The nurse is assessing a client who was recently diagnosed with Parkinson’s disease and is taking carbidopa-levodopa. The client is concerned that the medication is not working. Which intervention should the nurse implement first?
Ask if the client’s morning voids are dark colored.
Evaluate the client for signs of dyskinesia.
Determine if the client is taking the medication before meals.
Explore what the client means by the drug “is not working.”
The Correct Answer is D
A) Ask if the client’s morning voids are dark colored:
This intervention pertains to monitoring for potential adverse effects of carbidopa-levodopa, such as urine discoloration due to the breakdown of levodopa into dopamine. However, it does not directly address the client’s concern about the medication not working. While assessing for adverse effects is important, it may not provide immediate insight into the effectiveness of the medication in managing Parkinson’s disease symptoms.
B) Evaluate the client for signs of dyskinesia:
Dyskinesia refers to involuntary, abnormal movements that can occur as a side effect of long-term treatment with carbidopa-levodopa. While assessing for dyskinesia is essential during the management of Parkinson’s disease, it does not directly address the client’s immediate concern about the medication’s efficacy. It would be more appropriate to address the client’s primary concern first before assessing for potential adverse effects.
C) Determine if the client is taking the medication before meals:
The timing of medication administration, particularly with carbidopa-levodopa, can affect its absorption and effectiveness. Taking the medication with or without food can influence its onset of action and duration of effect. However, this intervention assumes that the client may not be taking the medication correctly, which may not necessarily be the case. It’s important to first clarify the client’s perception of the medication’s effectiveness before addressing administration instructions.
D) Explore what the client means by the drug “is not working.”
This option is correct. The nurse should prioritize exploring the client’s perception of the medication’s efficacy. Understanding the client’s specific concerns, such as which symptoms are not adequately controlled or how they define “not working,” can provide valuable information for further assessment and intervention. By actively listening to the client’s perspective, the nurse can collaboratively address any misconceptions, adjust the treatment plan if necessary, and provide education or reassurance accordingly.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) Serum ammonia level of 30 pg/dl (17.62 μmol /dL): Serum ammonia level is not directly affected by sodium polystyrene sulfonate administration. Ammonia levels are typically related to liver function and are not relevant in assessing the effectiveness of this medication for hyperkalemia.
B) Serum glucose level of 120 mg/dL (6.7 mmol/L): Serum glucose level is unrelated to the action of sodium polystyrene sulfonate. While hyperkalemia can sometimes lead to glucose metabolism abnormalities, the glucose level alone does not provide information about the medication's effectiveness.
C) Serum potassium level of 3.8 mEq/L (3.8 mmol/L): Sodium polystyrene sulfonate, also known as Kayexalate, is a medication used to treat hyperkalemia by exchanging sodium ions for potassium ions in the intestines, leading to potassium excretion through feces. A decrease in serum potassium level within the normal range indicates that the medication has been effective in lowering potassium levels, which is the intended therapeutic outcome in the context of treating hyperkalemia associated with acute kidney injury (AKI).
D) Hemoglobin level of 13.5 g/dL (135 g/L): Hemoglobin level is unrelated to the action of sodium polystyrene sulfonate. It reflects the oxygen-carrying capacity of red blood cells and is not directly influenced by potassium-lowering medications.
Correct Answer is D
Explanation
A) Apply the lotion to plaques on the face: Betamethasone valerate lotion is a potent corticosteroid that is generally not recommended for use on the face due to the risk of adverse effects, such as skin thinning and irritation. Therefore, applying the lotion to plaques on the face is not advisable.
B) Rub the lotion into the area twice daily for 5 weeks: While it is essential to follow the prescribed frequency and duration of medication use, specific instructions for betamethasone valerate lotion may vary depending on the severity of the condition and the healthcare provider's recommendations. This instruction lacks specificity and may not be accurate for all clients.
C) Use gloves to rub the lotion into the area: While wearing gloves may be necessary when applying certain topical medications to prevent contact dermatitis or to protect the hands, it is not typically required when using betamethasone valerate lotion. This instruction may be unnecessary and could lead to unnecessary waste of gloves.
D) Massage the lotion into the psoriasis plaques: This instruction is appropriate because it ensures proper absorption of the medication into the affected skin. Massaging the lotion gently into the psoriasis plaques helps enhance its penetration and effectiveness in treating the condition.
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