews the results. Which would indicate a therapeutic serum drug range?

10 to 20 mcg/mL

A client with trigeminal neuralgia tells the nurse that acetaminophen (Tylenol) is taken daily for the relief of generalized discomfort. Which laboratory value would indicate toxicity associated with the medication?

3. Direct bilirubin level of 2 mg/dL

A client is taking the prescribed dose of phenytoin (Dilantin) to control seizures. Results of a phenytoin blood level study reveal a level of 35 mcg/mL. Which finding would be expected as a result of this laboratory result?

3. Slurred speech

A client has a prescription for valproic acid (Depakene) 250 mg once daily. To maximize the client's safety, the nurse should plan to schedule the medication at what time?

At bedtime

7. A client with trigeminal neuralgia is being treated with carbamazepine (Tegretol), 400 mg orally daily. Which value indicates adverse effect to the medication?

4. White blood cell count, 3000 cells/mm3

A client with status epilepticus has been prescribed phenytoin (Dilantin) to be given by the intravenous (IV) route. The nurse administering the medication is careful not to exceed which recommended infusion rate?

50 mg/min

A client who has been taking phenytoin (Dilantin) for seizure control has a serum phenytoin drug level of 8 mcg/mL. The nurse should make which interpretation about this value?

An inadequate drug level

The nurse is assisting in the care of a client who is being evaluated for possible myasthenia gravis. The health care provider gives a test dose of edrophonium (Enlon). Evaluation of the results indicates that the test is positive. Which would be the expected response noted by the nurse?

An increase in muscle strength within 1 to 3 minutes

Carbamazepine (Tegretol) has been prescribed for a client, and the client asks the nurse about the action of the medication. The nurse's response should incorporate which information as a primary effect of this medication?

Anticonvulsant effect

The nurse is told that the result of a serum carbamazepine (Tegretol) level for a child who is receiving the medication for the control of seizures is 10 mcg/mL. Based on this laboratory result, the nurse anticipates that the health care provider (HCP) will document which prescription?

Continuation of the presently prescribed dosage

A client with vascular headaches is taking ergotamine (Cafergot). The home health nurse should periodically assess him or her for which finding?

Cool, numb fingers and toes

A nurse is transcribing a prescription for antibiotic therapy for a client with bacterial meningitis. The nurse understands that the medication that will be prescribed for the client will have which characteristic?

Crosses the blood-brain barrier

A client experiencing spasticity as a result of spinal cord injury has a new prescription for dantrolene (Dantrium). Before administering the first dose, the nurse checks to see if which baseline study has been done?

Liver function studies

A nurse is caring for a client receiving codeine sulfate for pain. The nurse determines that the client is experiencing a side effect of the medication based on which finding?

No bowel movement in 3 days

A client with suspected opioid overdose has received a dose of naloxone hydrochloride (Narcan). The client subsequently becomes restless, starts to vomit, and complains of abdominal cramping. The blood pressure increases from 110/72 mm Hg to 160/86 mm Hg. The nurse provides emotional support and reassurance while administering care to the client, knowing which piece of information?

2. These are signs of opioid withdrawal.

40. Dexamethasone (Decadron) intravenously is prescribed for the client with cerebral edema. The nurse prepares the medication for administration and plans to perform which action?

Prepare an undiluted direct injection of the medication.

A nurse is caring for a client who has been taking hydrocodone for the last 3 months. Which side/adverse effects of this medication should the nurse assess the client for

Psychological and physical dependence

A nurse preparing to administer carbamazepine (Tegretol) notices each of the following items on the client's breakfast tray. Which item should be a cause for concern and should be removed from the tray?

Grapefruit juice

The nurse is preparing an intravenous infusion of phenytoin (Dilantin) as prescribed by the health care provider for the client with seizures. Which solution should the nurse plan to use to dilute this medication?

Normal saline solution

A nurse is speaking with a client taking phenytoin (Dilantin) for seizure control. The client states that she has started using birth control pills to prevent pregnancy. Which would be an important point for the nurse to emphasize to the client?

Phenytoin may decrease effectiveness of birth control pills, and additional measures should be taken to avoid pregnancy.

The nurse is preparing to ambulate a client with Parkinson's disease who has recently been started on methyldopa (levodopa). Before performing this activity with the client, the nurse should include which most important assessment in the client's plan of care?

Postural (orthostatic) vital signs

A nurse is assisting in the care of a client being discharged on phenytoin (Dilantin), 100 mg three times daily, for seizure control. When providing client teaching about this medication, the nurse should be sure to include which points? Select all that apply.

◦2. Use a soft toothbrush while taking this medication. ◦4. Alcohol should be avoided while taking this medication. ◦5. The medication may turn the client's urine pink, red, or brown.

The nurse is caring for a client receiving mannitol (Osmitrol) via intravenous (IV) infusion. A vial is sent from the pharmacy, and in preparing the medication the nurse notes that the vial contains crystals. What is the most appropriate nursing action?

2. Place the vial in warm water.

Dantrolene sodium (Dantrium) has been administered to a client with a spinal cord injury. The nurse determines that the client is experiencing an adverse effect of the medication if which is noted?

Abdominal pain

The nurse has the following prescription for a postcraniotomy client, "dexamethasone (Decadron) 4 mg by the intravenous (IV) route now." How does the nurse administer the medication?

IV push over 1 minute

A home care nurse visits a client at home. Clonazepam (Klonopin) has been prescribed for the client, and the nurse teaches the client about the medication. Which client statement indicates that further teaching is necessary?

If I experience slurred speech, this problem will disappear in about 8 weeks."