The clinic nurse notes that a client with Parkinson's disease has been taking levodopa and carbidopa (Sinemet) for 10 years. Which assessment finding would indicate the client is experiencing a side effect of this medication?
Dyskinesias
Dyspnea
Hypertension
Cold intolerance
The Correct Answer is A
Choice A reason: Dyskinesias, which are involuntary, erratic, writhing movements of the face, arms, legs, or trunk, are common side effects of long-term use of levodopa and carbidopa, especially after many years of therapy.
Choice B reason: Dyspnea, or difficulty breathing, is not commonly associated as a side effect of levodopa and carbidopa.
Choice C reason: Hypertension is not typically a side effect of levodopa and carbidopa; these medications can sometimes cause low blood pressure, particularly upon standing.
Choice D reason: Cold intolerance is not a recognized side effect of levodopa and carbidopa.
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Correct Answer is D
Explanation
Choice A reason: The statement about the medication taking a few weeks to work fully is accurate and does not require follow-up.
Choice B reason: The statement that levothyroxine replaces the hormone the body used to produce is correct and reflects an understanding of the therapy.
Choice C reason: Acknowledging the possibility of lifelong medication is appropriate for levothyroxine therapy in the case of hypothyroidism.
Choice D reason: Levothyroxine should be taken on an empty stomach, typically 30 minutes to an hour before breakfast, to ensure proper absorption. This statement indicates a misunderstanding that requires nurse follow-up.
Correct Answer is A
Explanation
Choice A reason: A thyroidectomy, which is the surgical removal of the thyroid gland, directly leads to hypothyroidism because the body can no longer produce thyroid hormones. This client is at the greatest risk of developing hypothyroidism.
Choice B reason: While exposure to certain chemicals in pesticides can be a risk factor for thyroid dysfunction, it does not pose as immediate a risk as the removal of the thyroid gland itself.
Choice C reason: Thyroid nodules can be associated with thyroid dysfunction, but not all nodules result in hypothyroidism, and many are benign and asymptomatic.
Choice D reason: Vomiting secondary to influenza is not directly related to the development of hypothyroidism.
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