A nurse is providing discharge teaching to a client who will be taking levodopa/carbidopa for Parkinson's disease. Which of the following statements by the client indicates a need for further teaching?

I will report any unusual movements or behaviors to my healthcare provider."

I may experience nausea while taking this medication."

I will take this medication with a high-protein meal."

I will avoid sudden changes in position to prevent dizziness or falls."

Answer and Explanation

The Correct Answer is C

A. "I will report any unusual movements or behaviors to my healthcare provider."
This statement is correct and indicates that the client understands the potential side effects of levodopa/carbidopa. The medication can cause dyskinesia (uncontrolled movements) and other behavioral changes, so the client should report these symptoms to their healthcare provider for possible adjustment of the treatment plan.

B. "I may experience nausea while taking this medication."
This is also correct. Nausea is a common side effect of levodopa/carbidopa, especially when starting the medication. Taking it with food may help reduce this side effect, but some clients may still experience nausea.

C. "I will take this medication with a high-protein meal."
This statement is incorrect. Levodopa is absorbed best on an empty stomach or with a low-protein meal. Protein can interfere with the absorption of levodopa because amino acids (found in proteins) compete with levodopa for absorption across the blood-brain barrier. Therefore, it's recommended that levodopa/carbidopa be taken either 30 minutes before or 1 hour after meals, especially those high in protein.

D. "I will avoid sudden changes in position to prevent dizziness or falls."
This statement is correct. Levodopa/carbidopa can cause orthostatic hypotension (a sudden drop in blood pressure when standing up), which increases the risk of dizziness and falls. The client should be advised to change positions slowly and use support when rising from a sitting or lying position to avoid injury.

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Correct Answer is C

Explanation

A. Call for the rapid response team and request a portable chest x-ray: While it is important to call for help and obtain imaging if needed, the immediate action is to address the potential pneumothorax by sealing the wound. The rapid response team and chest x-ray are necessary for further assessment, but securing the wound is the priority in the moment.

B. Turn the suction drainage system off and auscultate breath sounds: Turning off the suction drainage system and auscultating breath sounds may be part of subsequent assessment and care, but these actions are secondary to stopping the entry of air into the pleural space. Auscultating breath sounds would be important after the chest tube is secured to assess for signs of pneumothorax or other complications, but it is not the first priority.

C. Apply a sterile dressing and tape on three sides: The first priority when a chest tube becomes accidentally dislodged is to seal the wound to prevent air from entering the pleural space, which could cause a pneumothorax (collapsed lung). The correct method to seal the chest tube insertion site is to apply a sterile dressing and tape it on three sides. This technique allows air to escape from the pleural space but prevents air from entering, creating a temporary "one-way valve" effect. This is crucial in stabilizing the patient until further medical intervention can be provided. The fourth side of the dressing is left open to allow for air to escape, which helps prevent a tension pneumothorax

D. Notify the healthcare provider immediately: While notifying the healthcare provider is important, securing the wound to prevent further air entry is the immediate priority. Notifying the provider can occur after the dressing is applied. Prompt action to stabilize the chest tube site is crucial to prevent further respiratory distress or complications.

A. This is a safe medication that is associated with minimal side effects B. Stop the medication if there is increased urination C. Change position slowly to prevent orthostatic hypotension D. Double the dose if a dose is missed at the next scheduled time

Correct Answer is C

Explanation

A. This is a safe medication that is associated with minimal side effects: Carbidopa/levodopa is an effective medication for managing the symptoms of Parkinson's disease, but it is not without side effects. Common side effects include nausea, dizziness, dyskinesia (involuntary movements), and orthostatic hypotension. It is important to be honest with clients about the potential side effects and manage them proactively, rather than describing the medication as "safe with minimal side effects," which could lead to underestimating the risks.

B. Stop the medication if there is increased urination: Increased urination is not a common or typical side effect of carbidopa/levodopa. In fact, the medication is more likely to cause urinary retention or difficulty urinating in some cases. The client should not stop taking the medication without consulting their healthcare provider. Any urinary changes should be reported, but abrupt discontinuation of the medication is not advised without medical supervision.

C. Change position slowly to prevent orthostatic hypotension: One of the common side effects of carbidopa/levodopa therapy is orthostatic hypotension, which occurs when a person experiences a drop in blood pressure upon standing up. This can lead to dizziness or fainting, increasing the risk of falls. The client should be educated to change positions slowly, such as sitting up slowly and standing up gradually from a lying position, to minimize the risk of orthostatic hypotension. This is a critical aspect of safety and should be emphasized as part of the teaching.

D. Double the dose if a dose is missed at the next scheduled time: Doubling the dose of carbidopa/levodopa if a dose is missed can lead to an overdose, which may cause serious side effects, including dyskinesias or other complications. Clients should be instructed to take the missed dose as soon as they remember, unless it is almost time for the next dose. In that case, they should skip the missed dose and continue with their regular dosing schedule. It is important to never double the dose without guidance from the healthcare provider.

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Arterial Blood Gases
pH	7.35-7.45
PaCO2	35-45mmHg
PaO2	80-100mmHg
HCO3-	22-26 mEq/L
O2 Saturation	>95%
Chemistry
BUN	8-21mg/dl
Creatinine	0.5-1.2mg/dl
Na	135-145 mEq/L
K	3.5-5.3 mEq/L
Cl	97-107 mEq/L
CO2	22-26 mEq/L
Ca	8.2-10.2 mg/dl
Glucose	65-99 mg/dl
Mg	1.7-2.2 mg/dl
PO4	2.5-4.5 mg/dl

A nurse is providing discharge teaching to a client who will be taking levodopa/carbidopa for Parkinson's disease. Which of the following statements by the client indicates a need for further teaching?

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Naxlex Comprehensive Predictor Exams

What is the first action the nurse should take with the accidental dislodgement of a chest tube?

Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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