Saunders quiz one

2 to 3 weeks Signs and symptoms of Parkinson's disease usually begin to resolve within 2 to 3 weeks of starting therapy, although in some clients marked improvement may not be seen for up to 6 months. Clients need to understand this concept to aid in compliance with medication therapy. Options 1, 2, and 3 are incorrect because of the short time frames.

A client with Parkinson's disease has begun therapy with carbidopa/levodopa. The nurse determines that the client understands the action of the medication if the client verbalizes that results may not be apparent for which length of time?

"I'll take this medication early in the morning and just before I go to bed. Amantadine hydrochloride is an antiparkinson medication administered twice a day, but the last dose should not be administered near bedtime because it may cause insomnia in some clients. Options 1, 2, and 3 are correct statements for this medication.

Amantadine hydrochloride 100 mg orally twice daily has been prescribed for a client with Parkinson's disease, and the nurse teaches the client about the medication. Which statement by the client indicates a need for further teaching?

A temporary worsening of the condition An edrophonium injection makes the client experiencing cholinergic crisis temporarily worse. This is known as a negative test. An improvement of weakness would occur if the client were experiencing myasthenia gravis. Options 1 and 2 would not occur in either crisis.

The client with myasthenia gravis becomes increasingly weak. The primary health care provider (PHCP) prepares to identify whether the client is reacting to an overdose of the medication (cholinergic crisis) or increasing severity of the disease (myasthenic crisis). An injection of edrophonium is administered. Which change in condition indicates that the client is in cholinergic crisis?

"I will eat lots of foods high in vitamin B6." Foods high in vitamin B6 can counteract the effects of carbidopa/levodopa, so their intake should be limited. Options 2, 3, and 4 are accurate statements regarding this medication.

The nurse has reinforced instructions to a client with Parkinson's disease who is taking carbidopa/levodopa. Which statement by a client indicates the need for further teaching?

Parkinson's disease Entacapone is an antiparkinsonian agent used in conjunction with levodopa to improve the quality of life in clients with Parkinson's disease. It is not used to treat cardiovascular disorders.

A client is admitted to the hospital because of complaints of vomiting and abdominal pain. During data collection, the client tells the nurse that he is taking entacapone. Based on this finding, the nurse elicits information from the client regarding the presence of which condition?

Taking the medication with food will help prevent the nausea. If carbidopa/levodopa is causing nausea and vomiting, the nurse would tell the client that taking the medication with food may decrease the nausea. Additionally, the client should be instructed not to take the medication with a high-protein meal because the high protein will affect absorption. Antiemetics from the phenothiazine class should not be used because they block the therapeutic action of dopamine. Options 1, 3, and 4 are incorrect.

A primary health care provider initiates carbidopa/levodopa therapy for a client with Parkinson's disease. A few days after the client starts the medication, the client complains of nausea and vomiting. What would the nurse tell the client regarding how to avoid side effects when taking this combination medication?

Impaired voluntary movements 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.

Carbidopa-levodopa is prescribed for a client with Parkinson's disease, and the nurse monitors the client for adverse effects of the medication. Which sign/symptom indicates the client is experiencing an adverse effect?

Urine discoloration to dark yellow or orange Entacapone is an antiparkinsonian agent that is used in conjunction with levodopa to improve the quality of life in clients with Parkinson's disease. A frequent side effect is a urine discoloration to dark yellow or orange. Joint pains, muscle weakness and pruritus are not associated with the use of this medication.

Entacapone is prescribed for a client with a diagnosis of Parkinson's disease. The nurse reinforces medication instructions to the client and instructs on which frequent side effect?

Atropine sulfate The antidote for cholinergic crisis is atropine sulfate. Acetylcysteine is the antidote for acetaminophen. Vitamin K is the antidote for warfarin and protamine sulfate is the antidote for heparin.

The client with myasthenia gravis is receiving pyridostigmine. The nurse monitors for signs and symptoms of cholinergic crisis caused by overdose of the medication. The nurse checks the medication supply to ensure that which medication is available for administration if a cholinergic crisis occurs?

Deep sedation The Richmond Agitation-Sedation Scale (RASS) is a standardized tool that can be used to categorize sedation levels and assist the primary health care provider with titrating sedation medications. The RASS scale measures from unresponsive to combative. If the client displays no response to voice, no response to physical stimuli, and no eye-opening response, the response would be categorized as deep sedation.

The nurse is assessing a client who is sedated. The client displays no response to voice, no response to physical stimuli, and no eye-opening response. Under which sedation levels would the nurse categorize this response?

Inability to urinate Urinary retention is a side effect of benztropine mesylate. The nurse should instruct the client or spouse about the need to monitor for difficulty with urinating, a distended abdomen, infrequent voiding in small amounts, and overflow incontinence. Options 2, 3, and 4 are unrelated to the use of this medication.

The nurse is caring for a client diagnosed with Parkinson's disease who is prescribed benztropine mesylate daily. The nurse reinforces instructions to both the client and the spouse regarding the side effects of this medication and the need to report which side effect if it occurs?

An increase in muscle strength Edrophonium is a short-acting acetylcholinesterase inhibitor used as a diagnostic agent. When a client with suspected myasthenia gravis is given the medication intravenously, an increase in muscle strength would be seen in 1 to 3 minutes. If no response occurs, another dose is given over the next 2 minutes, and muscle strength is again tested. If no increase in muscle strength occurs with this higher dose, the muscle weakness is not caused by myasthenia gravis. Clients receiving injections of this medication commonly demonstrate a drop of blood pressure, feel faint and dizzy, and are flushed.

A client is suspected of having myasthenia gravis, and the primary health care provider administers edrophonium to determine the diagnosis. After administration of this medication, which sign/symptom would indicate the presence of myasthenia gravis?

urinary retention Trihexyphenidyl is an anticholinergic medication. Because of this, it can cause urinary hesitancy and retention, constipation, dry mouth, and decreased sweating as side effects.

A client is taking trihexyphenidyl for the treatment of Parkinson's disease. The nurse would monitor for which side effect of this medication?

Caffeine Caffeine is a stimulant and should be limited in the client taking a central nervous system (CNS) stimulant. The client should also be taught to limit caffeine intake as well.

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

A harmless side effect of the medication With carbidopa/levodopa therapy, a darkening of the urine or sweat may occur. The client should be reassured that this is a harmless effect of the medication, and its use should be continued. Options 1, 2, and 4 are incorrect interpretations.

A client receiving therapy with carbidopa/levodopa is upset and tells the nurse that his urine has turned a darker color since he began to take the medication. The client wants to discontinue its use. In formulating a response to the client's concerns, how does the nurse interpret this development?

Eat a snack before taking the medication. Levodopa is a dopaminergic medication used to treat Parkinson's disease. The nurse should remind the client that a snack should be eaten before taking the medication to prevent the nausea. The interventions in options 1, 3, and 4 will not manage the client's problem.

A client who recently began medication therapy with levodopa for Parkinson's disease complains of nausea. The nurse reminds the client to do which action to manage this problem?

Dry mouth Common GI side effects of benztropine therapy include constipation and dry mouth. Other GI side effects include nausea and ileus. These effects are the result of the anticholinergic properties of the medication.

A client with Parkinson's disease has been prescribed benztropine. The nurse monitors for which gastrointestinal (GI) side effect of this medication?

"I should take my medication after a full meal." Carbidopa/levodopa should be taken on an empty stomach with a full glass of water to enhance absorption. Because the medication can cause orthostatic hypotension, clients should be taught to change positions slowly. To ease the side effect of dry mouth, sugarless chewing gum, hard candy, and frequent mouth rinses are indicated. The side effect of sleep difficulty should be reported. In addition, the client is taught to avoid high-protein meals because it affects the effectiveness of the medication.

A client with Parkinson's disease is beginning treatment with carbidopa/levodopa. Which statement made by the client indicates the need for further teaching?

At least 6 hours before bedtime Rationale:A central nervous system (CNS) stimulant acts by releasing norepinephrine from nerve endings. The client should take the medication at least 6 hours before going to bed at night to prevent disturbances with sleep. Taking the medication at the time frames indicated in options 1, 2, and 3 will prevent the client from sleeping because of the stimulant properties of the medication.

A client with narcolepsy has been prescribed a central nervous system (CNS) stimulant. The client complains to the nurse that he cannot sleep well anymore 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 time schedule?

Urinary retention Monitor clients taking carbidopa/levodopa for orthostatic hypotension and urinary retention. Amantadine and pergolide may cause insomnia. Anticholinergics cause dry mouth and constipation.

The nurse is caring for a client who has been prescribed carbidopa/levodopa. The nurse would monitor the client for which side effects? Select all that apply.