Neurological System 2
Therapeutic use of venlafaxine
reduced depression
therapeutic use of risperidone
treats schizophrenia
a client is taking risperidone for schizophrenia. Recognizing the adverse effects of risperidone, you advise the client to watch for and report which of the following?
tremor
a nurse is caring for a client who is about to begin taking lithium carbonate to treat bipolar disorder. The nurse should instruct the client to monitor for which of the following finding as indications of lithium toxicity?
tremors confusion nausea muscle weakness
a nurse is caring for a client who has been taking alprazolam for an extended period of time to treat anxiety. The nurse should identify that abruptly stopping alprazolam therapy can result in which of the following adverse effects?
withdrawal symptoms physical dependence can develop with extended use of alprazolam, and benzodiazepine. to prevent withdrawal symptoms, clients should tape the dose slowly over several weeks.
a nurse is providing teaching to a client who has a prescription for buspirone to treat anxiety. Which of the following instructions should the nurse include?
"Take a missed dose as soon as you remember" buspirone should be taken on a regular scheduled basis to be therapeutic if a client misses a dose, then they should take one as soon as they remember, as long as it is not close to time for the next scheduled dose.
a nurse is providing teaching to a client who has a new prescription for fluoxetine. Which of the following instructions should the nurse include?
"if you have persistent headaches, let the provider know." the client should report persistent headache, anxiety or, insomnia to the provider as an adverse drug reaction.
a nurse is caring for a client who has a prescription for alprazolam. for which of the following adverse effects should the nurse monitor?
-tolerance tolerance and dependence can develop with benzodiazepines, such as alprazolam. clients should use these drugs only as needed and for short periods of time. -anxiety paradoxical reactions, such as anxiety and insomnia, can develop when taking alprazolam, especially in older adults. should report. -sedation CNS depression -respiratory depression CNS depression
a nurse should identify that timolol is contraindicated for a client who has which of the following disorders?
Asthma timolol, a beta-adrenergic antagonist, can cause bronchospasm and difficulty breathing. clients who have asthma or any disorder that compromises respiratory function should not use the drug.
Which of the following drugs, used to treat open-angle glaucoma, should primary care providers use with caution for a client who is taking propranolol
Betaxolol can cause bradycardia and hypotension
A nurse is caring for a client who has schizoaffective disorder and who has been prescribed chlorpromazine IV. Which of the following client findings should the nurse monitor after administering the medication?
Blood pressure clients who receive chlorpromazine are at risk for hypotension during and immediately after IV administration. the client should remain supine for 30 minutes while the nurse monitors their blood pressure. the nurse should instruct the client to change positions slowly as a safety precaution to prevent client injury. this medication can also cause orthostatic hypotension.
a nurse is reviewing the drug history of a client who is taking lithium carbonate for bipolar disorder. Which of the following finding should indicate to the nurse to monitor for lithium toxicity?
Furosemide for hypertension furosemide, a high-ceiling loop diuretic, increases sodium loss and can cause lithium reabsorption. the nurse should evaluate the client for lithium toxicity.
a nurse is caring for a client who is taking venlafaxine to treat major depressive disorder. the nurse should identify that which of the following drugs can cause serotonin syndrome when taken concurrently with venlafaxine?
Phenelzine clients should not take venlafaxine, a serotonin norepinephrine reuptake inhibitor, within 14 days of taking phenelzine, other MAOI's or serotonergic drugs. Serotonin syndrome is a life-threatening complication characterized by anxiety, confusion, hallucinations, and fever.
A nurse is providing teaching to a client who has a prescription for chlorpromazine. Which of the following instructions should the nurse include?
Wear sunscreen when exposed to sunlight. chlorpromazine, a conventional antipsychotic, can cause photosensitivity, or increased susceptibility to sunburn, when exposed to sunlight. clients should limit their exposure to sunlight and wear sunscreen and protective clothing while outdoors.
a nurse is caring for a client who recently began taking chloroprozamine to treat schizophrenia and who was admitted to the emergency room w/ spasms of their face & back. which of the following adverse reactions should the nurse suspect?
acute dystonia acute dystonia can develop during the first few days of tx with chlorpromazine. manifestations include muscle spasms of the back and neck, face, and tongue. tx includes immediate administration of an anticholinergic drug such as diphedydramine (benadryl).
you are instructing a client about taking phenelzine to treat depression. Which of the following foods should you tell the client to avoid?
aged cheese Tyramine-enriched foods may trigger severe hypertension (hypertensive crisis) in clients manifestations are hypertension, headache, and nausea.
a nurse is providing teaching to a client who has a prescription for buspirone. Which of the following instructions should the nurse include?
allow 2-4 weeks for full therapeutic effects it can take up to 4 weeks to feel the drug's full therapeutic effects
the client returns to the primary care provider after 1 week. He is sweating and reports urinary urgency. He suspects systemic effects from the pilocarpine. Which of the following drugs can reverse systemic toxicity from pilocarpine?
atropine sulfate
a nurse is caring for a client who has a prescription for fluoxetine and who reports self-administrating St. John's wort daily for the past 2 weeks. Which of the following findings should the nurse report to the provider as an indication of serotonin syndrome?
hallucinations hallucinations are an expected finding of serotonin syndrome. SSRI's are contraindicated with st. John's wort because the combination can increase the risk of developing serotonin syndrome.
a nurse is providing teaching to a client who has a new prescription for diazepam for anxiety disorders. which of the following client statements indicates an understanding of the teaching?
if i become pregnant, it is important to let my healthcare provider know diazepam can increase the risk of congenital malformations and is contraindicated for clients who are pregnant.
the nurse should include that orthostatic hypotension is a common adverse reaction of which of the following drugs?
imipramine imipramine, tricyclic antidepressant, can result in orthostatic (postural) hypotension. clients who take this drug should change positions slowly from sitting or lying to standing.
a nurse is caring for a client who is taking lithium carbonate to treat bipolar disorder. Which of the following diagnostic tests should the nurse recommend to the client undergo periodically?
thyroid function tests hypothyroidism is an adverse effect of lithium carbonate. clients should report neck enlargement, weight gain, lethargy, and constipation. they should also have their thyroid function checked before they begin taking lithium and annually thereafter.
a nurse is assessing a client who has been taking alprazolam for several days. which of the following findings should the nurse identify as an adverse drug reaction caused by alprazolam?
anxiety the client can experience a paradoxical effect when taking benzodizepines or buspirone, indicated by increased anxiety rather than relief of anxiety. the nurse should report this to the provider, who might consider a different medication.
a nurse is providing teaching to a client about instilling pilocarpine for managing open-angle glaucoma. Which of the following instructions should the nurse include in the teaching?
apply gentle pressure to the nasolacrimal duct for 1 min after do not touch the tip of the dropper remove contact lenses prior to instilling the drops
the primary care provider prescribes pilocarpine for the client. Which of the following information should he include when instructing the client about instilling pilocarpine eye drops?
apply gentle pressure to the nasolacrimal duct for 1 minute after instillation do not touch the tip of the dropper remove contact lenses prior to instilling the drops
a nurse is providing teaching to a client who has a prescription for lithium carbonate about reducing he risk of lithium toxicity. Which of the following instructions should the nurse include?
avoid taking NSAIDs NSAIDs increase renal absorption of lithium and sodium. aka don't take nsaids
Which of the following drug classifications is the first line of therapy for treating open-angle glaucoma?
betablockers reduce the production of aqueous humor, reducing ophthalmic pressure
which of the following drugs blocks beta-adrenergic receptors and thereby decreases intraocular pressure by reducing the amount of aqueous humor produced?
betaxolol
therapeutic use of lithium carbonate
controls manic episodes
when instructing a client about taking buspirone, you tell the client to watch for and report a paradoxical reaction to buspirone. Which of the following is a paradoxical effect of buspirone?
insomnia
early clinical manifestations of lithium toxicity include which of the following?
nausea, muscle weakness
during an assessment of a client taking chlorpromazine, you note a slow shuffling gait, rigid facial expression, and fine tremors. These manifestations indicate which of the following?
parkinsonism
therapeutic use of betaxolol
reduces intraocular pressure
a nurse is reviewing the medical history of a client who has a new prescription for a reduced dosage of alprazolam for anxiety. Which of the following findings should indicate to the nurse the reason for the prescription modification
renal function impairment alprazolam dosage should be decreased for clients who have renal or hepatic impairment.
A nurse is caring for a client who was admitted to the ED with a head injury. The nurse notes that the client has an existing prescription for bupropion hydrochloride to treat depression. For which of the following adverse effects is the client at increased risk?
seizure activity bupropion, an atypical antidepressant, can cause seizure activity when clients take high doses or have a seizure disorder, a CNS tumor, or history of head trauma.
a nurse is providing teaching to a client who is about to begin amitriptyline therapy to treat major depressive disorder. Which of the following instruction should the nurse include?
-change positions slowly from sitting or lying to standing amitriptyline, a tricyclic antidepressant can cause orthostatic hypotension. Clients should move slowly from sitting or lying to standing. -do not stop taking the drug abruptly relapse and withdrawal symptoms can occur with abrupt discontinuation of amitriptyline. when discontinuing the drug, it is important to reduce the dosage over a 2-week period to prevent or minimize withdrawal symptoms. -take the drug at bedtime to prevent daytime drowsiness can cause drowisness. take at bedtime and avoid activites that require alretness until they know how the drug will affect them -increase fiber and fluid intake causes anticholinergic effects, such as dry mouth, constipation, and urinary retention. clients should increase fiber and fluid intake during drug therapy and urinate before taking the drug.
When reviewing the indications for various antidepressants, a nurse should always identify that bupropion hydrochloride is an appropriate choice for clients who have which of the following?
-seasonal affective disorder -nicotine addiction -depression a typical antidepressant: can cause insomnia and agitation. it does not prevent or treat insomnia or treat motion sickness.
the primary care provider continues to instruct the client about using pilocarpine. He tells the client to watch for and report which of the following adverse effects of this drug?
blurred vision, headache, visual floaters
a client is to start taking amitriptyline. For which of the following should you instruct the client to watch for and report?
blurred vision, urinary hesitancy, tachycardia
a nurse is providing teaching for a client who has a new prescription for betaxolol eye drops. Which of the following adverse effects should the nurse include in the teaching?
bradycardia betaxolol and timolol can cause bradycardia because of the blockade of cardiac beta 1 receptors. clients should check their pulse rate regularly and report any sustained decreases.
a client is taking venlafaxine to treat major depression. Which of the following instruction should you include when advising the client and family about the use of venlafaxine?
take it with food monitor and report insomnia have blood pressure checked regularly check with primary care provider before taking any herbal supplements
