Author Question: A patient will begin taking a cholinesterase inhibitor for early Alzheimer's disease. The nurse is ... (Read 73 times)

nmorano1 · **on:** Jul 23, 2018

A patient will begin taking a cholinesterase inhibitor for early Alzheimer's disease. The nurse is teaching the patient's spouse about the medication. Which statement by the spouse indicates a need for further teaching?

a. Gastrointestinal symptoms are common with this medication.
b. People taking this drug should not take antihistamines.
c. This drug helps neurons that aren't al-ready damaged to function better.
d. This drug significantly slows the pro-gression of the disease.

Question 2

A patient with bipolar disorder is admitted to the hospital. The patient has been taking lithium Lithobid for several years and has not been evaluated by a provider for over a year.

Besides obtaining a lithium level, the nurse caring for this patient will anticipate orders for which labora-tory tests? (Select all that apply.) a. Calcium level
b. Complete blood count with differential
c. Liver function tests
d. Renal function tests
e. Serum potassium
f. Thyroid function tests

JCABRERA33 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

D
Cholinesterase inhibitors produce modest improvements in cognition, behavior, and function and may slightly delay disease progression; they do not have a major impact on delaying progression of the disease. Gastrointestinal symptoms are common side effects. Drugs that block cholinergic receptors, including antihistamines, can reduce therapeutic effects and should be avoided. Cho-linesterase inhibitors do not affect neurons already damaged, but they do improve function in those not yet affected.

Answer to Question 2

B, D, F
Patients taking lithium can develop a mild, reversible leukocytosis, so annual CBC evaluation with differential is recommended. Chronic lithium use is associated with degenerative changes in the kidneys, so renal function should be assessed annually. Lithium can reduce the incorporation of iodine into thyroid hormone and can inhibit thyroid secretion; therefore, thyroid hormone and thyroid-stimulating hormone (TSH) levels should be measured annually. Lithium is affected by sodium levels but not by calcium or potassium levels. Because lithium is excreted by the kidneys, hepatic function tests are not indicated.