A patient with advanced Parkinson's disease who takes levodopa ...

[penza]

A patient with advanced Parkinson's disease who takes levodopa (Dopar) has been taking bromocriptine (Parlodel) for several weeks. Which of the following findings should most concern the nurse?
 
  a. Increased urine output
  b. Nightmares and agitation
  c. A consistent increase in respirations
  d. Swelling and redness in the feet

Question 2

A patient with Parkinson's disease who takes levodopa (Dopar) and pramipexole (Mirapex) was admitted with a peptic ulcer.
 
  A nurse is providing discharge instructions a week later and notes that the prescriber has added cimetidine (Tagamet) to the patient's drug regimen. What statement made by the patient indicates a need for further teaching?
  a. I should take the Tagamet at least 1 hour before the other medications.
  b. I should rise slowly from seated or lying positions.
  c. I very likely could experience dyskinesias.
  d. I should see an improvement in dyskinesias.

[mfedorka]

Answer to Question 1

ANS: C
A consistent increase in respirations should most concern the nurse, because bromocriptine can cause pulmonary infiltrates.
Bromocriptine does not cause an increase in urine output.
Nightmares and agitation may occur, but the increase in respirations should cause the most concern, because pulmonary infiltrates may lead to congestive heart failure.
Swelling and redness in the feet are important but rare side effects They are not as notable as a consistent increase in respirations.

Answer to Question 2

ANS: D
Cimetidine can inhibit renal excretion of pramipexole, resulting in an increase in the drug's blood level. The patient needs further teaching, because he will not see an improvement in dyskinesias, but rather, more dyskinesias.
Cimetidine should be taken at least 1 hour prior to any other medications; no further teaching is needed.
Postural hypotension is common in patients taking levodopa and pramipexole; no further teaching is indicated.
This patient will experience an increase in dyskinesias; no further teaching is needed.

[penza]

Both answers were spot on, thank you once again

[mfedorka]

Great! Please up vote