Author Question: A patient with Parkinson disease asks the nurse what an onoff problem means with medications. What ... (Read 38 times)

genevieve1028 · **on:** Jun 25, 2018

A patient with Parkinson disease asks the nurse what an onoff problem means with medications. What should the nurse explain to the patient?

1. The on' times will be when your symptoms are under control; the off' times are when you will have increased problems with symptom management.
2. There will be times when you are depressed (off) and when you are happy (on).
3. You will have to take breaks from this medicine by stopping (off) and starting it (on) again, so you don't build up a tolerance to it.
4. I'm not a pharmacist, so I shouldn't be answering this question.

Question 2

A patient with myasthenia gravis is prescribed pyridostigmine (Mestinon). When teaching about this medication, what should the nurse teach the patient to immediately report?

Select all that apply.
1. increased weakness
2. problems with increased drooling
3. orthostatic hypotension
4. headache
5. increased difficulty swallowing

emily12345 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Correct Answer: 1
The onoff phenomenon occurs after the patient takes levodopa for several years; this phenomenon is characterized by unexpected dyskinesias (abnormal movements) and lack of symptom control. The onoff phenomenon has nothing to do with depressive episodes and the medication for Parkinson disease should not be started and stopped. A nurse should be able to answer questions about the patient's medications, or at least attempt to find the answer if it is not known.

Answer to Question 2

Correct Answer: 1, 2, 3, 5
An overdose or underdose of anticholinesterase drugs can lead to a myasthenic or cholinergic crisis. The goal of pharmacological therapy is to increase muscle tone; weakness after taking the medication should be reported as soon as possible to offset a medical emergency. Manifestations of myasthenic crisis include increased difficulty swallowing and chewing, muscle weakness, fast heartbeat and restlessness. Increased drooling and lowering of blood pressure should be reported. Headache does not need to be reported.