A nurse is assigned to care for a 40-year-old client with a ...

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A nurse is assigned to care for a 40-year-old client with a hepatic injury that has occurred due to the administration of tolcapone. Which of the following interventions should the nurse perform when caring for this client?
 
  A) Monitor the client for signs of tactile hallucinations.
  B) Monitor the client for signs of dystonic movements.
  C) Perform regular blood tests of the client.
  D) Perform serum transaminase level testing every day.

Question 2

A nurse is caring for a 70-year-old client who is receiving anticholinergic drug therapy for Parkinson's disease. The nurse would be alert for the development of which of the following in this client?
 
  A) Confusion and disorientation
  B) Choreiform movements
  C) Suicidal tendencies
  D) Psychotic episodes

[ambernicolefink]

Answer to Question 1

Ans: C
Feedback:
A serious and potentially fatal adverse reaction to tolcapone is hepatic injury. The nurse should, therefore, perform regular blood testing to monitor liver function of the client as prescribed. The testing of serum transaminase levels may be ordered at frequent intervals such as every 2 weeks for the first year and every 8 weeks thereafter. The nurse need not perform serum transaminase level testing every day. The nurse should monitor for signs of dystonic movements when caring for a client receiving carbidopa and levodopa, not tolcapone. The nurse should monitor for signs of tactile hallucinations when caring for an elderly client receiving tolcapone.

Answer to Question 2

Ans: A
Feedback:
The nurse should assess for confusion and disorientation when caring for this elderly client receiving anticholinergic drug therapy. Individuals older than 60 years frequently develop increased sensitivity to anticholinergic drugs and require careful monitoring. Lower doses may also be required in such cases. Choreiform movements, suicidal tendencies, and psychotic episodes are serious adverse reactions associated with the use of levodopa, which is a dopaminergic drug.

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Thanks

[ambernicolefink]

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