A nurse is caring for a 68-year-old male client on a medical-surgical unit.
A nurse is providing client teaching on the newly prescribed medication. Which of the following statements made by the client indicate an understanding of the teaching?
“I might have low blood pressure when I get out of bed.”
“I may experience a return of my symptoms in between doses of my medication.”
“I should eat a diet high in protein.”
“I should take this medication on an empty stomach.”
“My symptoms should resolve in a couple of days after starting this medication.”
Correct Answer : A,B,D
Choice A rationale: Orthostatic hypotension is a common side effect of carbidopa-levodopa due to its vasodilatory effects and impact on the autonomic nervous system. Patients may experience dizziness or lightheadedness when standing up quickly, caused by a drop in blood pressure. Normal blood pressure ranges around 120/80 mm Hg, and sudden decreases can lead to falls, especially in Parkinson’s disease patients who already have balance issues.
Choice B rationale: Wearing-off phenomenon is common with carbidopa-levodopa therapy. This occurs when medication effects diminish before the next dose, causing symptom recurrence such as bradykinesia and tremor. The medication has a relatively short half-life, and patients often report fluctuation in symptom control, especially as disease progresses. Understanding this helps manage expectations and medication timing.
Choice C rationale: High-protein diets can interfere with the absorption of levodopa, as dietary amino acids compete with levodopa for transport across the intestinal mucosa and the blood-brain barrier. Patients are typically advised to moderate protein intake during dosing times to maximize medication effectiveness, rather than increase protein consumption.
Choice D rationale: Levodopa is best absorbed on an empty stomach because food, particularly proteins, delays gastric emptying and competes with levodopa for absorption. Taking the medication 30 minutes before or 1 hour after meals improves bioavailability and symptom control. This knowledge helps optimize medication efficacy.
Choice E rationale: Parkinson’s symptoms usually do not resolve within days of starting carbidopa-levodopa. It often takes weeks to months for optimal symptom control and dose adjustments. Patients should understand that this medication manages symptoms but is not a cure and requires ongoing therapy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Pseudoephedrine is a sympathomimetic agent that primarily acts as a vasoconstrictor and bronchodilator. It does not directly affect kidney function to cause polyuria. In fact, due to its vasoconstrictive properties, it could theoretically decrease renal blood flow, although this is not a common or expected adverse effect leading to increased urine output.
Choice B rationale
Pseudoephedrine's primary mechanism of action involves stimulating alpha- and beta-adrenergic receptors. It does not have a known effect on appetite regulation; it is not typically associated with either increased or decreased appetite. Therefore, an increased appetite is not an expected adverse effect of this medication.
Choice C rationale
Pseudoephedrine is a sympathomimetic drug that stimulates adrenergic receptors, leading to effects similar to sympathetic nervous system activation. This stimulation typically results in tachycardia, not bradycardia. It increases heart rate and contractility, which can be problematic for individuals with pre-existing cardiovascular conditions.
Choice D rationale
As a sympathomimetic, pseudoephedrine causes vasoconstriction by stimulating alpha-1 adrenergic receptors in the arterioles. This widespread vasoconstriction leads to an increase in peripheral vascular resistance, which in turn can elevate blood pressure. Therefore, hypertension is a common and important adverse effect to monitor for, especially in individuals with pre-existing hypertension.
Correct Answer is C
Explanation
Choice A rationale
A prothrombin time (PT) of 15.5 seconds, while slightly above the normal range of 11 to 12.5 seconds, indicates a mild prolongation of clotting time. For a client on warfarin, a slight elevation in PT is often expected as it reflects the anticoagulant effect. This value alone may not necessitate immediate reporting.
Choice B rationale
An activated partial thromboplastin time (aPTT) of 45 seconds, slightly above the normal range of 30 to 40 seconds, indicates a minor prolongation in the intrinsic and common pathways of coagulation. While relevant for heparin therapy, its direct significance for warfarin's primary monitoring is less critical.
Choice C rationale
An International Normalized Ratio (INR) of 5.2 is significantly elevated above the therapeutic range for most conditions, which is typically 2.0 to 3.0 for clients on warfarin. An INR of 5.2 indicates a high risk of bleeding complications due to excessive anticoagulation, requiring immediate provider notification. Normal range is 0.8 to 1.1.
Choice D rationale
A platelet count of 90,000/mcL is below the normal range of 150,000 to 400,000/mcL, indicating thrombocytopenia. While important for hemostasis, warfarin primarily affects clotting factors, not platelet production. However, a low platelet count combined with high INR further increases bleeding risk, necessitating reporting.
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