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.

Answer and Explanation

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.

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Correct Answer is B

Explanation

A) Collecting a capillary glucose level is not indicated in response to hand tremors reported by a client taking pregabalin for fibromyalgia. Hand tremors are not typically associated with hypoglycemia, which is what capillary glucose levels assess. Therefore, this action does not directly address the reported symptom.

B) Notifying the healthcare provider is the most appropriate action in response to the client’s report of experiencing tremors while taking pregabalin. Hand tremors can be a potential adverse effect of pregabalin, and the healthcare provider should be informed to assess the severity of the symptom, consider alternative medications or dosage adjustments, and determine the need for further evaluation or intervention.

C) Obtaining orthostatic blood pressure readings is not indicated in response to hand tremors reported by a client taking pregabalin for fibromyalgia. Orthostatic blood pressure readings assess for changes in blood pressure upon position changes (e.g., from lying down to standing up) and are not directly relevant to the reported symptom of tremors.

D) Administering a PRN dose of an antianxiety drug is not the first-line intervention for hand tremors reported by a client taking pregabalin. While antianxiety medications may help alleviate symptoms of anxiety, they do not address the underlying cause of the tremors. Additionally, the client’s tremors may not necessarily be related to anxiety. Therefore, the nurse should prioritize notifying the healthcare provider for further assessment and management of the reported symptom.

A. Measure the client’s vital signs. B. Obtain a fingerstick blood glucose. C. Perform a neurological exam. D. Administer glucagon intramuscularly (IM).

Correct Answer is B

Explanation

A) While measuring the client’s vital signs is a routine nursing intervention, the reported symptoms of confusion and blurred vision after receiving glipizide suggest the possibility of hypoglycemia. Vital signs may not provide immediate information about the client’s glucose levels or help confirm hypoglycemia. However, if the client’s symptoms persist or worsen, assessing vital signs becomes important to monitor for signs of shock or other complications.

B) Obtaining a fingerstick blood glucose is the priority action in this situation. Glipizide is an oral antidiabetic medication that stimulates insulin release from the pancreas, leading to lower blood glucose levels. Symptoms such as confusion and blurred vision are indicative of hypoglycemia, a potential adverse effect of glipizide. Checking the client’s blood glucose level will confirm hypoglycemia and guide further interventions.

C) While performing a neurological exam may be warranted if the client’s symptoms persist or if there are concerns about other neurological issues, confirming hypoglycemia with a fingerstick blood glucose test should be the immediate priority.

D) Administering glucagon intramuscularly (IM) is indicated for severe hypoglycemia when the client is unconscious or unable to swallow. However, in this scenario, the client is conscious and able to report symptoms. Before administering glucagon, it is essential to confirm hypoglycemia with a blood glucose measurement to avoid unnecessary interventions.

Therefore, the nurse should promptly obtain a fingerstick blood glucose to confirm hypoglycemia and initiate appropriate treatment for the client’s symptoms.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who is receiving pregabalin for fibromyalgia reports experiencing tremors in the hands. Which action should the nurse implement?

Correct Answer is B

Explanation

A client reports confusion and blurred vision after receiving a dose of glipizide. Which action should the nurse implement?

Correct Answer is B

Explanation

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