The physician writes an order for ziprasidone hydrochloride (Geodon) 80 mg. Each tablet contains 20 mg. How many tablets would you administer?

A. "I may experience urinary retention, dry mouth, and constipation."

This statement is accurate. Urinary retention, dry mouth, and constipation are common side effects of carbidopa-levodopa. The patient should be aware of these potential side effects and report them to the healthcare provider if they become problematic.

B. "I may feel dizzy at first, but this side effect will go away with time."

This statement is accurate. Dizziness is a common initial side effect of carbidopa-levodopa, and it often improves with continued use. The patient should be encouraged to report persistent dizziness to the healthcare provider.

C. "I should report nightmares and mental disturbances to my provider."

This statement is accurate. Nightmares and mental disturbances can be side effects of carbidopa-levodopa. The patient should report these symptoms to the healthcare provider for further evaluation and potential adjustments to the medication.

D. "I should take the drug with food to increase absorption."

This statement indicates a need for further teaching. Carbidopa-levodopa is best absorbed when taken on an empty stomach. Taking it with food, especially high-protein meals, can reduce its absorption. The patient should be instructed to take the medication at least 30 minutes before meals or one to two hours after meals for optimal effectiveness.

A. Administer the dose since the patient is not toxic.

This is not the appropriate action. With a drowsy patient and a high serum phenytoin level, there is a concern for toxicity. Administering the next dose could worsen the toxicity.

B. Contact the provider to discuss decreasing the phenytoin dose.

While adjusting the dose may be a consideration, the immediate action should be to withhold the next dose and report the elevated level to the healthcare provider. The provider can then determine the appropriate course of action.

C. Give the drug and monitor closely for adverse effects.

Giving the drug without further intervention is not appropriate when there are signs of potential toxicity, such as drowsiness. Monitoring alone is not sufficient in this case.

D. Report drug toxicity to the providers.

This is the correct choice. With a drowsy patient and a serum phenytoin level of 18 mcg/mL, which is considered high, reporting the drug toxicity to the healthcare provider is the immediate and appropriate action. The provider can then determine the next steps, such as adjusting the dose or ordering additional tests.