Author Question: An older adult client is hospitalized with Guillain-Barr syndrome. The client is given amitriptyline ... (Read 49 times)

savannahhooper · **on:** Jun 25, 2018

An older adult client is hospitalized with Guillain-Barr syndrome. The client is given amitriptyline (Elavil). After receiving the hand-off report, what actions by the nurse are most important? (Select all that apply.)

a. Administering the medication as ordered
b. Advising the client to have help getting up
c. Consulting the provider about the drug
d. Cutting the dose of the drug in half
e. Placing the client on safety precautions

Question 2

A client with myasthenia gravis is prescribed pyridostigmine (Mestinon). What teaching should the nurse plan regarding this medication? (Select all that apply.)

a. Do not eat a full meal for 45 minutes after taking the drug.
b. Seek immediate care if you develop trouble swallowing.
c. Take this drug on an empty stomach for best absorption.
d. The dose may change frequently depending on symptoms.
e. Your urine may turn a reddish-orange color while on this drug.

lolol · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: B, C, E
Amitriptyline is a tricyclic antidepressant and is considered inappropriate for use in older clients due to concerns of anticholinergic effects, confusion, and safety risks. The nurse should tell the client to have help getting up, place the client on safety precautions, and consult the provider. Since this drug is not appropriate for older clients, cutting the dose in half is not warranted.

Answer to Question 2

ANS: A, B, D
Pyridostigmine should be given with a small amount of food to prevent GI upset, but the client should wait to eat a full meal due to the potential for aspiration. If difficulty with swallowing occurs, the client should seek immediate attention. The dose can change on a day-to-day basis depending on the client's manifestations. Taking the drug on an empty stomach is not related although the client needs to eat within 45 to 60 minutes afterwards. The client's urine will not turn reddish-orange while on this drug.