Nursing Application: Antiparkinson Drugs
Which statement(s) by the client indicate further education regarding their antiparkinson medication is needed? Select all that apply.
*"If I forget a dose of medication, I will take it as soon as I remember." *"I can drink alcohol as long as it is no more than 1 time per week."
A client is prescribed benztropine, an anticholinergic. Which teaching point(s) should the nurse include when providing client education? Select all that apply.
*Anticholinergics block the effect of acetylcholine. *Anticholinergics can cause dry mouth, urinary retention, and constipation. *It may take up to several weeks for the client to have an improvement in tremors.
Which of the client's prescribed medications is used to treat dyskinesia related to their medication therapy for Parkinson's disease?
Amantadine
The nurse is caring for a client with Parkinson's disease who is prescribed tolcapone. Which assessment finding is most concerning?
Client has yellowing of eyes and skin
The nurse is reviewing the medication history of a client diagnosed with Parkinson's disease who is prescribed selegiline. Which other medication prescription on the client's medication list is the most concerning to the nurse?
Meperidine
Bill started taking selegiline for Parkinson's disease. What should be included in the discharge directions about this medication?
Take with food to decrease GI upset
The client is taking carbidopa-levodopa for Parkinson's disease. The nurse just reviewed the discharge instructions with the client and family. Which statement by the client indicates more teaching is needed?
"I can stop taking the medicine once the tremors stop."
Which statement by the client regarding a prescription of controlled-release carbidopa-levodopa requires further education by the nurse?
"Sometimes I have trouble swallowing the pill, so I crush it and put it in applesauce."
Bill is preparing to attend a holiday party with his family. The nurse realizes that since Bill is taking carbidopa-levodopa and selegiline there may be a need for education regarding the consumption of which of the following: (Select all that apply.)
*Sourdough bread *Smoked cheese *Smoked meat *Smoked fish
1. Entacapone is taken with levodopa and begins its effect with the first dose. It benefits patients who experience the wearing-off effect of levodopa and facilitates a lower dose of levodopa being used. 2. Benztropine mesylate is indicated as adjunct pharmacotherapy to manage debilitating motor effects (cogwheel rigidity, muscle tremors, pill-rolling movements, and bobbing of the head) of Parkinson's disease. 3. Amantadine is indicated for the early stages of Parkinson's disease and is usually only effective for 6 to 12 months, after which it becomes ineffective in relieving hypokinesia and rigidity. 4. Carbidopa-levodopa has side effects, such as nausea, vomiting, dyskinesia, orthostatic hypotension, cardiac dysrhythmias, and psychosis. 5. Bromocriptine nondopamine works by direct stimulation of presynaptic and/or postsynaptic dopamine receptors in the brain. 6. Ropinirole's drug action increases dopamine presynaptic receptors in the brain. It is indicated for early and late state Parkinson's disease. 7. Selegiline is used in combination with levodopa to reduce the dosage needed for symptom control. Adverse effects appear with doses greater than 10 mg.
1. COMT inhibitor 2. Anticholinergic 3. Dopamine modulator 4. Dopamine replacement 5. Dopamine receptor agonist 6. Nondopamine dopamine receptor agonist 7. MAO-B inhibitor
Selegiline is given to 1._____________ the needed dose of levodopa.
1. Decrease
During the start of antiparkinson medications therapy, the patient will most likely need assistance with 1._____________.
1. Walking
What should be included as discharge instructions for the client who received a new prescription for selegiline?
Notify your healthcare provider if you have a severe headache.
What is the goal of drug therapy in treating Parkinson's disease?
Slow the progression of the disease
The client is receiving discharge instructions on carbidopa-levodopa. When should the nurse tell the family to notify the healthcare provider immediately?
Weight gain of 2 lbs in 24 hours
What is the wearing off phenomenon related to Parkinson's disease?
When Parkinson's disease medications are at maximum doses and the drug loses its effectiveness
