Seizures
A patient with a history of seizures is prescribed phenytoin (Dilantin) for seizure control. What nursing intervention is essential when administering phenytoin?
A) Administer the medication with a high-fat meal.
B) Monitor the patient's blood pressure regularly.
C) Encourage the patient to discontinue the medication if seizure frequency decreases.
D) Administer phenytoin IV push as a bolus for rapid seizure control.
Answer 1: B) Monitor the patient's blood pressure regularly.
Rationale 1: Phenytoin can cause changes in blood pressure, so it's essential to monitor the patient's blood pressure regularly to detect and manage any abnormalities. Administering the medication with a high-fat meal is not necessary and can affect absorption. Patients should not discontinue the medication without healthcare provider guidance, even if seizure frequency decreases. Administering phenytoin as an IV push bolus is unsafe and can lead to adverse effects.
A patient with bacterial meningitis is prescribed intravenous ceftriaxone (Rocephin). What is the primary rationale for administering this medication?
A) To relieve headache and fever.
B) To reduce intracranial pressure.
C) To treat the underlying infection.
D) To provide pain relief.
Answer 1: C) To treat the underlying infection.
Rationale 1: Ceftriaxone is an antibiotic used to treat the underlying bacterial infection responsible for meningitis. It is not primarily administered to relieve symptoms like headache and fever, reduce intracranial pressure, or provide pain relief.
Which medication is commonly prescribed to manage the motor symptoms of Parkinson's disease by increasing dopamine levels in the brain?
A) Acetylcholinesterase inhibitors
B) Beta-blockers
C) Dopamine agonists
D) Benzodiazepines
Answer: C) Dopamine agonists
Rationale: Dopamine agonists stimulate dopamine receptors in the brain, helping to alleviate the motor symptoms of Parkinson's disease. Acetylcholinesterase inhibitors, beta-blockers, and benzodiazepines are not typically used as primary treatments for Parkinson's disease.
A nurse is caring for a patient with Alzheimer's disease who is prescribed donepezil (Aricept), a cholinesterase inhibitor. The patient's family asks about the expected effects of this medication. Which response by the nurse is most accurate? a) "Donepezil will reverse the cognitive decline associated with Alzheimer's disease."
b) "Donepezil will slow down the progression of Alzheimer's disease and may temporarily improve cognitive function."
c) "Donepezil will eliminate all behavioral symptoms of Alzheimer's disease."
d) "Donepezil will primarily address the motor symptoms of Alzheimer's disease."
Answer and Rationale: b) "Donepezil will slow down the progression of Alzheimer's disease and may temporarily improve cognitive function."
Donepezil is a cholinesterase inhibitor that is used to manage the symptoms of Alzheimer's disease. It does not reverse the cognitive decline, but it can help slow down the progression of the disease and provide temporary improvement in cognitive function by increasing the availability of acetylcholine in the brain.
A patient is prescribed valproic acid (Depakote) for the management of epilepsy. What should the nurse monitor in this patient to assess for potential adverse effects of valproic acid?
A) Renal function
B) Serum potassium levels
C) Liver function
D) Lung function
Answer 2: C) Liver function
Rationale 2: Valproic acid is known to affect liver function, potentially leading to hepatotoxicity. Therefore, the nurse should monitor the patient's liver function regularly while on this medication. Monitoring renal function, serum potassium levels, and lung function is not specific to valproic acid and its potential adverse effects.
A patient with viral meningitis is prescribed acyclovir (Zovirax) and dexamethasone (Decadron). What nursing assessments are essential for monitoring the patient's response to this medication regimen? Select all that apply.
A) Daily measurement of intracranial pressure (ICP).
B) Assessment of cerebrospinal fluid (CSF) analysis.
C) Monitoring for signs of fluid overload.
D) Observation for changes in neurological status.
E) Regular vital sign assessments.
Answers 2: B) Assessment of cerebrospinal fluid (CSF) analysis. D) Observation for changes in neurological status. E) Regular vital sign assessments.
Rationale 2: For a patient with viral meningitis receiving acyclovir and dexamethasone, monitoring CSF analysis, observing for changes in neurological status, and regular vital sign assessments are essential nursing assessments to evaluate the patient's response to the medication regimen. Daily measurement of intracranial pressure (ICP) is not typically indicated for viral meningitis, and monitoring for signs of fluid overload is less relevant in this context.
A patient with Parkinson's disease is prescribed levodopa-carbidopa (Sinemet). Which of the following is an important nursing consideration when administering this medication?
A) Administer with food to enhance absorption
B) Administer with antacids to reduce gastric irritation
C) Monitor for signs of serotonin syndrome
D) Administer with a high-protein meal to maximize therapeutic effect
Answer: A) Administer with food to enhance absorption
Rationale: Levodopa-carbidopa (Sinemet) should be administered with food to enhance its absorption and reduce the risk of gastrointestinal side effects. Administering it with antacids can decrease its absorption. Monitoring for serotonin syndrome is not relevant to this medication. Administering it with a high-protein meal may reduce its effectiveness.
A nurse is providing care to a patient with Alzheimer's disease who is experiencing sundowning behavior. Which nursing intervention is most appropriate to help manage sundowning in this patient?
a) Administering an additional dose of Alzheimer's medication before bedtime
b) Encouraging the patient to engage in physical activity during the late afternoon
c) Providing the patient with a caffeinated beverage in the evening
d) Dimming the lights in the patient's room to create a calming atmosphere
Answer and Rationale: b) Encouraging the patient to engage in physical activity during the late afternoon
Sundowning is a common behavior in Alzheimer's patients characterized by increased confusion and agitation in the late afternoon and evening. Encouraging physical activity during the late afternoon can help reduce restlessness and promote better sleep patterns. It's important to avoid caffeine in the evening (option c) as it can worsen symptoms, and while creating a calming atmosphere with dimmed lights (option d) can be helpful, physical activity is a more direct intervention for managing sundowning.
A patient with epilepsy is taking multiple antiepileptic medications, including phenytoin and valproic acid. What nursing interventions are important when caring for this patient? Select all that apply.
A) Administer phenytoin and valproic acid together in one medication dose.
B) Monitor the patient's serum drug levels regularly.
C) Encourage the patient to abruptly discontinue the medications if side effects occur.
D) Educate the patient about the importance of medication adherence.
E) Instruct the patient to avoid all forms of physical activity to prevent seizure triggers.
Answers 3: B) Monitor the patient's serum drug levels regularly. D) Educate the patient about the importance of medication adherence.
Rationale 3: Monitoring serum drug levels is crucial when a patient is taking multiple antiepileptic medications to ensure therapeutic levels and prevent toxicity. Educating the patient about the importance of medication adherence is essential for seizure control. Administering phenytoin and valproic acid together in one medication dose is not appropriate, as they may interact. Encouraging abrupt discontinuation of medications is unsafe and not recommended. Instructing the patient to avoid all forms of physical activity is not necessary for most patients with epilepsy.
A patient with suspected bacterial meningitis is started on empirical antibiotic therapy with ceftriaxone (Rocephin) and vancomycin (Vancocin). What nursing action is most important when administering vancomycin?
A) Administer the medication as a rapid IV push.
B) Monitor the patient for allergic reactions.
C) Encourage the patient to drink plenty of fluids.
D) Administer vancomycin with food to minimize gastrointestinal upset.
Answer 3: B) Monitor the patient for allergic reactions.
Rationale 3: When administering vancomycin, the nurse's most critical action is to monitor the patient for allergic reactions, including rash, itching, and difficulty breathing. Administering vancomycin as a rapid IV push is contraindicated. Encouraging fluid intake is generally advisable but is not specific to vancomycin administration. Vancomycin should be administered without regard to food.
A patient with Parkinson's disease is prescribed levodopa-carbidopa (Sinemet) to manage their motor symptoms. Which nursing action is essential to ensure the effectiveness of this medication?
A) Administer an additional dose if the patient experiences "off" periods.
B) Encourage the patient to consume a diet high in protein.
C) Monitor for signs of serotonin syndrome.
D) Administer the medication with a full glass of grapefruit juice.
Answer: C) Monitor for signs of serotonin syndrome.
Rationale: Monitoring for signs of serotonin syndrome is crucial when a patient is taking levodopa-carbidopa, as some medications or substances (like certain antidepressants) can interact with it and increase the risk of serotonin syndrome. The other options are not appropriate actions or may even be harmful in the context of Parkinson's disease management.
A nurse is educating a family member of a patient with Alzheimer's disease who is prescribed rivastigmine (Exelon), another cholinesterase inhibitor. The family member asks about common side effects. Which side effect is most commonly associated with rivastigmine?
a) Hypertension
b) Diarrhea
c) Hyperglycemia
d) Bradycardia
Answer and Rationale: b) Diarrhea
Diarrhea is a common side effect associated with cholinesterase inhibitors like rivastigmine. It occurs due to increased cholinergic activity in the gastrointestinal tract. Monitoring for diarrhea and managing it appropriately is essential while administering this medication.
A patient with epilepsy is prescribed levetiracetam (Keppra) as an adjunctive therapy. The patient is concerned about potential side effects. What should the nurse include in the patient's education regarding levetiracetam?
A) Levetiracetam is associated with a high risk of severe skin reactions.
B) Levetiracetam may cause significant weight gain.
C) Levetiracetam can lead to behavioral and psychiatric changes.
D) Levetiracetam should be taken on an empty stomach for optimal absorption.
Answer 4: C) Levetiracetam can lead to behavioral and psychiatric changes.
Rationale 4: Levetiracetam is associated with behavioral and psychiatric changes, including mood swings, aggression, and irritability. Patients should be informed about these potential side effects. It is not known for causing severe skin reactions or significant weight gain. Levetiracetam can be taken with or without food; taking it on an empty stomach is not required.
A patient with meningitis is prescribed mannitol (Osmitrol) and dexamethasone (Decadron) to manage increased intracranial pressure (ICP). What nursing interventions are appropriate when administering these medications? Select all that apply.
A) Administer mannitol as a continuous IV infusion.
B) Monitor serum electrolyte levels regularly.
C) Assess for signs of fluid volume excess.
D) Measure urine output hourly.
E) Administer dexamethasone with food to minimize gastrointestinal irritation.
Answers 4: B) Monitor serum electrolyte levels regularly. C) Assess for signs of fluid volume excess. D) Measure urine output hourly.
Rationale 4: When administering mannitol and dexamethasone to manage increased ICP in a patient with meningitis, it is essential to monitor serum electrolyte levels due to potential electrolyte imbalances, assess for signs of fluid volume excess, and measure urine output hourly to evaluate the effectiveness of mannitol in promoting diuresis. Administering mannitol as a continuous IV infusion is not typically indicated. Administering dexamethasone with food is not necessary for gastrointestinal irritation.
When caring for a patient with Parkinson's disease who is taking medications, which nursing interventions are appropriate? (Select all that apply.)
A) Monitor for orthostatic hypotension
B) Encourage a low-protein diet
C) Assess for signs of dyskinesias
D) Administer medications on an empty stomach
E) Promote a consistent exercise routine
Answers: A) Monitor for orthostatic hypotension, C) Assess for signs of dyskinesias, and E) Promote a consistent exercise routine
Rationale: A) Monitoring for orthostatic hypotension is important as many Parkinson's medications can cause a drop in blood pressure. C) Assessing for signs of dyskinesias is crucial, as these involuntary movements can occur as a side effect of medication. E) Promoting a consistent exercise routine can help maintain muscle strength and mobility in patients with Parkinson's disease.
B) Encouraging a low-protein diet is not typically recommended, as protein can interfere with the absorption of levodopa.
D) Administering medications on an empty stomach is not generally recommended for Parkinson's medications. Some may be taken with food to minimize gastrointestinal side effects.
A nurse is providing care to a patient with Alzheimer's disease who is taking a combination of medications. Which nursing interventions are appropriate for this patient? (Select all that apply.) a) Encourage physical exercise and a balanced diet.
b) Monitor for signs of worsening depression.
c) Administer medications with high iron content.
d) Educate the patient about the importance of memory-enhancing herbs.
e) Assess and document cognitive changes regularly.
f) Limit fluid intake to prevent urinary incontinence.
Answer and Rationale: a) Encourage physical exercise and a balanced diet. b) Monitor for signs of worsening depression. e) Assess and document cognitive changes regularly.
a) Encouraging physical exercise and a balanced diet can help support overall health and cognitive function in Alzheimer's disease patients. b) Monitoring for signs of worsening depression is important, as depression is common in Alzheimer's patients and can further impair their quality of life. e) Regular assessment and documentation of cognitive changes are crucial for tracking disease progression and evaluating the effectiveness of treatments.
A patient with epilepsy is prescribed carbamazepine (Tegretol) and has been on the medication for several months. What nursing interventions are essential when caring for this patient? Select all that apply.
A) Monitor the patient's complete blood count (CBC) regularly.
B) Encourage the patient to consume a high-calcium diet.
C) Advise the patient to avoid grapefruit juice.
D) Instruct the patient to discontinue the medication abruptly if side effects occur.
E) Administer the medication with a high-fat meal.
Answers 5: A) Monitor the patient's complete blood count (CBC) regularly. C) Advise the patient to avoid grapefruit juice.
Rationale 5: Regular monitoring of the complete blood count (CBC) is crucial for patients taking carbamazepine, as it can affect blood cell counts. Patients should be advised to avoid grapefruit juice, as it can interact with carbamazepine metabolism. Encouraging a high-calcium diet is not specific to carbamazepine. Instructing the patient to discontinue the medication abruptly is unsafe and not recommended. Administering carbamazepine with a high-fat meal is not necessary for optimal absorption.
A patient with fungal meningitis is prescribed amphotericin B (Fungizone). What nursing assessment should take priority when administering amphotericin B?
A) Monitoring the patient's temperature for fever.
B) Checking serum glucose levels regularly.
C) Assessing for signs of renal impairment.
D) Evaluating the patient's response to pain medications.
Answer 5: C) Assessing for signs of renal impairment.
Rationale 5: When administering amphotericin B, the nurse should prioritize assessing for signs of renal impairment, as this medication can be nephrotoxic. Monitoring the patient's temperature for fever is important but not the top priority. Checking serum glucose levels and evaluating the patient's response to pain medications are less relevant in the context of amphotericin B administration for fungal meningitis.
When providing nursing care for a patient with Parkinson's disease who is taking levodopa, carbidopa, pramipexole, and rasagiline, which pharmacological and nursing interventions are appropriate? (Select all that apply.)
A) Monitor for orthostatic hypotension
B) Administer antipsychotic medications for mood stabilization
C) Assess for signs of dyskinesias
D) Administer medications on an empty stomach
E) Promote a consistent exercise routine
Answers: A) Monitor for orthostatic hypotension, C) Assess for signs of dyskinesias, and E) Promote a consistent exercise routine
Rationale: A) Monitoring for orthostatic hypotension is crucial, especially when a patient is taking multiple medications for Parkinson's disease, as many of these drugs can cause a drop in blood pressure. C) Assessing for signs of dyskinesias is important because these involuntary movements can occur as a side effect of Parkinson's medications. E) Promoting a consistent exercise routine can help maintain muscle strength and mobility in patients with Parkinson's disease.
B) Administering antipsychotic medications is generally avoided in Parkinson's disease, as they can worsen motor symptoms. D) Administering medications on an empty stomach is not typically recommended for Parkinson's medications; some may be taken with food to minimize gastrointestinal side effects.
A nurse is caring for a patient with Alzheimer's disease who is taking multiple medications. Which medications should the nurse administer with caution due to potential drug interactions with Alzheimer's disease medications? (Select all that apply.)
a) Warfarin (Coumadin)
b) Furosemide (Lasix)
c) Metoprolol (Lopressor)
d) Fluoxetine (Prozac)
e) Acetaminophen (Tylenol)
Answer and Rationale: a) Warfarin (Coumadin) d) Fluoxetine (Prozac)
a) Warfarin (Coumadin) may interact with Alzheimer's disease medications, particularly cholinesterase inhibitors, potentially increasing the risk of bleeding. Close monitoring of the international normalized ratio (INR) is essential when these drugs are used together. d) Fluoxetine (Prozac) is an antidepressant that can interact with Alzheimer's medications, potentially leading to an increased risk of serotonin syndrome or other adverse effects. Careful monitoring and dose adjustments may be necessary when using these drugs together.