The nurse is teaching a client with parkinsonism about carbidopa-levodopa. Which statement(s) by the client indicate(s) the need for further teaching? Select All That Apply

A. Aspirin and warfarin

The combination of aspirin and warfarin poses a potential risk of increased bleeding and bruising. Both aspirin and warfarin are anticoagulants, and when used together, they can potentiate each other's effects, leading to a higher risk of bleeding events, including easy bruising.

B. Sulfasalazine and acetaminophen

Sulfasalazine is often used in the treatment of arthritis and inflammatory bowel disease, while acetaminophen is a commonly used pain reliever. There is no significant interaction between these two medications leading to increased bleeding or bruising.

C. Tolmetin and propranolol

Tolmetin is a nonsteroidal anti-inflammatory drug (NSAID) used for pain relief, and propranolol is a beta-blocker used for conditions such as hypertension. While both medications have their own potential side effects, there is no specific interaction between them that significantly increases the risk of bleeding or bruising.

D. Meloxicam and amlodipine

Meloxicam is an NSAID, and amlodipine is a calcium channel blocker used for hypertension. Similar to option C, there is no known significant interaction between these two medications that would lead to increased bleeding or bruising.

A. Before breakfast or lunch

Methylphenidate (Ritalin), a stimulant medication commonly used to treat attention deficit hyperactivity disorder (ADHD), is usually administered before breakfast or lunch for maximum effectiveness. This schedule helps align the peak concentration of the medication with the times when increased focus and attention are often needed, such as during school hours.

B. With meals

While it can be administered with meals, the goal is often to have the medication take effect before meals to help with focus and attention during activities like school or work.

C. After dinner

Administering methylphenidate after dinner may interfere with the patient's ability to fall asleep, as the medication can cause insomnia. It is generally recommended to avoid administering it in the late afternoon or evening.

D. At bedtime

Administering methylphenidate at bedtime is not appropriate due to the potential for insomnia. The stimulant effect of the medication is not aligned with the patient's sleep-wake cycle.