A client recently diagnosed with Parkinson's disease receives a new prescription for carbidopa-levodopa. To reduce the client's risk for injury, which instruction should the nurse provide?

Caution when changing from a sitting to a standing position.

Ambulate using a four point cane or a walker with wheels.

Place small rugs on smooth surfaces such as tile or wood floors.

Obtain a hospital bed with side rails and an over bed trapeze.

Answer and Explanation

The Correct Answer is A

A. Caution when changing from a sitting to a standing position: Carbidopa-levodopa can cause orthostatic hypotension, leading to dizziness and falls. Teaching the client to rise slowly and carefully helps prevent sudden drops in blood pressure and significantly reduces the risk of injury.

B. Ambulate using a four point cane or a walker with wheels: Assistive devices can help with mobility in Parkinson’s disease, but their use should be based on a physical therapist’s evaluation. Not every client will immediately require a walker or cane upon starting treatment.

C. Place small rugs on smooth surfaces such as tile or wood floors: Small rugs actually increase the risk of tripping and falling, especially for clients with Parkinson’s disease, who already have gait instability. It is safer to remove rugs rather than add them.

D. Obtain a hospital bed with side rails and an over bed trapeze: A hospital bed with side rails and an overbed trapeze might be necessary for clients with advanced Parkinson's disease who have significant mobility limitations or require assistance with repositioning in bed. However, for a newly diagnosed client, this level of equipment is likely unnecessary and could foster dependence.

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Free Nursing Study Resources

Correct Answer is B

Explanation

A. Evaluate muscle strength every 4 hours: While assessing muscle strength is important in clients with multiple sclerosis, it does not need to be done this frequently unless the client is unstable. Baclofen may cause weakness, but routine assessments every 4 hours are excessive for stable patients.

B. Advise the client to move slowly and cautiously when rising and walking: Baclofen can cause dizziness, sedation, decreased muscle tone and orthostatic hypotension, particularly in the early stages of treatment. Educating the client to change positions carefully helps reduce the risk of falls and injury.

C. Ensure the client knows to stop baclofen before using other antispasmodics: Baclofen should not be stopped abruptly due to the risk of withdrawal symptoms like hallucinations or seizures. Combining different antispasmodic medications can increase the risk of adverse effects such as excessive sedation or muscle weakness. Medication changes therefore should only be made under the supervision of the healthcare provider.

D. Monitor intake and output every 8 hours: Baclofen does not typically affect renal function or fluid balance significantly. Monitoring intake and output is not a standard intervention specific to baclofen administration unless there is another underlying condition.

A. Schedule the medication to be given just before bedtime. B. Break the medication into small pieces and sprinkle onto food. C. Instruct the client to avoid dairy products for at least 30 minutes. D. Administer the medication thirty minutes prior to meals.

Correct Answer is D

Explanation

A. Schedule the medication to be given just before bedtime: Pyridostigmine should be timed to coincide with periods of increased activity, especially before meals, to improve muscle strength. Giving it at bedtime would not offer functional benefit unless the client experiences nighttime symptoms.

B. Break the medication into small pieces and sprinkle onto food: Pyridostigmine tablets are not designed to be crushed or split unless specifically directed. Altering the form may affect its absorption and reduce its effectiveness in managing symptoms of myasthenia gravis.

C. Instruct the client to avoid dairy products for at least 30 minutes: Dairy does not interfere significantly with the absorption or action of pyridostigmine. Dietary restrictions should be based on known drug-food interactions, which are not typically associated with pyridostigmine and dairy.

D. Administer the medication thirty minutes prior to meals: Administering pyridostigmine before meals helps enhance swallowing and chewing abilities, reducing the risk of aspiration. This timing optimizes muscle strength during eating, which is a high-risk activity for clients with myasthenia gravis.

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A client recently diagnosed with Parkinson's disease receives a new prescription for carbidopa-levodopa. To reduce the client's risk for injury, which instruction should the nurse provide?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is administering the muscle relaxant baclofen PO to a client diagnosed with multiple sclerosis. Which intervention should the nurse implement?

Correct Answer is B

Explanation

A client diagnosed with myasthenia gravis receives a prescription for pyridostigmine. Which intervention should the nurse implement when preparing to administer this medication?

Correct Answer is D

Explanation

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