pharmacology neurologic system II

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 instilling the drops -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 is about to begin amitriptyline therapy to treat major depressive disorder. which of the following instructions should the nurse include?

-change positions slowly from sitting or lying to standing -do not stop taking the drug abruptly (relapse and w/drawl can occur with abrupt discontinuation. should be tapered off) -take the drug at bedtime to prevent daytime drowsiness -increase fiber and fluid intake (causes anticholingernic effects such as dry mouth, constipation, and urinary retention)

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 findings as indications of lithium toxicity?

-confusion -tremors -nausea -muscle weakness

when reviewing the indications for various antidepressants, a nurse should identify that bupropion hydrochloride is an appropriate choice for clients who have which of the following?

-seasonal effective disorder -nicotine addiction -depression

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 -anxiety -sedation -respiratory depression

a nurse is caring for a client who recently began taking chlorpromazine to treat schizophrenia and who was admitted to the emergency room with spasms of their face and back. which of the following adverse reactions should the nurse suspect?

acute dystonia -acute dystonia can develop during the first few days of treatment with chlorpromazine. manifestations include muscle spasms of the back, neck, face, and tongue. treatment include immediate administration of an anticholinergic drug, such as diphenhydramine.

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 to 4 weeks for a client to feel the drug's full therapeutic effects.

a nurse is reviewing the medical history of a client who has a new prescription for a reduced dosage 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 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 benzodiazepines 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 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 or difficulty breathing. clients who have asthma or any disorder that compromises respiratory function should not use the drug.

a nurse is providing teaching to a client who has a prescription for lithium carbonate about reducing the risk for lithium toxicity. which of the following instructions should the nurse include?

avoid taking NSAIDS -NSAIDs increase renal absorption of lithium and sodium. clients who take lithium should not take NSAIDs.

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 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 cardia beta 1 receptors. clients should check their pulse rate regularly and report any sustained decrease.

a nurse is reviewing the drug history of a client who is taking lithium carbonate for bipolar disorder. which of the following findings 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 has a prescription for fluoxetine and who reports self administering 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 -expected finding of serotonin syndrome. SSRIs are contraindicated with St. John's wort because the combination can increase the risk of developing serotonin syndrome

a nurse is providing teaching for a client who has a prescription for phenelzine. the nurse should instruct the client to avoid tyramine-enriched foods because of an increased risk for which of the following adverse reactions?

hypertensive crisis -tyramine-enriched foods, such as aged cheese and processed meat, can trigger sever hypertension in clients who are taking phenelzine. manifestations include hypertension, headache, and nausea.

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 health care provider know. -diazepam can increase the risk of congenital malformations and is contraindicated for clients who are pregnant.

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 providing teaching to a client about the adverse effects of drug therapy. the nurse should include that orthostatic hypotension is a common adverse reaction of which of the following drugs?

imipramine -imipramine, a tricyclic antidepressant, can result in orthostatic 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 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 MAOIs, or serotonergic drugs. serotonin syndrome is a life threatening complication characterized by anxiety, confusion, hallucinations, and fever.

a nurse is caring for a client who was admitted to the emergency department 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 a history of head trauma.

a nurse is providing teaching to a client who has a prescription for bus-irons to treat anxiety. which of the following instruction 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. should be taken as long as it is not too close to next dose.

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 that 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 in also have their thyroid function checked before they begin taking lithium and annually thereafter.

a nurse is providing teaching to a client who has a prescription for chlorpromazine. which of the following instruction 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 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, a benzodiazepine. to prevent withdrawal symptoms, clients should taper the dose slowly over several weeks.