The nurse is assessing a client who was recently diagnosed with Parkinson’s disease and is taking carbidopa-levodopa. The client is concerned that the medication is not working. Which intervention should the nurse implement first?

Ask if the client’s morning voids are dark colored.

Evaluate the client for signs of dyskinesia.

Determine if the client is taking the medication before meals.

Explore what the client means by the drug “is not working.”

Answer and Explanation

The Correct Answer is D

A) Ask if the client’s morning voids are dark colored:
This intervention pertains to monitoring for potential adverse effects of carbidopa-levodopa, such as urine discoloration due to the breakdown of levodopa into dopamine. However, it does not directly address the client’s concern about the medication not working. While assessing for adverse effects is important, it may not provide immediate insight into the effectiveness of the medication in managing Parkinson’s disease symptoms.

B) Evaluate the client for signs of dyskinesia:
Dyskinesia refers to involuntary, abnormal movements that can occur as a side effect of long-term treatment with carbidopa-levodopa. While assessing for dyskinesia is essential during the management of Parkinson’s disease, it does not directly address the client’s immediate concern about the medication’s efficacy. It would be more appropriate to address the client’s primary concern first before assessing for potential adverse effects.

C) Determine if the client is taking the medication before meals:
The timing of medication administration, particularly with carbidopa-levodopa, can affect its absorption and effectiveness. Taking the medication with or without food can influence its onset of action and duration of effect. However, this intervention assumes that the client may not be taking the medication correctly, which may not necessarily be the case. It’s important to first clarify the client’s perception of the medication’s effectiveness before addressing administration instructions.

D) Explore what the client means by the drug “is not working.”
This option is correct. The nurse should prioritize exploring the client’s perception of the medication’s efficacy. Understanding the client’s specific concerns, such as which symptoms are not adequately controlled or how they define “not working,” can provide valuable information for further assessment and intervention. By actively listening to the client’s perspective, the nurse can collaboratively address any misconceptions, adjust the treatment plan if necessary, and provide education or reassurance accordingly.

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Correct Answer is A

Explanation

A) Advise the client to move slowly and cautiously when rising and walking: This intervention is essential because baclofen, a muscle relaxant, can cause dizziness, drowsiness, and muscle weakness as side effects. Instructing the client to move slowly and cautiously can help prevent falls and injuries due to these potential side effects.
B) Monitor intake and output every 8 hours: Monitoring intake and output is not directly related to the administration of baclofen. While it is essential to monitor fluid balance in some situations, it is not specifically indicated in this case.
C) Ensure the client knows to stop baclofen before using other antispasmodics: While it is important to avoid concurrent use of multiple antispasmodic medications without proper medical supervision, stopping baclofen abruptly without medical guidance can lead to withdrawal symptoms. Therefore, this intervention is not appropriate without further clarification from the healthcare provider.
D) Evaluate muscle strength every 4 hours: While monitoring muscle strength is essential for clients receiving muscle relaxants, such as baclofen, evaluating it every 4 hours may not be necessary unless there are specific concerns or as directed by the healthcare provider. Monitoring for signs of muscle weakness or adverse effects should be ongoing but may not require such frequent assessments.

A. Diminished renal output. B. Pruritis and macular rash. C. Vomiting and diarrhea. D. Vaginal discharge.

Correct Answer is B

Explanation

A) Diminished renal output:
Diminished renal output could be a potential concern with cefoxitin administration, as it is primarily excreted by the kidneys. However, it is not specifically related to the client’s allergy to penicillin. While it warrants monitoring, it is not the most critical finding to report in this context.

B) Pruritis and macular rash:
The development of pruritis (itchiness) and a macular rash (flat, discolored skin lesions) following the administration of cefoxitin in a client with a documented allergy to penicillin is a significant finding. It suggests a possible allergic reaction to cefoxitin, which belongs to the cephalosporin class of antibiotics. Cross-reactivity between penicillin and cephalosporins is well-documented, with some cephalosporins having a higher risk of allergic reactions in individuals with penicillin allergy. Therefore, pruritis and rash in this context may indicate an allergic response, and it is crucial to report this finding promptly to the healthcare provider for further evaluation and management.

C) Vomiting and diarrhea:
While gastrointestinal symptoms such as vomiting and diarrhea can occur as adverse effects of cefoxitin, they are not specific to an allergic reaction and may occur with various medications. While it is essential to monitor for these symptoms, they are not the most important findings to report in the context of a known penicillin allergy.

D) Vaginal discharge:
Vaginal discharge is not typically associated with an allergic reaction to cefoxitin. While changes in vaginal discharge may be clinically relevant in certain contexts, such as indicating a possible yeast infection or bacterial vaginosis, it is not directly related to the client’s allergy to penicillin or the administration of cefoxitin.

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The nurse is assessing a client who was recently diagnosed with Parkinson’s disease and is taking carbidopa-levodopa. The client is concerned that the medication is not working. Which intervention should the nurse implement first?

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Explanation

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