The nurse evaluates that carbidopa and levodopa (Sinemet) is therapeutically effective if the client has:
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Solution
Decreased tremors at rest
Carbidopa and levodopa help restore the balance between dopamine and acetylcholine, thereby controlling the responses of Parkinson’s disease.
Which of the following assessment is most essential before beginning a drug regimen of an antimuscarinic agent?
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Solution
Date of birth
Antimuscarinic agents are contraindicated in elderly patients.
The priority nursing intervention for a client receiving amantadine is to teach the client to:
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Solution
Monitor the pulse for rate and regularity.
Dopaminergic agents can cause heart rate changes and cardiac arrhythmias. Choice B is incorrect because amantadine can cause insomnia. Choice C is incorrect because an adverse effect of amantadine is a mottled discoloration of the skin. Choice D is incorrect because dry mouth is an expected side effect and not an indication to discontinue amantadine.
Before administering amantadine (Symadine), the nurse should investigate which of the following client statements?
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Solution
“I had to take Dilantin 6 months ago.”
Amantadine is used cautiously in clients with a history of seizures. A and D are clinical manifestations of Parkinson’s disease. Amantadine does not interact negatively with aspirin.
The client asks the nurse why he is taking bromocriptine (Parlodel). The nurse’s reply is based in the understanding that bromocriptine mimics the effects of dopamine by:
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Solution
Activating dopamine receptors in the brain
Bromocriptine is a dopaminergic agent, and this response refers to its action. Choice A refers to the action of levodopa. Choice B refers to the action of carbidopa and levodopa. Choice D refers to the action of selegiline.
When caring for a client who is receiving phenytoin and warfarin (Coumadin), the nurse would expect which of the following drug-drug interactions?
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Solution
Decreased effectiveness of warfarin
The interaction will reduce the effectiveness of warfarin.
When administering IV phenytoin (Dilantin), the nurse should:
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Solution
Mix the drug in saline solution.
Phenytoin must be mixed in saline solution only. Phenytoin should be administered at a rate of 50 mg/min. There is no need to protect phenytoin from light because it does not destabilize with light exposure. Phenytoin will precipitate when mixed with a dextrose solution.
Amphetamines and amphetamine-like compounds are most commonly used for:
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Solution
All of the above
The most common uses of amphetamines and amphetamine-like compounds are narcolepsy, exogenous obesity, and attention deficit disorder.
Use of methylphenidate for attention deficit disorders in children can result in:
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Solution
A and B
Use of Ritalin does not cause a growth spurt. Instead, it can cause Tourette’s syndrome and growth suppression in children.
As a knowledgeable nurse, you know that you should never give amphetamines in combination with:
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Solution
MAO inhibitors
MAO inhibitors must never be given with drugs affecting the CNS because hypertension can occur. Amphetamines can be given with oral hypoglycemics and insulin as long as blood sugar levels are monitored because these can decrease antidiabetic requirements.