Chapter 14

The nurse is assessing an older patient with Parkinsons disease who was started on entacapone 1 week ago. The patient has a history of coronary artery disease and takes an antihypertensive and aspirin. Which information would support the need for a reduction in medication dosage by the health care provider?

Dizziness

The nurse is providing education to a patient recently placed on selegiline disintegrating tablets. Which statement by the patient indicates a need for further teaching?

I will place the tablet on my tongue before breakfast.

What point(s) should be included when teaching a patient about the use of apomorphine for treatment of Parkinsons disease? (Select all that apply.)

Apomorphine does not have any opioid activity. A multidose injector pen is commonly used to administer apomorphine. You may experience nausea and vomiting, which can be treated with trimethobenzamide (Tigan). You may experience sleep attacks or episodes of daytime sleepiness.

Dopamine agonists have been linked with which adverse effects in patients with Parkinsons disease?

Sudden sleep events

Which vitamin will reduce the therapeutic effects of levodopa?

B6

Parkinsons disease has which characteristic symptom(s)? (Select all that apply.)

Muscle tremors Posture alterations Slow body movement

The nurse is teaching a patient with Parkinsons disease about levodopa. Which statement by the nurse is accurate regarding drug administration?

Take this medication with food or antacids to reduce GI upset.

Which cholinergic symptoms of Parkinsons disease are reduced with anticholinergic drugs?

Tremors and drooling

The nurse is preparing to begin administration of apomorphine to a patient. Before administering, the nurse will perform a baseline assessment of the patients: (Select all that apply.)

mobility. orientation alertness. vital signs.

When a patient taking a monoamine oxidase B inhibitor receives his dietary tray, the nurse knows to remove the:

cheese.

A patient taking rasagiline is assessed by the nurse to have a lasting significant increase in blood pressure. When reviewing the patients current list of medications, the nurse decides to hold the next dose of:

ciprofloxacin.

Which adverse effects associated with levodopa therapy would support the nursing diagnosis Risk for injury?

Orthostatic hypotension

What is the rationale for administering levodopa instead of dopamine for treatment of Parkinsons disease?

Dopamine does not cross the bloodbrain barrier when administered orally.

What is the pharmacologic action of entacapone, a potent catechol O methyl transferase (COMT) inhibitor?

Reduces the destruction of dopamine in peripheral tissues

The nurse is providing information to a patient recently prescribed entacapone. Which statement is correct?

Dosage is adjusted according to the patients response.