Answer to Question 1
Ans: D
Feedback:
The nurse should monitor for dyskinesia, which is an adverse reaction of the COMT inhibitors, in the client. The other adverse reactions include dizziness, hyperkinesia, nausea, anorexia, diarrhea, orthostatic hypotension, sleep disorders, excessive dreaming, somnolence, and muscle cramps. A serious, and possibly fatal, adverse reaction that can occur with the administration of tolcapone, one of the COMT inhibitors, is liver failure. Increased hand tremor and constipation are adverse effects associated with the use of dopaminergic drugs. Urinary retention is an adverse reaction associated with the administration of cholinergic blocking drugs.
Answer to Question 2
Ans: A
Feedback:
The nurse should instruct the client to suck on ice chips or hard candy (if allowed). The nurse should also instruct the client to take frequent sips of water throughout the day and between meals. The nurse encourages the client to have small, frequent meals when the client experiences a GI disturbance and not when the client complains of dry mouth. The nurse also need not instruct the client to avoid protein-rich foods because this will not reduce the client's discomfort due to dry mouth. The nurse should stop the use of the antiparkinsonism drug when the client complains of severe nausea or vomiting and not when the client is experiencing dry mouth. If dry mouth is so severe that there is difficulty in swallowing or speaking, or if loss of appetite and weight loss occur, the dosage of the antiparkinsonism drug may be reduced but not stopped completely.