A client recently diagnosed with Parkinson's disease receives a new prescription for carbidopa-levodopa, a dopaminergic drug. To reduce the client's risk for injury, which instruction should the nurse provide?

Obtain a hospital bed with side rails and an over-bed trapeze.

Place small rugs on smooth surfaces such as tile or wood floors.

Use caution when changing from a sitting to a standing position.

Ambulate using a four point cane or a walker with wheels.

Answer and Explanation

The Correct Answer is C

Choice A reason: Obtaining a hospital bed with side rails and an over-bed trapeze is not a necessary instruction for reducing the risk of injury for a client taking carbidopa-levodopa, which is a combination of two drugs that increase dopamine levels in the brain and improve motor function in patients with Parkinson's disease. A hospital bed may be helpful for patients with severe mobility impairment or bedridden status, but not for all patients with Parkinson's disease.

Choice B reason: Placing small rugs on smooth surfaces such as tile or wood floors is an incorrect instruction for reducing the risk of injury for a client taking carbidopa-levodopa, which is a combination of two drugs that increase dopamine levels in the brain and improve motor function in patients with Parkinson's disease. Small rugs can pose a tripping hazard and increase the risk of falls, especially for patients with impaired balance or coordination.

Choice C reason: Using caution when changing from a sitting to a standing position is a correct instruction for reducing the risk of injury for a client taking carbidopa-levodopa, which is a combination of two drugs that increase dopamine levels in the brain and improve motor function in patients with Parkinson's disease. Carbidopa-levodopa can cause orthostatic hypotension, which is a sudden drop in blood pressure when changing positions. This can cause dizziness, fainting, or falls. Patients should change positions slowly and carefully, and use support if needed.

Choice D reason: Ambulating using a four point cane or a walker with wheels is not a specific instruction for reducing the risk of injury for a client taking carbidopa-levodopa, which is a combination of two drugs that increase dopamine levels in the brain and improve motor function in patients with Parkinson's disease. The type of assistive device that is appropriate for each patient depends on their individual needs and abilities. Some patients may not need any device, while others may need different types of canes, walkers, or wheelchairs.

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Correct Answer is ["B","C","F"]

Explanation

Choice A: Printing an electrocardiogram strip is not a priority in this situation. The client is not responsive and has a low respiratory rate, which indicates a possible overdose of morphine. The nurse should focus on reversing the effects of the opioid and maintaining the client's airway and circulation.

Choice B: Providing rescue breaths with a manual ventilation bag is a correct and urgent action. It can supply oxygen to the client until naloxone takes effect and restore normal breathing.

Choice C: Giving naloxone 2 mg intravenously is a correct and urgent action. Naloxone is an opioid antagonist that can block the effects of morphine and reverse respiratory depression.

Choice D: This can help increase the patient’s oxygen levels, which may be low due to the decreased respiratory rate.

Choice E: Performing chest compressions is not a correct or urgent action. It is only indicated if the client has no pulse or signs of life. It can also cause harm if the client has a heartbeat.

Choice F: Calling for rapid response is a correct and urgent action. Rapid response is a team of health care professionals that can assist in emergency situations and provide advanced care.

Correct Answer is []

Explanation

Potential Condition:Methemoglobinemia

Methemoglobinemia is a condition in which the hemoglobin in the blood is unable to bind oxygen effectively, resulting in tissue hypoxia. It can be caused by exposure to certain drugs or chemicals, such as nitrates, benzocaine, or dapsone. Some symptoms of methemoglobinemia include cyanosis, headache, fatigue, dyspnea, and tachycardia. In severe cases, it can lead to seizures, coma, and death.

Actions to Take:

Draw blood for a complete blood count
administer methylene blue

A complete blood count (CBC) can help diagnose methemoglobinemia by measuring the level of methemoglobin in the blood. A normal level is less than 1%, while a level above 15% can cause symptoms. A level above 30% can be life-threatening. Methylene blue is a medication that can reduce methemoglobin back to normal hemoglobin and restore oxygen delivery to the tissues. It is given intravenously at a dose of 1-2 mg/kg over 5 minutes.

Parameters to Monitor:

Methemoglobin level
heart rate and rhythm

The methemoglobin level is the most important parameter to monitor in methemoglobinemia, as it indicates the severity of the condition and the response to treatment. The goal is to lower the level below 10% or until symptoms resolve. The heart rate and rhythm are also important to monitor, as methemoglobinemia can cause tachycardia and dysrhythmias due to hypoxia and acidosis. The goal is to maintain a normal sinus rhythm and a heart rate within the normal range for the client’s age and condition.

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A client recently diagnosed with Parkinson's disease receives a new prescription for carbidopa-levodopa, a dopaminergic drug. To reduce the client's risk for injury, which instruction should the nurse provide?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Patient Data Exhibits What should the nurse do immediately? Select all that apply.

Correct Answer is ["B","C","F"]

Explanation

Patient Data Exhibits Review H and P, and nurse’s note. Identify from the choices below which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client’s progress.

Correct Answer is []

Explanation

The nurse is administering sevelamer during lunch to a client with chronic kidney disease (CKD). The client asks the nurse to bring the medication later. The nurse should describe which action of sevelamer as an explanation for taking it with meals?

A client with bipolar disorder admitted with severe depression and suicidal ideation receives a prescription for lithium carbonate. Which instruction should the nurse provide to the client?

A female client with mild depression reports to the nurse recently starting St. John's wort. Which information provided by the client requires further instruction?

Patient Data Exhibits For each statement, click to indicate whether the statements by the student nurse indicate understanding or no understanding of naloxone.

A client who experiences migraine headaches reports having fewer headaches since using the herbal remedy feverfew. Which information is most important for the nurse to include in a teaching plan for this client?

A client receives a new prescription for somatropin. Which information provided by the client indicates a need for further education by the nurse?

Patient Data Exhibits The charge nurse places a fall precautions sign on the client's door. What side effects of morphine could contribute to this client's fall risk? Select all that apply.