During a home visit, the nurse assesses a client with Alzheimer's Di’ease who recently started a new prescription for rivastigmine. The caregiver reports that the client seems to be thinking more clearly but is not sleeping well at night. Which action should the nurse take?
Instruct the caregiver to withhold the medication until the dosage can be decreased to ensure the client's sa’ety.
Notify the healthcare provider that the dosage of the medication may need to be increased to manage the client's in’omnia.
Advise the caregiver that the purpose of the medication is to promote sleep, so a change in medication may be needed.
Explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started.
The Correct Answer is D
A) Instruct the caregiver to withhold the medication until the dosage can be decreased to ensure the client's sa’ety: Withholding the medication without consulting the healthcare provider may not be appropriate, especially if the client is experiencing improvements in cognitive function. The insomnia may be a temporary side effect that could resolve with continued use or adjustment of the dosage.
B) Notify the healthcare provider that the dosage of the medication may need to be increased to manage the client's in’omnia: Increasing the dosage of rivastigmine to manage insomnia may not be the most appropriate action. It's es’ential to assess the client further and explore other interventions before considering a dosage adjustment.
C) Advise the caregiver that the purpose of the medication is to promote sleep, so a change in medication may be needed: Rivastigmine is not typically used to promote sleep. It is a cholinesterase inhibitor used to treat cognitive symptoms associated with Alzheimer's di’ease. Therefore, advising a change in medication solely based on the client's in’omnia is not appropriate.
D) Explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started: Rivastigmine and other cholinesterase inhibitors may cause insomnia, especially when therapy is initiated. Educating the caregiver about this common side effect helps manage expectations and provides reassurance that the insomnia may improve over time as the client's bo’y adjusts to the medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) Cheese, milk, and yogurt: These foods are high in calcium and may not be the best choice for a client taking furosemide, as they can contribute to calcium levels and potentially exacerbate hypercalcemia, which is a risk with loop diuretic use.
B) Bananas, oranges, and peaches: This is the correct response. These fruits are rich in potassium, which is often depleted in clients taking loop diuretics like furosemide. Encouraging foods high in potassium can help replenish electrolytes and prevent hypokalemia.
C) Pasta, cereal, and bread: While these foods are generally well-tolerated and can provide carbohydrates for energy, they do not specifically address the electrolyte imbalances associated with loop diuretic use.
D) Liver, beef, and chicken: These foods are good sources of protein but do not directly address the electrolyte imbalances associated with loop diuretic use.
Therefore, encouraging the client to consume foods rich in potassium, such as bananas, oranges, and peaches, can help offset the potassium loss caused by furosemide and mitigate the risk of hypokalemia.
Correct Answer is D
Explanation
A) Instruct the caregiver to withhold the medication until the dosage can be decreased to ensure the client's sa’ety: Withholding the medication without consulting the healthcare provider may not be appropriate, especially if the client is experiencing improvements in cognitive function. The insomnia may be a temporary side effect that could resolve with continued use or adjustment of the dosage.
B) Notify the healthcare provider that the dosage of the medication may need to be increased to manage the client's in’omnia: Increasing the dosage of rivastigmine to manage insomnia may not be the most appropriate action. It's es’ential to assess the client further and explore other interventions before considering a dosage adjustment.
C) Advise the caregiver that the purpose of the medication is to promote sleep, so a change in medication may be needed: Rivastigmine is not typically used to promote sleep. It is a cholinesterase inhibitor used to treat cognitive symptoms associated with Alzheimer's di’ease. Therefore, advising a change in medication solely based on the client's in’omnia is not appropriate.
D) Explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started: Rivastigmine and other cholinesterase inhibitors may cause insomnia, especially when therapy is initiated. Educating the caregiver about this common side effect helps manage expectations and provides reassurance that the insomnia may improve over time as the client's bo’y adjusts to the medication.
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