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.”

Answer and Explanation

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.

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Correct Answer is B

Explanation

A) Schedule both medications at bedtime:
Administering both medications at bedtime may not be the most appropriate schedule. PTU is typically administered multiple times a day to maintain consistent therapeutic levels in the bloodstream. Additionally, administering Lugol’s solution at bedtime may not provide sufficient time for the iodine to take effect before the PTU.

B) Administer iodine one hour before PTU:
This option is correct. Lugol’s solution, a strong iodine solution, is often given before antithyroid medications such as PTU or methimazole to temporarily block thyroid hormone production. Administering iodine about one hour before PTU allows the iodine to be taken up by the thyroid gland, effectively reducing thyroid hormone synthesis before the PTU starts to inhibit the conversion of T4 to T3.

C) Give parental dose once every 24 hours:
This option does not address the timing of administration between PTU and Lugol’s solution. While it may be correct for the dosing frequency of PTU, it does not specify when to administer Lugol’s solution in relation to PTU.

D) Offer both drugs together with a meal:
Administering both drugs together with a meal may not be appropriate, especially considering that Lugol’s solution needs to be absorbed into the bloodstream to exert its effect on the thyroid gland. Administering Lugol’s solution and PTU together may not allow adequate time for the iodine to take effect before the PTU starts to inhibit thyroid hormone production.

A. A dimly lit room. B. A warm room temperature. C. Cool, humidified air. D. A quiet, restful environment.

Correct Answer is A

Explanation

A) A dimly lit room:
Mydriatic medications cause pupil dilation by stimulating the dilator muscle of the iris. In bright light, dilated pupils can lead to photophobia (sensitivity to light) and discomfort for the client. Therefore, placing the client in a dimly lit room helps to minimize the discomfort associated with increased sensitivity to light. This environment also supports visual acuity and reduces the risk of visual disturbances that can occur with bright light.

B) A warm room temperature:
While maintaining a comfortable room temperature is important for overall client comfort, it is not specifically related to the administration of mydriatic medications. The choice of room temperature may vary based on the client’s preferences and individual comfort needs but is not directly influenced by the use of mydriatic medications.

C) Cool, humidified air:
Cool, humidified air may be beneficial for certain respiratory conditions or for promoting comfort in some clients. However, it is not directly relevant to the administration of mydriatic medications. The choice of room temperature and humidity level should prioritize the client’s overall comfort and specific health needs but does not specifically relate to the effects of mydriatic drugs.

D) A quiet, restful environment:
While providing a quiet, restful environment is important for promoting relaxation and comfort, it is not specifically related to the administration of mydriatic medications. Clients receiving mydriatic drugs may benefit from restful surroundings to minimize stress or anxiety, but this choice does not address the potential visual discomfort associated with pupil dilation induced by mydriatic drugs.

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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?

Nursing Test Bank

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Correct Answer is A

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