Levodopa Pharm NCLEX QS

The nurse cares for a patient receiving pramipexole (Mirapex) (dopamine agonist). The nurse is most concerned if the patient makes which statement? A "I now use a patch instead of taking birth control pills." B. "Sometimes I just fall asleep without warning." may cause day time sleep attacks C."The pills make me sleepy, so I take a nap in the afternoon." D."I have noticed that this medicine makes me constipated."

B. "Sometimes I just fall asleep without warning." may cause day time sleep attacks Day time sleep attacks are an adverse effect

Dietary instructions for a PT taking Levodopa/Carbidopa A. Eat large amounts of protein-rich foods B. May take the medication with whole-grain cereal C. Consider eating a banana D. May take the med crushed in grapefruit juice

D. May take the med crushed in grapefruit juice You can take this drug with ANY type of juice

Carbidopa-levodopa (Sinemet) is prescribed for a client with Parkinson's disease, and the nurse monitors the client for adverse reactions to the medication. Which of the following indicates that the client is experiencing an adverse reaction? 1. Pruritus 2. Tachycardia 3. Hypertension 4. Impaired voluntary movements

4. Impaired voluntary movements Rationale: Dyskinesia and impaired voluntary movement may occur with high levodopa dosages. Nausea, anorexia, dizziness, orthostatic hypotension, bradycardia, and akinesia (the temporary muscle weakness that lasts 1 minute to 1 hour, also known as the "on-off phenomenon") are frequent side effects of the medication.

When teaching a patient about carbidopa-levodopa (Sinemet), the nurse responds based on knowledge that A) carbidopa decreases levodopa's conversion in the periphery, increasing the levodopa available to cross the blood-brain barrier. B) carbidopa increases levodopa's conversion in the periphery, enhancing the amount of dopamine available to the brain. C) giving both drugs together minimizes side effects. D) carbidopa crosses the blood-brain barrier to increase the metabolism of levodopa to dopamine in the brain

A) carbidopa decreases levodopa's conversion in the periphery, increasing the levodopa available to cross the blood-brain barrier.

The patient asks the nurse to explain the difference between carbidopa-levodopa (Sinemet) and ropinirole (Requip). The nurse's response is based on knowledge that A) ropinirole is a dopamine agonist that has fewer side effects than carbidopa-levodopa. B) carbidopa-levodopa is less effective than ropinirole in treating the symptoms of Parkinson's disease. C) both drugs have the same pharmacodynamic and side effect profiles. D) carbidopa-levodopa acts as a dopamine agonist, whereas ropinirole directly replaces dopamine.

A) ropinirole is a dopamine agonist that has fewer side effects than carbidopa-levodopa.

Which comment to the nurse indicates more teaching is needed for a client taking carbidopa/levodopa?

Answer: "I know I need to take this drug once a day." Rationale: A statement from the client such as "I know I need to take this drug once a day" indicates that more teaching is needed because carbidopa/levodopa has a short half-life and must be taken 3 or 4 times per day. The other answers are true.

Which side effect/adverse effect of carbidopa/levodopa does the nurse realize is most important to monitor? A. Agranulocytosis B.Dysphagia C. Increased Libido D. Urinary Retention

Answer: Agranulocytosis Rationale: It is most important for the nurse to monitor the client taking carbidopa/ levodopa for agranulocytosis (decreased white blood cells), which is life-threatening. Dysphagia, increased libido, and urinary retention are not life threatening.

The patient with Parkinson's disease who has been positively responding to carbidopa-levodopa (Sinemet) suddenly develops a relapse of symptoms. Which explanation by the nurse is appropriate? A) "You have obviously developed resistance to your current medication and will have to be switched to another drug." B) "This is an atypical response. Unfortunately, there are no other options of drug therapy to give you." C) "This is called the 'on-off phenomenon.' Your health care provider can change your medication regimen slightly to help diminish this effect." D) "You just need to keep taking your medication and these effects will go away."

C) "This is called the 'on-off phenomenon.' Your health care provider can change your medication regimen slightly to help diminish this effect."

What is the goal of pharmacologic therapy in treating Parkinson's disease? A) Increase the amount of acetylcholine at the presynaptic neurons. B) Decrease the amount of dopamine available in the substantia nigra. C) Balance cholinergic and dopaminergic activity in the brain. D) Block dopamine receptors in both presynaptic and postsynaptic neurons

C) Balance cholinergic and dopaminergic activity in the brain.

The nurse is caring for a patient with Parkinson's disease. The patient has been taking entacapone (Comtan) for the past week to treat an on-off phenomenon. The patient expresses concern over brownish-orange urine. The nurse's response is based on the knowledge that A) the patient may be developing renal failure. B) the patient may be developing hepatic failure. C) brownish-orange urine signifies a lack of fluid intake. D) this is a normal occurrence related to entacapone (Comtan).

D) this is a normal occurrence related to entacapone (Comtan).

A patient is prescribed a dopamine agonist, pramipexole (Mirapex). Which statement made by the patient indicates a need for further teaching? A. "The drug should be taken with food to prevent nausea." B. "I may experience hallucinations while taking this drug." C. "I should rise slowly to prevent dizziness and fainting." D. "This drug will stop the progression of Parkinson's disease."

D. "This drug will stop the progression of Parkinson's disease." No it won't. D is the correct answer

What would the nurse teach a patient who is taking anticholinergic therapy for parkinsonism? (Select all that apply.) a. Avoid alcohol, cigarettes, and caffeine. b. Relieve dry mouth with hard candy or ice chips. c. Use sunglasses to reduce photophobia. d. Urinate 2 hours after taking the drug. e. Receive routine eye examinations.

a. Avoid alcohol, cigarettes, and caffeine. b. Relieve dry mouth with hard candy or ice chips. c. Use sunglasses to reduce photophobia. e. Receive routine eye examinations.

Which is a nursing intervention for a patient taking carbidopa-levodopa for parkinsonism? a. Encourage the patient to adhere to a high-protein diet. b. Inform the patient that perspiration may be dark and stain clothing. c. Advise the patient that glucose levels should be checked with urine testing. d. Warn the patient that it may take 4 to 5 days before symptoms are controlled.

b. Inform the patient that perspiration may be dark and stain clothing.

A patient is receiving carbidopa-levodopa for parkinsonism. What should the nurse know about this drug? a. Carbidopa-levodopa may lead to hypertension. b. Carbidopa-levodopa may lead to excessive salivation. c. Dopaminergic and anticholinergic therapy may lead to drowsiness and sedation. d. Dopaminergics and anticholinergics are contraindicated in patients with glaucoma.

d. Dopaminergics and anticholinergics are contraindicated in patients with glaucoma.