Test4

A HCP prescribes selegiline 5 mg twice a day for a client with a diagnosis of PD. What is the most important for the nurse to teach the client?

ensure than an opioid is not taken currently results in a fatal reaction (excitation, rigidity, HTN, hypotension, coma)

Bupropion has a unique side effect not shared by most other drugs of its class. The nurse will assess the client for which unique possible side effects of this drug?

generalized seizures bupropion inhibits the reuptake of dopamine, serotonin, and norepinephrine and may cause seizures that can be life-threatening; also, it may cause HA, agitation, sedation, tremors, and confusion.

A client with osteoporosis is prescribed raloxifene. what should the nurse monitor in the client?

monitor liver function tests increases the risk for hepatic disease. Therefore the liver function test is monitored in a client who is prescribed this drug.

A client is admitted to the hospital with a diagnosis of PD. Which common signs of PD does the nurse expect to identify when completing a nursing admission H&P? Select all that apply

muscle rigidity, blank facial expression

A client is assessing a client with MS. Which common initial clinical effects should the nurse expect to find?

nystagmus, scanning speech, intention tremors

What should the nurse include when teaching a client with severe Parkinson's Disease about carbidopa-levodopa?

the medication can be taken with meals taken with meals to reduce the nausea and vomiting commonly associated with this drug

A client with the diagnosis of MS develops hand tremors. When performing a H&P assessment, which finding should the nurse expect the client to report?

the tremors increase when I perform an activity

Which nursing interventions would help to ensure the safe adminstration of antiepileptics to children? Select all that apply

avoid carbonated bevs while taking valproic acid, use a graduated device to deliver an oral dose, encourage the wearing of a medical alert bracelet, maintain a record of symptoms of seizures before during and after treatment with anti-epileptics carbonated bevs cause gastric irritation. graduated device should be used for accurate measurement of liquids.

Which ethnic group has a greater incidence of osteoporosis due to musculoskeletal differences?

chinese americans because they are shorter and smaller bones with lower bone density

Carbidopa-levodopa is prescribed for a client with PD. The nurse monitors the client for which side effects of the medication?

vomiting, anorexia, changes in mood N/V may occur; it reflects a central emetic reaction to levodopa. Anorexia may occur; decreased appetite results because of N/V. Changes in affect, mood, and behavior are related to toxic effects of the drug. Tachycardia and palpitations may occur.

A client develops a seizure disorder as a result of a traumatic fall. When the client returns to the clinic for a routine visit, the client states, "I have not had a seizure in 2 years. When can I stop taking my anti-seizure medications?" What is the nurse's best response?

A gradual reduction in seizure medication may be considered Meds must be withdrawn slowly to prevent an abrupt reduction in serum drug levels, which may precipitate a seizure.

The primary HCP prescribed meds to four clients with osteoporosis. Which client is instructed to remain upright for 30 minutes after medication administration?

Aldendronate may cause esophageal ulcers. therefore the nurse instructs a patient taking this to remain upright for 30 minutes after medication adminstration to avoid ulcers.

A client is diagnosed with PD and asks the nurse what causes the disease. On which underlying pathology does the nurse base a response?

Degeneration of the neurons of the basal ganglia PD involves destruction of the neurons of the substantia nigra, reducing dopamine.

The medical history of a client with osteoporosis indicates renal calculi. Which medication would be contraindicated?

Os-cal calcium supplement should not be prescribed to a client with osteoporosis with a history of urinary stones.

The primary HCP prescribed zoledronic acid to a client with osteoporosis. Before admin, the nurse instructs the client to have a dental exam. What is the rational for this nursing intervention?

To prevent maxillary osteonecrosis zoledronic acid is a biphosphonate used to treat osteoporosis that can cause maxillary osteonecrosis. The client should have a dental exam before starting the drug therapy to prevent maxillary osteonecrosis.

A client has a diagnosis of MS and is currently in remission. The client is a parent of two active preschoolers. What should the nurse encourage the client to do?

develop a flexible schedule for completion of routine daily activities activity should cease before the point of fatigue. Although quality time with children is important, it must be done on a flexible schedule to prevent fatigue.

Which term refers to the exaggeration of the posterior curvature of the thoracic spine?

kyphosis

Which term should the nurse use to describe bone less greater then normal but less than that caused by osteoporosis?

osteopenia

Phenytoin 75 mg twice daily is prescribed for a school-aged child with a seizure disorder. What instruction will the nurse include when teaching the parents about activities to limit the consequences of long-term phenytoin therapy?

provide oral hygiene, including gum massage and flossing of the teeth these procedures reduce the risk for gingival hyperplasia, a side effect of phenytoin.

Which estrogen antagonist is specifically used to prevent and treat osteoporosis in postmenopausal women?

raloxifene used to prevent and treat osteoporosis in postmenopausal women by increasing bone mineral density, reducing bone desorption, and reducing incidences of osteoporotic vertebral fractures. Denosumab is a monoclonal antibody used to treat osteoporosis when other drugs are not effective. Alendronate and zoledronic acid are commonly used for the prevention and treatment of osteoporosis

A client with a history of seizures is admitted with a partial occlusion of the left common carotid artery. The client has been taking phenytoin for 10 years. When planning care for this client, what should the nurse do first?

obtain a history of seizure type and incidence data collection before planning nursing care for a client with a seizure disorder should always include a history of the seizures.

When explaining the occurrence of febrile seizures to a parents' class, what information should the nurse include?

they may occur in minor illnesses febrile seizures are not usually associated with major neurologic problems. The cause of febrile seizures is still uncertain. Most occur after 6 months of age and before 3 years, with the average age of onset between 18 and 22 months. Boys are affected about twice as frequently as girls.

Which antiepileptic drug is used as the first-line treatment for absence seizures?

valproic acid (depakote)

A thin 24 year old woman who runs 10 miles each week asks the nurse for advice about preventing osteoporosis. Which vitamin and other dietary supplement should the nurse recommend?

vitamin D and calcium citrate

Carbidopa/levodopa is prescribed for a client with Parkinson Disease. What will the nurse teach the client about this medication?

you may experience dizziness when moving from sitting to standing. it's a metabolic precursor of dopamine; it reduces sympathetic outflow by limiting vasoconstriction, which may result in orthostatic hypotension

Which drug is derived from a natural source and may be prescribed for the treatment of osteoporosis?

calicitonin fish; prescribed to prevent

Which autoimmune disease is directly related to the client's CNS?

MS a central nervous system-specific autoimmune disease

An elderly adult with Parkinson's disease falls while going to the bathroom and gets injured. The nurse taking care of the client informs the primary healthcare provider. What step should the nurse take to alert the risk management system?

The nurse should document the incident in the occurrence report tool

Which information from the client's history does the nurse identify as a risk factor for developing osteoporosis?

receives long term steroid therapy increased levels of steroids will accelerate bone demineralization. hyperparathyroidism, not hypoparathyroidism, accelerates bone demineralization.

A client is admitted to the ED in the midst of persistent tonic-clonic seizures (status epilepticus). Diazepam is to be administered immediately. In addition to decreasing central neuronal activity, what other effect does the nurse anticipate?

relaxing peripheral muscles diazepam is a tranquilizer and anticonvulsant use to relax skeletal muscles during continuous seizures.

The nurse is assessing the client with subdural hematoma after a fall. The client was admitted for observation with a normal neurologic assessment on admission. Upon entering the room, the nurse finds the client exhibiting seizure activity. Which is the first action the nurse should take?

assess the client's airway ensuring an airway is the first action in an emergency response to any client

A nurse is caring a school-aged child who has had a tonic-clonic seizure. How should the nurse describe the clonic phase?

spasmodic body jerking

A nurse determines that a client exhibits the characteristic gait associated with PD. How should the nurse describe this gait when documenting on the client's progress report?

shuffling steps are short and dragging; this is seen with defects of the basal ganglia

A nurse administers carbidopa-levodopa to a client with Parkinson disease. Which therapeutic effect does the nurse expect the medication to produce?

replacement of a neurotransmitter in the brain used because levodopa is the precursor of dopamine. it is converted to dopamine in the brain cells, where it is stored until needed by axon terminals; it functions as a neurotransmitter.

An older client experience urinary frequency and nocturia. While ambulating, the client develops severe back pain and is found to have vertebral compression fracture. When planning care, the nurse will focus interventions on which type of fracture?

collapse of vertebral bodies osteoporotic vertebrae collapse under the weight of the upper body or by improper or rapid turning, reaching, or lifting. Bones, not the spinal cord, demineralize in osteoporosis. Wearing and tearing of the spinous processes occur in osteoarthritis.

A client has a tonic-clonic seizure that involves all extremities. The nurse anticipates that the HCP will prescribe the IV admin of which drug?

diazepam benzo that has muscle relaxant and anticonvulsant effects that help limit massive muscular spasms

Shortly after admission an adolescent falls to the floor and exhibits tonic-clonic movements. There is no verbal response, but a nurse observes that the client is still chewing gum. What should the nurse do next?

document the observation if seizures were physiologically based, the client would not be able to continue chewing gum. This "attack" should be reported as a behaviorial response, with the characteristics associated with the situation noted. The chewing gum is not a danger when the client is not having a true seizure.

when helping a client with parkinson disease to ambulate, what instructions should the nurse give the client?

avoid leaning forward client with PD often had a stopped posture because of the tendency of the head and neck to be drawn down; this shift away from the center of gravity causes instability.

A nurse is reviewing a postmenopausal client's history, which reveals that the client previously received hormonal therapy (HT) as treatment for osteoporosis. The nurse recognizes that HT increases the risk of which condition?

breast cancer there is a relationship between HT that combines estrogen and progesterone compounds and an increased risk of invasive breast cancer.

The nurse teaches a premenopausal obese client about strategies to prevent osteoporosis. Which strategy identified by the client indicates that teaching is effective?

joins a tennis league and practices everyday high-impact exercises are best for building bone mass. weight loss should be slow and reasonable; restricting calories promotes prodcution of the hormone leptin, which stimulates bone loss.

A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which observation by the nurse should indicate that the desired outcome of the medication is being achieved? A) Decreased blood pressure. B) Lessening of tremors. C) Increased salivation. D) Increased attention span.

lessening of tremors

A client with parkinsonism is taking an anticholinergic medication for morning stiffness and tremors in the right arm. During a visit to the clinic, the client complains of some numbness in the left hand. What is the nurse's priority intervention?

make arrangements immediately for further medical eval by the client's primary HCP Numbness, a sensory deficit, is inconsistent with parkinsonism; furth medical eval is necessary.

When making rounds, a nurse observes a client who is experiencing a seizure. What should the nurse do?

move obstacles away from the client this help the client avoid hitting objects and prevents trauma during the tonic-clonic phase of the seizure

A nurse is performing the H&P examination of a client with PD. Which assessments identified by the nurse support this diagnosis?

non intention tremors, masklike facial expression, rigidity to passive movement

A primary HCP prescribes teriparatide, a parathyroid hormone agonist, for a client with osteoporosis. Which statement about this drug does the nurse recognize as accurate?

osteoblastic activity is stimulated more than osteoclastic activity

A pregnant client is prescribed heparin to prevent the risk of thromboembolism. Which adverse effects should the nurse anticipate with this medication? Select all that apply

osteoporosis, compression fractures of the spine heparin is an anticoagulant. When heparin is taken concurrently during pregnancy, it may cause osteoporosis, which in turn can cause compression fractures of the spine. The use of aspirin in near term of pregnancy can suppress contractions in labor. The increased risk of serious bleeding also occurs with the use of aspirin during pregnancy.

Increasing consumption of which food selection is most important for the nurse to teach post-menopausal clients?

yogurt female clients usually attain menopause at 55 years of age. Due to reduced amounts of circulating estrogen in postmenopausal women, bone density decreases, thus increasing the risk of osteoporosis. Older female clients should be advised to consumes foods rich in calcium such as yogurt, which helps reduce loss of bone mass.