During a home visit, the nurse assesses a client with Alzheimer's Di’ease who recently started a new prescription for rivastigmine. The caregiver reports that the client seems to be thinking more clearly but is not sleeping well at night. Which action should the nurse take?

Instruct the caregiver to withhold the medication until the dosage can be decreased to ensure the client's sa’ety.

Notify the healthcare provider that the dosage of the medication may need to be increased to manage the client's in’omnia.

Advise the caregiver that the purpose of the medication is to promote sleep, so a change in medication may be needed.

Explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started.

Answer and Explanation

The Correct Answer is D

A) Instruct the caregiver to withhold the medication until the dosage can be decreased to ensure the client's sa’ety: Withholding the medication without consulting the healthcare provider may not be appropriate, especially if the client is experiencing improvements in cognitive function. The insomnia may be a temporary side effect that could resolve with continued use or adjustment of the dosage.

B) Notify the healthcare provider that the dosage of the medication may need to be increased to manage the client's in’omnia: Increasing the dosage of rivastigmine to manage insomnia may not be the most appropriate action. It's es’ential to assess the client further and explore other interventions before considering a dosage adjustment.

C) Advise the caregiver that the purpose of the medication is to promote sleep, so a change in medication may be needed: Rivastigmine is not typically used to promote sleep. It is a cholinesterase inhibitor used to treat cognitive symptoms associated with Alzheimer's di’ease. Therefore, advising a change in medication solely based on the client's in’omnia is not appropriate.

D) Explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started: Rivastigmine and other cholinesterase inhibitors may cause insomnia, especially when therapy is initiated. Educating the caregiver about this common side effect helps manage expectations and provides reassurance that the insomnia may improve over time as the client's bo’y adjusts to the medication.

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Correct Answer is B

Explanation

A) Taking ferrous sulfate elixir with a glass of milk is not recommended because milk can interfere with the absorption of iron. Iron absorption is enhanced in an acidic environment, and milk's ca’cium content can inhibit this process.

B) Using a straw to ingest the ferrous sulfate elixir is advisable because it can help minimize contact between the medication and the teeth, reducing the risk of staining. Iron supplements can cause discoloration of the teeth, and using a straw directs the liquid towards the back of the mouth, bypassing the teeth.

C) Swallowing ferrous sulfate elixir undiluted is the usual method of administration; however, doing so may increase the risk of staining the teeth due to direct contact with the oral mucosa and teeth. It is important to follow the healthcare provider's in’tructions regarding dosage and administration.

D) Mixing ferrous sulfate elixir with an antacid is generally not recommended unless specifically directed by the healthcare provider. Antacids containing calcium or magnesium can bind to iron, forming complexes that are poorly absorbed in the gastrointestinal tract, thereby reducing the effectiveness of iron supplementation.

A. pH. B. Calcium. C. Potassium. D. Phosphate.

Correct Answer is D

Explanation

pH: Calcium acetate is not directly related to changes in blood pH. Therefore, monitoring pH levels would not indicate the effectiveness of the medication for CKD.

B) Calcium: Calcium levels may be affected by calcium acetate, but the primary goal of using calcium acetate in CKD is to reduce phosphate levels, not calcium levels. Therefore, monitoring calcium levels would not directly indicate the effectiveness of the medication.

C) Potassium: Calcium acetate is not typically used to affect potassium levels. Monitoring potassium levels would not indicate the effectiveness of calcium acetate for CKD.

D) Phosphate: This is the correct answer. Calcium acetate is a phosphate binder commonly used in CKD to help lower elevated phosphate levels. A decrease in phosphate levels in the blood would indicate that the medication is having the desired effect in controlling phosphate levels, which is important in managing CKD and preventing complications associated with hyperphosphatemia. Therefore, monitoring phosphate levels is essential to assess the effectiveness of calcium acetate therapy in CKD.

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During a home visit, the nurse assesses a client with Alzheimer's Di’ease who recently started a new prescription for rivastigmine. The caregiver reports that the client seems to be thinking more clearly but is not sleeping well at night. Which action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Ferrous sulfate elixir is prescribed for a client with iron deficiency anemia. Which instruction should the nurse provide this client about taking the liquid medication?

Correct Answer is B

Explanation

A client with chronic kidney disease (CKD) is receiving calcium acetate 667 mg PO. A decrease in which blood value indicates to the nurse that the medication is having the desired effect?

Correct Answer is D

Explanation

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