During a home visit, the nurse assesses a client with Alzheimer's disease 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?
Explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started.
Advise the caregiver that the purpose of the medication is to promote sleep, so a change in medication may be needed.
Instruct the caregiver to withhold the medication until the dosage can be decreased to ensure the client's safety.
Notify the healthcare provider that the dosage of the medication may need to be increased to manage the client's insomnia.
The Correct Answer is A
Choice A reason: Insomnia can be a common and temporary side effect when starting rivastigmine. Educating the caregiver about this potential side effect helps them understand that it may resolve over time and reassures them about the safety of the medication.
Choice B reason: Advising that the purpose of the medication is to promote sleep is incorrect. Rivastigmine is used to improve cognitive function in Alzheimer's disease, not specifically to promote sleep.
Choice C reason: Instructing the caregiver to withhold the medication without consulting the healthcare provider is not advisable. Adjusting or discontinuing medication should always be done under medical supervision.
Choice D reason: Notifying the healthcare provider about increasing the dosage for insomnia is inappropriate. The focus should be on managing the side effect without altering the intended therapeutic effect of the medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Calling the clinic for diarrhea or headache is important, but it is not as urgent as reporting black stools, which can indicate gastrointestinal bleeding.
Choice B reason: Resuming NSAID therapy once pain subsides is incorrect. NSAIDs should be avoided due to their adverse effects on the gastrointestinal tract, especially if the client has already experienced bleeding.
Choice C reason: Resuming a diet of milk, cream, and bland foods is not necessarily required for managing the condition and may not address the primary concerns related to gastrointestinal bleeding.
Choice D reason: Notifying the healthcare provider of the passage of black stools is critical as it may indicate ongoing gastrointestinal bleeding, which requires immediate medical evaluation and intervention.
Correct Answer is ["100"]
Explanation
- First, convert the client's weight from kilograms to pounds:
- 1 kg = 2.2 lbs
- Step 1: 90 kg × 2.2 lbs/kg = 198 lbs
- Since the client weighs less than 265.5 pounds, the protocol specifies cefazolin 2 grams/100 mL over 1 hour.
- Determine the flow rate in mL/hr:
- The total volume to be infused is 100 mL.
- The infusion time is 1 hour.
- Step 2: 100 mL ÷ 1 hour = 100 mL/hr
Therefore, the nurse should program the pump to deliver 100 mL/hr.
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