A nurse is reviewing the medical history of a client who is to start taking prednisone.
Which of the following findings should the nurse identify as a contraindication to
prednisone therapy?

A) Decreased blood pressure - IV fluid replacement is expected to improve hydration

status, which should lead to stabilization or normalization of blood pressure rather

than a decrease.

B) Excessive thirst - Excessive thirst indicates dehydration and would not indicate

effective IV fluid replacement.

C) Moist oral mucous membranes - Moist oral mucous membranes are a sign of

adequate hydration and indicate that IV fluid replacement has been effective.

D) Increased heart rate - IV fluid replacement is expected to improve hydration status,

leading to stabilization or normalization of heart rate rather than an increase.

A. “You may initially notice an increase in involuntary movements."- Levodopa- carbidopa can initially cause an increase in involuntary movements, known as dyskinesias. This is an important aspect to educate the client about, as it may be alarming if not expected.
B. “The medication can cause nausea, so take with a meal.”- It is also crucial to mention that the medication can cause nausea; therefore, taking it with a meal can help mitigate this issue
C. “You may notice your urine becomes lighter in color."- Levodopa can cause dark- colored urine (brown, black) and not light discoloration.
D. “You can experience vivid nightmares."- Vivid dreams or nightmares are possible side effects of levodopa-carbidopa therapy. Informing the client about this potential adverse effect prepares them for what they may experience.
E. “This medication can make you light-headed if you stand up too quickly from a seated or lying position."- Orthostatic hypotension is a common side effect of levodopa-carbidopa, especially when standing up quickly. Advising the client about this risk helps prevent falls and injuries.
F. "Consumption of a high protein meal can reduce the effectiveness of the medication."- Protein intake can interfere with the absorption of levodopa. Therefore, advising the client to avoid high-protein meals around the time of medication administration can optimize its effectiveness.