Chapter 20-25 CNS; Neurodegenerative disorder drugs/neurological drugs – Flashcards
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A patient is experiencing constant impairment of voluntary actions after taking levodopa [Dopar]. Which medication should the nurse expect the primary healthcare provider to prescribe?
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Entacapone [Comtan]
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Which cholinesterase inhibitor has the highest incidence of adverse gastrointestinal (GI) effects?
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Rivastigmine [Exelon]
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A patient has been started on donepezil [Aricept]. The patient's family member notifies the nurse that the patient fainted at home. What is the highest priority action on the part of the nurse?
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Notify the healthcare provider the patient may need to be taken off the drug
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The nurse is administering morning medications. Which administration technique is an error?
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The nurse administers carbamazepine with grapefruit juice.
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What information should the nurse include in the care plan of a young woman who has been prescribed phenytoin [Dilantin]?
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"Use birth control while on this medication."
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The nurse is preparing to give ethosuximide [Zarontin]. The nurse should understand that this drug is only indicated for which seizure type?
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Absence
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Which instruction would be inappropriate to include in the teaching plan for a patient starting carbamazepine [Tegretol]?
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"Take the medication with a glass of grapefruit juice each morning."
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What information is essential to teach the client who will begin taking an antiepileptic drug?
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"There is a good chance that you will become seizure free on this one medication."
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The nurse is administering phenytoin [Dilantin] intravenously. What intervention is essential?
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Administer the medication no faster than 50 mg/min
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The nurse on an orthopedic unit routinely cares for patients receiving carisoprodol [Soma]. For which adverse effects should the nurse monitor these patients? Select all that apply.
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Risk of dependence Drowsiness and sedation
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The nurse is caring for a patient who has been prescribed entacapone [Comtan] to reduce the on-off effects of carbidopa-levodopa [Sinemet]. What should the nurse do to assess for any adverse effects in the patient? Select all that apply.
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Check the patient's urinalysis reports. Observe for any abnormal movements. Assess the patient for vomiting and diarrhea.
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Which statement should the nurse include in the teaching plan for a patient being started on levodopa/carbidopa [Sinemet] for newly diagnosed Parkinson's disease?
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Change positions slowly.
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A patient is in status epilepticus. Which are essential nursing actions? Select all that apply.
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Administer diazepam as ordered Turn the patient's head to the side Assess oxygenation and apply oxygen
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The nurse is caring for a patient hospitalized with an acute episode (relapse) of multiple sclerosis (MS). Which agent is the preferred treatment during relapse?
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Methylprednisolone [Solu-Medrol] IV
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The nurse is teaching a patient about therapy for a newly diagnosed seizure disorder. What statement should be included in the plan of care?
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"Your medication is chosen based on your type of seizure."
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Which intervention is a priority in the administration of intravenous (IV) Dilantin therapy?
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Administering it by slow IV push
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The nurse is teaching a patient about a new prescription for mitoxantrone [Novantrone]. Which statement made by the patient indicates a need for further teaching?
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"I volunteer at a local day care center once a week."
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The nurse is caring for a patient with multiple sclerosis (MS) who is having worsening recurrent episodes of neurologic dysfunction followed by periods of partial recovery. How would this subtype be classified?
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Secondary progressive
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A patient with Parkinson's disease and comorbid depression is prescribed selegiline [Emsam]. What should the nurse do when administering the medication to the patient?
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Apply the transdermal patch of the drug on the patient's upper arm.
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A patient with Parkinson's disease is treated with levodopa [Parcopa]. During the follow-up visit, the nurse finds that the patient is having an on-off phenomenon caused by the medication. Which findings would likely cause the nurse to come to this conclusion?
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Uncontrollable voluntary movements
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The nurse is caring for a patient with Parkinson's disease who has been prescribed carbidopa-levodopa [Sinemet]. Which statement, if made by the patient, indicates a need for further teaching?
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"I will take this medication with a high-protein meal to avoid nausea."
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Which class of drugs is administered to treat on-off phenomenon in a patient with Parkinson's disease?
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Catechol O-methyltransferase (COMT)
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The nurse is caring for a patient receiving glatiramer acetate [Copaxone] for multiple sclerosis. Which finding, if present in this patient, could be considered a potential adverse effect of this drug?
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Injection site pain and redness
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The nurse is conducting discharge teaching related to a new prescription for phenytoin [Dilantin]. Which statements are appropriate to include in the teaching for this patient and family? Select all that apply.
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"It is very important to have good oral hygiene and to visit your dentist regularly." "Be sure to call the clinic if you or your family notice increased anxiety or agitation." "You may have some mild sedation. Do not drive until you know how this drug will affect you."
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A patient is prescribed carisoprodol [Soma] for relief of muscles spasms. What does the nurse instruct the patient to avoid while taking carisoprodol?
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Beer
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Which patient should be evaluted for potential toxic effects of antiepileptic therapy?
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The patient with a carbemazepine level of 15 mcg/mL
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The nurse is teaching a patient newly diagnosed with epilepsy about her disease. Which statement made by the nurse best describes the goals of therapy with antiepilepsy medication?
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"Our goal is to reduce your seizures to an extent that helps you live a normal life."
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A provider has ordered once-daily phenytoin [Dilantin] for an 8-year-old child who has a seizure disorder, and the parents say that it is impossible to have the child take pills by mouth. What intervention would the nurse recommend?
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The parents should ask the healthcare provider for a suspension form of the medication.
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Which action is the highest priority for a patient who is receiving antiepileptic drug therapy for the first time?
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Observing for suicidal tendencies
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The nurse is assessing a patient who is receiving antiepileptic drug therapy with phenytoin. What assessment finding requires immediate action?
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Nystagmus
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Which statement made by a female patient newly diagnosed with complex partial seizures and starting treatment with valproic acid [Depakene] indicates a need for further teaching by the nurse?
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"I should take the medication on an empty stomach."
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Which medication is used to treat spasticity?
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Baclofen [Lioresal]
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A 25-year-old female patient has begun taking phenobarbital therapy for seizure control. What information is essential for the nurse to include in discharge teaching?
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"Discuss forms of birth control with the healthcare provider."
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Which medication is most effective in treating the remission-exacerbation phase of multiple sclerosis in a patient?
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Glatiramer acetate [Copaxone]
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The nurse is caring for a geriatric patient. During the assessment, the nurse finds that the patient has tremors in the fingers, a mask-like facial expression, and bradykinesia. Which drug would the nurse expect the primary healthcare provider to prescribe to the patient?
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Carbidopa-levodopa [Sinemet]
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The nurse is caring for a patient receiving phenytoin [Dilantin] for treatment of tonic-clonic seizures. Which symptoms, if present, would indicate an adverse effect of this drug? Select all that apply.
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Measles-like rash Unusual hair growth Swollen, tender gums
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A patient with Parkinson's disease who takes levodopa/carbidopa [Sinemet] comes to the clinic for a semiannual physical examination. Which question is the most important for the nurse to ask?
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"Are you having vivid dreams or hallucinations?"
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The patient is prescribed cyclobenzaprine ER [Amrix]. What information does the nurse include in medication teaching? Select all that apply.
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"Avoid the consumption of alcohol." "Avoid consumption of barbiturates. "Avoid consumption of tricyclic antidepressants."
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Dantrolene [Dantrium] acts on the sarcoplasmic reticulum in the treatment of malignant hyperthermia. What does it help to block?
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Calcium
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The nurse is caring for a patient who has a spinal cord injury and who was administered dantrolene [Dantrium]. What are the necessary nursing interventions required for the patient? Select all that apply.
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Monitoring liver enzyme levels in the patient Observing the patient for side effects related to the central nervous system
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Which statement about memantine [Namenda] is false?
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Memantine does not slow the decline in function.
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The nurse is reviewing the care of patients with Alzheimer's disease (AD). Which factors are associated with the pathophysiology of this disease? Select all that apply.
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Beta-amyloid and neuritic plaques Neurofibrillary tangles and tau Neuronal degeneration and decreased acetylcholine
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Which complaint by a patient taking fingolimod [Gilenya] requires prompt evaluation by the prescriber?
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Dizziness and fatigue
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A patient who is originally from Thailand is seen in the clinic for seizure control. She receives a new prescription for carbamazepine [Tegretol]. Before the patient takes the drug, which is the most appropriate initial nursing intervention?
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Ensure that genetic testing for HLA-B*1502 is performed.
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The nurse is caring for a patient receiving dantrolene [Dantrium] for spasticity associated with multiple sclerosis (MS). Which laboratory test will be important in monitoring for a potential adverse effect of this drug?
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Gamma-glutamyltransferase (GGTP)
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The nurse is caring for a patient who has been diagnosed with multiple sclerosis. The healthcare provider opts to include baclofen [Lioresal] as part of this patient's treatment regimen. The nurse recognizes that this is an appropriate medication for this patient because the drug will treat which symptom?
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Muscle spasticity
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The nurse needs to administer phenytoin [Dilantin] 400 mg IV bolus to a patient. At a minimum, over how many minutes should the nurse administer this dose? Record your answer using a whole number. _____ minutes
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8 The nurse administers IV phenytoin no faster than 50 mg/min to reduce the risk of cardiovascular collapse. Calculation: (1 min/50 mg) × 400 mg = 400 ÷ 50 = 8 minutes.
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Which assessment is essential before a patient receives a second dose of mitoxantrone [Novantrone]? Select all that apply.
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Pregnancy test Echocardiogram Complete blood count
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The primary healthcare provider has prescribed cyclobenzaprine ER [Amrix] to a patient who has muscle spasms. After reviewing the patient's medical history, the nurse requests the primary healthcare provider to revise the prescription. Which finding would most likely be the rationale for the nurse's action? Select all that apply.
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The patient has hyperthyroidism. The patient has narrow-angle glaucoma.
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The nurse is caring for a patient who has Parkinson's disease who has been prescribed selegiline [Emsam]. The nurse instructs the patient to avoid wine and cheese. Which food-drug interaction is the nurse trying to prevent?
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Hypertension
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The nurse is caring for a patient with multiple sclerosis who is receiving interferon beta-1a [Rebif] by subcutaneous injection. Which laboratory tests should be performed regularly in this patient to monitor for a potential adverse effect? Select all that apply.
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Alkaline phosphatase Complete blood count
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The nurse is assessing a patient with Parkinson's disease who has been prescribed levodopa [Sinemet] and selegiline [Emsam]. The nurse advises the patient to avoid drinking red wine and beer. What is the most probable reason for giving such instructions?
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Red wine and beer interact with selegiline [Emsam].
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The nurse notes that a patient has taken an excessive dose of baclofen [Lioresal]. Which action does the nurse implement immediately?
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Airway maintenance
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A primary healthcare provider has prescribed entacapone [Comtan] to a patient diagnosed with Parkinson's disease. The nurse is teaching the patient's caregiver about the administration of the drug. Which statement made by the caregiver indicates the need for additional education?
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"I will administer the drug when the patient has an empty stomach."
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The nurse caring for a patient who is prescribed diazepam [Valium] finds that the patient is taking an herbal therapy. Which instructions should the nurse provide the patient? Select all that apply.
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"Avoid consuming valerian." "Avoid consuming kava kava."
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A patient has elected to use rasagiline as a monotherapy treatment for Parkinson's disease (PD). Which teaching statement by the nurse is incorrect?
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"Rasagiline may cause insomnia, so keep a log of your sleeping habits."
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A patient who has paraplegia reports muscle spasms. Which medication should the nurse expect the primary healthcare provider to prescribe for the patient?
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Diazepam [Valium]
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The nurse prepares to administer cyclobenzaprine [Flexeril] to a patient who has been in a motor vehicle accident (MVA). Which preadministration assessment is the nurse's priority in the evaluation of adverse effects of therapy?
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Level of consciousness
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The nurse is caring for a patient who has muscle spasms and who is prescribed orphenadrine citrate [Norflex]. After reviewing the medical history of the patient, the nurse requests that the primary healthcare provider revise the prescription. What is the reason behind this nursing action?
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The patient has narrow-angle glaucoma.
