A nurse is preparing to discharge a client who has a new diagnosis of chronic kidney disease (CKD). Which of the following referrals should the nurse plan to initiate?

Choice A Reason:

Carbidopa/levodopa can cause the urine to turn a dark color, such as red, brown, or black. This is a harmless side effect but can be alarming to patients if they are not forewarned. Informing patients about this potential change helps to prevent unnecessary concern.

Choice B Reason:

Expecting immediate relief after taking carbidopa/levodopa is not accurate. While some patients may experience symptom relief relatively quickly, it often takes several weeks for the full therapeutic effects to be realized. Patients should be advised to continue taking the medication as prescribed and to communicate with their healthcare provider about their progress.

Choice C Reason:

Taking carbidopa/levodopa with high-protein food is not recommended. High-protein foods can interfere with the absorption of the medication, reducing its effectiveness. It is generally advised to take the medication on an empty stomach or with a low-protein snack.

Choice D Reason:

Skipping a dose of the medication if experiencing dizziness is not advisable. Dizziness can be a side effect of carbidopa/levodopa, but it should be managed by adjusting the dose or timing of the medication rather than skipping doses. Patients should discuss any side effects with their healthcare provider to find the best management strategy.

Choice A Reason:

Provide assistance with ambulation: Patients with cerebellar tumors often experience ataxia, which is a lack of muscle coordination affecting voluntary movements such as walking and balance. Assisting with ambulation is crucial to prevent falls and ensure the patient’s safety. The cerebellum plays a significant role in motor control, and damage to this area can severely impair a patient’s ability to move safely. Therefore, providing assistance with ambulation is a priority to prevent injury and promote mobility.

Choice B Reason:

Facilitate retention of facts by repeating instructions: While repeating instructions can be beneficial for patients with cognitive impairments, it is not the primary concern for a patient with a cerebellar tumor. The main issues with cerebellar tumors are related to motor control and balance. Although cognitive support is important, ensuring physical safety through assistance with ambulation takes precedence.

Choice C Reason:

Place the client in a darkened room: Placing a patient in a darkened room might help with symptoms like photophobia (sensitivity to light), but it does not address the primary concerns associated with cerebellar tumors, such as balance and coordination. This action does not directly contribute to the patient’s immediate safety and mobility needs.

Choice D Reason:

Speak slowly and clearly: Clear communication is always important in nursing care, especially for patients who may have difficulty understanding due to neurological issues. However, for a patient with a cerebellar tumor, the immediate priority is to address motor dysfunction and prevent falls. Speaking slowly and clearly is supportive but not the primary action needed to ensure the patient’s safety.