A nurse is providing teaching to an adolescent who has a prescription for cromolyn for the management of asthma.
Which of the following statements by the adolescent indicates an understanding of the teaching?

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.

Choice A rationale

Amiodarone is known to cause various adverse effects, but ototoxicity leading to hearing impairment is not a commonly reported or significant side effect. The primary concerns with amiodarone involve pulmonary, thyroid, hepatic, and ocular toxicities. Therefore, routine hearing screenings are not a standard intervention in the care plan for clients on amiodarone.

Choice B rationale

An increase in appetite is not a recognized or common adverse effect associated with amiodarone. Amiodarone can cause gastrointestinal side effects such as nausea, vomiting, and anorexia, but an increased appetite is not typically observed. Monitoring for such a symptom would not be a priority in the client's plan of care.

Choice C rationale

Amiodarone is extensively metabolized by the liver and is known to cause hepatotoxicity, ranging from asymptomatic transaminase elevation to severe hepatitis and cirrhosis. Therefore, periodic monitoring of liver enzyme levels (e.g., AST, ALT, alkaline phosphatase) is crucial to detect early signs of liver injury and adjust treatment if necessary. Normal AST levels are typically 10-40 U/L, and ALT levels are 7-56 U/L.

Choice D rationale

While some medications can cause psychiatric disturbances, manic behavior is not a commonly reported or characteristic adverse effect of amiodarone. The central nervous system effects of amiodarone are more likely to include peripheral neuropathy, ataxia, and tremors. Monitoring for manic behavior is not a standard intervention for clients on amiodarone therapy.