Question 1

While a patient is receiving drug therapy for Parkinson's disease,the nurse monitors for dyskinesia,which is manifested by which finding?

Accepted Answer

Dyskinesia is a movement disorder characterized by involuntary muscle movements, which can include chorea (writhing or jerky movements), athetosis (slow, writhing movements), dystonia (abnormal posture), and tremors. Patients with Parkinson's disease who receive drug therapy can experience dyskinesia as a side effect of their medications, particularly during the "on" phase of their medication cycle. Difficulty in performing voluntary movements is a common manifestation of dyskinesia. Rigid, tense muscles are seen in Parkinson's disease itself, not dyskinesia. Limp extremities with weak muscle tone are seen in conditions such as muscular dystrophy and amyotrophic lateral sclerosis. Confusion and altered mental status are not typically associated with dyskinesia.

Question 2

A patient has been treated with antiparkinson medications for 3 months.What therapeutic responses should the nurse look for when assessing this patient?

Accepted Answer

The nurse should look for an improved ability to perform activities of daily living as a therapeutic response to antiparkinson medications. Decreased appetite and cogwheel rigidity are not therapeutic responses, while newly developed dyskinesias may be a side effect of the medication.

Question 3

The prescriber writes this order,"Give amantadine (Symmetrel)100 mg per PEG tube twice a day." The medication is available in a liquid form with a concentration 50 mg/5 mL.Identify how many milliliters will the nurse give with each dose._______

Accepted Answer

10 mL

Question 4

A patient has been given a prescription for levodopa-carbidopa (Sinemet)for her newly diagnosed Parkinson's disease.She asks the nurse,"Why are there two drugs in this pill?" The nurse's best response reflects which fact?

Accepted Answer

Carbidopa prevents the breakdown of levodopa in the periphery, allowing more levodopa to reach the brain to be converted to dopamine. This results in improved Parkinson's symptoms with lower doses and fewer side effects.

Question 5

A patient taking entacapone (Comtan)for the first time calls the clinic to report a dark discoloration of his urine.After listening to the patient,the nurse realizes that what is happening in this situation?

Accepted Answer

Dark discoloration of urine is a harmless effect of entacapone (Comtan) and is due to the excretion of a metabolite of the drug. It is important to reassure the patient that this is a normal effect and not a sign of any serious problem.

Question 6

The nurse is developing a care plan for a patient who is taking an anticholinergic drug.Which nursing diagnosis would be appropriate for this patient?

Accepted Answer

Anticholinergic drugs can cause urinary retention, making it difficult for patients to completely empty their bladder. This can put them at risk for urinary tract infections and other related complications. The other options (diarrhea, risk for infection, disturbed sleep pattern) are not directly related to anticholinergic drug therapy.

Question 7

A patient has a new order for a catechol ortho-methyltransferase (COMT)inhibitor as part of treatment for Parkinson's disease.The nurse recognizes that which of these is an advantage of this drug class?

Accepted Answer

COMT inhibitors are used in conjunction with levodopa/carbidopa to prolong the effects of levodopa and reduce the wearing-off effects that can occur with long-term use of levodopa. They do not have a shorter duration of action, do not cause less gastrointestinal distress, and do not have a slower onset than traditional Parkinson's disease drugs.

Question 8

A patient has been taking selegiline (Eldepryl),20 mg/day for 1 month.Today,during his office visit,he tells the nurse that he forgot and had a beer with dinner last evening,and "felt awful." What did the patient most likely experience?

Accepted Answer

Selegiline is an MAO inhibitor, which means it interacts with the enzyme monoamine oxidase. When combined with alcohol, there is a risk of an increase in blood pressure (hypertension), which can lead to symptoms such as headache, dizziness, and feeling "awful."

Question 9

When treating patients with medications for Parkinson's disease,the nurse knows that the wearing-off phenomenon occurs for which reason?

Accepted Answer

The wearing-off phenomenon occurs when antiparkinson medications begin to lose their effectiveness, despite maximal dosing, as the disease progresses. The other options are incorrect.

Question 10

The nurse is assessing the medication history of a patient with a new diagnosis of Parkinson's disease.Which condition is a contraindication for the patient,who will be taking tolcapone (Tasmar)?

Accepted Answer

Tolcapone is contraindicated in patients with a history of liver failure or active liver disease due to the risk of hepatic failure. The drug can cause serious and potentially fatal hepatotoxicity. Therefore, the medication should only be used when the potential benefits outweigh the risks, and the patient's liver function should be carefully monitored during treatment. Glaucoma, seizure disorder, and benign prostatic hyperplasia are not listed as contraindications for tolcapone.

Question 11

Carbidopa-levodopa (Sinemet)is prescribed for a patient with Parkinson's disease.The nurse informs the patient that which common adverse effects can occur with this medication?

Accepted Answer

Common adverse reactions associated with carbidopa-levodopa include palpitations, hypotension, urinary retention, dyskinesia, and depression. The other effects may occur with other antiparkinson drugs.

Question 12

When assessing the medication history of a patient with a new diagnosis of Parkinson's disease,which conditions are contraindications for the patient who will be taking carbidopa-levodopa? (Select all that apply.)

Accepted Answer

A) Angle-closure glaucoma is a contraindication for carbidopa-levodopa use since the drug can cause mydriasis and increase intraocular pressure.
B) There have been reports of melanoma in patients receiving levodopa, so it is contraindicated in patients with a history of malignant melanoma.
C) Hypertension is not a contraindication for carbidopa-levodopa use but it may require close monitoring and adjustment of the patient's antihypertensive medications.
D) Benign prostatic hyperplasia is not a contraindication for carbidopa-levodopa use.
E) Concurrent use of monoamine oxidase inhibitors (MAOIs) is contraindicated with carbidopa-levodopa since it can lead to hypertensive crisis. MAOIs should be discontinued at least two weeks before starting carbidopa-levodopa.

Question 13

When a patient is taking an anticholinergic such as benztropine (Cogentin)as part of the treatment for Parkinson's disease,the nurse should include which information in the teaching plan?

Accepted Answer

Anticholinergic medications such as benztropine (Cogentin) can cause dry mouth as a side effect. Using artificial saliva, sugarless gum, or hard candy can help to counteract this symptom. Minimizing fluid intake is not necessary and could lead to dehydration. Patients should not discontinue their medication without consulting their healthcare provider. Taking medication on an empty stomach may increase the risk of gastrointestinal side effects.

Quiz 15: Antiparkinson Drugs

While a patient is receiving drug therapy for Parkinson's disease,the nurse monitors for dyskinesia,which is manifested by which finding?

A patient has been treated with antiparkinson medications for 3 months.What therapeutic responses should the nurse look for when assessing this patient?

The prescriber writes this order,"Give amantadine (Symmetrel)100 mg per PEG tube twice a day." The medication is available in a liquid form with a concentration 50 mg/5 mL.Identify how many milliliters will the nurse give with each dose._______

A patient has been given a prescription for levodopa-carbidopa (Sinemet) for her newly diagnosed Parkinson's disease.She asks the nurse,"Why are there two drugs in this pill?" The nurse's best response reflects which fact?

A patient taking entacapone (Comtan) for the first time calls the clinic to report a dark discoloration of his urine.After listening to the patient,the nurse realizes that what is happening in this situation?

The nurse is developing a care plan for a patient who is taking an anticholinergic drug.Which nursing diagnosis would be appropriate for this patient?

A patient has a new order for a catechol ortho-methyltransferase (COMT) inhibitor as part of treatment for Parkinson's disease.The nurse recognizes that which of these is an advantage of this drug class?

A patient has been taking selegiline (Eldepryl) ,20 mg/day for 1 month.Today,during his office visit,he tells the nurse that he forgot and had a beer with dinner last evening,and "felt awful." What did the patient most likely experience?

When treating patients with medications for Parkinson's disease,the nurse knows that the wearing-off phenomenon occurs for which reason?

The nurse is assessing the medication history of a patient with a new diagnosis of Parkinson's disease.Which condition is a contraindication for the patient,who will be taking tolcapone (Tasmar) ?

Carbidopa-levodopa (Sinemet) is prescribed for a patient with Parkinson's disease.The nurse informs the patient that which common adverse effects can occur with this medication?

When assessing the medication history of a patient with a new diagnosis of Parkinson's disease,which conditions are contraindications for the patient who will be taking carbidopa-levodopa? (Select all that apply.)

When a patient is taking an anticholinergic such as benztropine (Cogentin) as part of the treatment for Parkinson's disease,the nurse should include which information in the teaching plan?