Chapter 42 EAQ

What medications should the nurse assess for after a patient has developed a rebound headache?

Eletriptan, sumatriptan, isometheptene, and ergotamine with caffeine can all cause rebound headaches in patients that have taken these medications for a migraine.

A patient has chorea, poor balance, explosive speech, and dysphagia. Altered mental status such as poor judgment, and memory loss with dementia was also reported. The nurse instructs the patient's family to report early signs of depression in the patient after the drug administration. Which drug is prescribed for the patient?

Tetrabenazine

The primary health care provider prescribes tetrabenazine for the treatment of Huntington's disease (HD). Which side effect of the drug is most important for the patient and family to be aware of before beginning the medication?

Tetrabenazine is prescribed to decrease chorea associated with HD. In some patients, it may increase the risk for suicidal ideation and depression.

What conditions should the nurse evaluate in a patient whose magnetic resonance imaging (MRI) result shows reduced brain weight and atrophy of the cerebral cortex?

Sense of smell Family history Memory Reduced brain weight, atrophy of the cerebral cortex, and loss of cortical neurons are the clinical manifestations of Alzheimer's disease (AD). Therefore, the patient should be assessed for other clinical conditions in order to confirm AD. The patient should be evaluated about changes in memory or increasing forgetfulness. There is increasing evidence that an altered sense of smell is associated with the development of AD. The patient's family history of AD or Down's syndrome should be evaluated because AD may be a genetic disorder.

A patient with severe symptoms of Parkinson disease is prescribed sinemet. Which instruction does the nurse include while teaching the patient's family about the drug administration?

Sinemet may be the initial drug of choice for the patient with severe symptoms of Parkinson disease. The patient who is prescribed sinemet must take the drug before meals to increase absorption and transport across the blood-brain barrier.

Which statements by a student nurse regarding the drugs used to treat Parkinson's disease indicate effective learning?

"Entacapone should not be taken with cheese and red wine." "Apomorphine causes orthostatic hypotension and drowsiness." "Benztropine should be avoided in older patients." Anticholinergic drugs such as benztropine should be avoided in older patients because they can cause side effects such as acute confusion, urinary retention, constipation, dry mouth, and blurred vision. Monamine oxidase type B (MAO-B ) inhibitors (MAOIs) such as entacapone and rasagiline mesylate should not be taken with food and beverages that contain tyramine to prevent severe headache and life-threatening hypertension. Dopamine agonists such as apomorphine and pramipexole are associated with adverse effects such as orthostatic (postural) hypotension, hallucinations, and sleeplessness. Sinemet should be given before meals to increase absorption and transport across the blood-brain barrier. Apomorphine should not be taken with cheese and red wine to avoid severe headaches and life-threatening hypertension.

The nurse questions an order for a triptan preparation for migraine management when it is ordered for which patient?

50-year-old with a history of transient ischemic attacks Triptans are contraindicated in patients with actual or suspected ischemic heart disease, cerebrovascular ischemia, hypertension, or peripheral vascular disease.

What signs and symptoms are indicative of an absence seizure?

An absence seizure is characterized by brief episodes of loss of consciousness or blank staring, as if the person is daydreaming. It may be accompanied by involuntary movements, such as lip smacking and picking at clothes, of which the patient is unaware.

A patient with Alzheimer's disease is independent in activities of daily living (ADLs), has no social or employment problems, forgets names and misplaces items, and suffers short-term memory loss. The nurse documents that the patient is in which stage of the disease?

Characteristics of stage I Alzheimer's disease stage include independence in ADLs, having no social problems, denying symptoms, and experiencing short-term memory loss.

Which food is commonly thought to be a trigger for causing migraine headaches?

Chocolate contains tyramine, which may trigger migraine attacks.

patient with a history of epilepsy has been taking an antiepileptic drug (AED) for several years. The patient's admission lab work reveals elevated levels of the drug, even though the patient reports taking the prescribed amount. The patient takes no other medications. Which action by the nurse is correct?

Citrus fruits, especially grapefruit, can interfere with the metabolism of AEDs, leading to increased serum drug levels. The initial action should be to perform a dietary history.

A patient who has a blood pressure of 158/98 mm Hg and a history of chest pain is hospitalized with a migraine headache. Which drug should not be included in the primary health care provider's drug therapy?

Frovatriptan is a triptan preparation that relieves migraine headache and its symptoms. It acts by having a vasoconstrictive effect on the cranial arteries, the basilar artery, and the blood vessels of the dura mater. Frovatriptan is contraindicated for patients with hypertension and Prinzmetal's angina as it may cause coronary vasospasm.

Which characteristic accurately describes the occurrence of status epilepticus?

Status epilepticus is a medical emergency and is a prolonged seizure lasting longer than 5 minutes or repeated seizures over the course of 30 minutes. Status epilepticus seizures are not preceded by an aura; this type of seizure is manifested by bilateral symptoms. The patient will remain unconscious during this type of seizure.

Which clinical manifestation should the nurse assess for in a patient in the prodrome phase of migraine headache?

The manifestation of food craving appears in the prodrome phase of migraine headache.

Which clinical findings helped the nurse conclude that a patient is in the moderate stage of Parkinson's disease (PD)?

The moderate stage of PD is characterized by manifestations such as postural instability and increased gait disturbances.

A patient is hospitalized for a seizure lasting 4 minutes. It began with arm muscles stiffening and immediate loss of consciousness, followed by rhythmic jerking of all extremities. The patient subsequently developed tongue biting and urinary incontinence. Which prescribed medication requires the patient to undergo periodic liver enzyme testing?

The symptoms signify that the patient may have sustained an epileptic tonic-clonic seizure. Divalproex will help control seizure activity, but it increases the liver enzymes. Therefore, liver enzyme testing is performed for patients taking divalproex medication.

The primary health care provider performed vagal nerve stimulation for a patient with partial seizures. Which complications should the nurse anticipate in the patient?

Vagal nerve stimulation is performed by stimulating the vagus nerve with electric impulses to treat simple, complex, or partial seizures. Dyspnea (shortness of breath), neck pain, and dysphagia (difficulty in swallowing) are common complications of vagal nerve stimulation.