A client with Alzheimer disease is admitted for an overdose of ...

[sammy]

A client with Alzheimer disease is admitted for an overdose of donepezil (Aricept). What will the nurse most likely assess in this client?
 
  Standard Text: Select all that apply.
  1. Tachycardia
  2. Vomiting
  3. Muscle twitching
  4. Abdominal cramping
  5. Urinary retention

Question 2

While assessing a client before administering neostigmine for myasthenia gravis management, the nurse documents that the client has increased muscle strength compared with the last assessment over an hour ago.
 
  Which interpretation of this data by the nurse is the most accurate?
  1. Toxicity from the medication is imminent.
  2. The client's dose should be increased.
  3. The medication appears to be effective.
  4. The next dose of the medication should not be given.

[Christopher]

Answer to Question 1

Correct Answer: 1,2,3,4
Rationale 1: Tachycardia is a sign of progressing cholinergic crisis.
Rationale 2: Vomiting is a sign of intense parasympathetic stimulation associated with a cholinergic crisis.
Rationale 3: Muscle twitching is a sign of intense parasympathetic stimulation associated with a cholinergic crisis.
Rationale 4: Abdominal cramping is a sign of intense parasympathetic stimulation associated with a cholinergic crisis.
Rationale 5: Urinary retention is not associated with a cholinergic crisis.
Global Rationale: Tachycardia, vomiting, muscle twitching, and abdominal cramping are signs of progressing cholinergic crisis. Urinary retention is not associated with a cholinergic crisis.

Answer to Question 2

Correct Answer: 3
Rationale 1: There is no indication that the client is hyperreflexive.
Rationale 2: The client has already gained some strength from the previous dose.
Rationale 3: This is the expected outcome.
Rationale 4: It is not appropriate to hold the next dose as there is no indication of toxicity.
Global Rationale: The medication is effective and appears to be effective. There is no indication that the client is hyperreflexive; therefore, the medication should not be withheld. The client has already gained some strength from the previous dose.

[sammy]

Excellent

[Perkypinki]

TYSM