A nurse is teaching a client who has Alzheimer's disease and their caregiver about
memantine. Which of the following instructions should the nurse
... [Show More] include?
A. Increase fluid intake to improve renal excretion.
B. Report memory loss or confusion.
C. Watch for signs of liver impairment, such as jaundice and abdominal pain.
D. Avoid taking over-the-counter antacids. - D. Avoid taking over-the-counter
antacids.
Rationale:
A. It is not necessary to increase fluids. Memantine is essentially unchanged when
it is excreted in the urine. Therefore, it is not necessary to increase fluids because
fluid intake does not affect this process.
B. Clients who have Alzheimer's disease already have and will continue to have
memory loss and confusion. The drug can help slow the progressive decline, but
will not eliminate the disease's manifestations.
C. Memantine should not result in liver impairment, although it should be used
cautiously with clients who have severe liver impairment.
D. Antacids that contain sodium bicarbonate increase urine alkalinity and can
decrease drug excretion, ultimately leading to toxicity.
A nurse is caring for a client who has a new prescription for pramipexole to treat
Parkinson's disease. The nurse should recognize that which of the following
laboratory tests requires monitoring?
A. C-reactive proteinB. Creatinine clearance
C. Thyroid function
D. CBC - B. Creatinine clearance
Rationale:
A. Pramipexole, a direct-acting dopamine receptor agonist, is unlikely to alter Creactive protein. Pravastatin is a drug that alters C-reactive protein in a beneficial
way by helping to lower the risk of heart disease.
B. Pramipexole, a direct-acting dopamine receptor agonist, should be used with
caution for clients who have renal disease. Therefore, the nurse should monitor the
client's renal function.
C. Pramipexole, a direct-acting dopamine receptor agonist, is unlikely to alter
thyroid function. Amiodarone is a drug that can alter thyroid function.
D. Pramipexole, a direct-acting dopamine receptor agonist, is unlikely to alter
CBCs. Interferon beta-1b, an immunomodulator, can cause myelosuppression and
warrants monitoring of CBCs periodically.
A nurse is caring for a client who has a new prescription for dantrolene to treat
skeletal muscle spasms. The nurse should instruct the client to report which of the
following adverse effects?
A. Slow heart rate
B. Cough
C. Diarrhea
D. Hearing loss - C. Diarrhea
Rationale:
A. Dantrolene is more likely to cause tachycardia than bradycardia.B. Dantrolene is unlikely to cause a cough, but it can cause difficulty swallowing.
C. Prolonged diarrhea can cause dehydration and other serious effects. Diarrhea,
nausea, and vomiting are adverse effects of dantrolene. The client should report
these effects so the nurse can monitor fluid balance and intervene accordingly.
D. Dantrolene can cause blurred vision, but it is unlikely to cause hearing loss.
A nurse is caring for a client who has a new prescription for valproic acid to treat a
seizure disorder. The nurse should instruct the client to monitor for which of the
following adverse effects?
A. Hirsutism
B. Depression
C. Jaundice
D. Gum irritation - C. Jaundice
Rationale:
A. Valproic acid is unlikely to cause hirsutism, or excessive hair growth, but it can
cause transient hair loss.
B. Valproic acid is unlikely to cause depression, but it can cause aggression.
C. Valproic acid can cause hepatic toxicity, characterized by jaundice, abdominal
pain, and nausea. Clients taking the drug should report these manifestations, and
the nurse should monitor liver function studies prior to treatment and periodically
during therapy.
D. Valproic acid is unlikely to cause gum irritation. Phenytoin can cause gingival
hyperplasia. [Show Less]