Author Question: The spouse of a patient with Alzheimer's disease asks a nurse for more information about the ... (Read 77 times)

Ebrown · **on:** Jul 23, 2018

The spouse of a patient with Alzheimer's disease asks a nurse for more information about the rivastigmine (Exelon) transdermal patch that is being used. Which statement by the spouse indicates a need for further explanation?

a. Doses are lower but more steady with the transdermal patch.
b. Reduced side effects occur with the transdermal patch.
c. We only need to change the patch every 2 weeks.
d. We should remove the old patch before applying the new one.

Question 2

The spouse of a patient who acts confused and forgetful wants to know if there is a test to determine whether the patient has Alzheimer's disease. Which response by the nurse is correct?

a. A diagnosis is made by administering medications and observing for potential improvement in symptoms.
b. The diagnosis is based on a patient's age, family history, serum apolipoproteins, and genetic testing.
c. Magnetic resonance imaging to demonstrate brain atrophy is the definitive test to determine Alzheimer's disease.
d. Proposed diagnostic criteria include measures of cognitive function and the presence of one known biomarker.

Dominic · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: C
The rivastigmine transdermal patch needs to be changed daily. Sites used should not be reused for 14 days. Transdermal dosing provides lower, steady levels of the drug. Intensity of side effects is lower with the transdermal patch. The old patch must be removed prior to applying the new patch to prevent toxicity.

Answer to Question 2

ANS: D
In 2010 an international group of AD experts proposed revising diagnostic criteria to add the presence of at least one AD biomarker to current measures of cognitive function after a patient has been observed to have episodic memory impairment. The diagnosis currently is made by observing memory impairment and then measuring cognitive function. Most medications used for AD do not demonstrate sustained or unequivocal improvement, so they would not be useful for diagnostic purposes. The patient's age and family history are risk factors. The serum ApoE level and genetic testing are not used to diagnose AD. Magnetic resonance imaging (MRI) can measure one brain marker of AD; however, brain atrophy has several different causes and is not definitive.