NU 272 Fractures, MS, Osteoarthritis, DJD, Parkinson's Disease, Spinal Cord Questions and Correct Answers Common side effects of anticholinergics include: dry mouth, urinary retention, constipation, and increased pulse rate. blurred vision, decreased liver enzymes, increased B/P, and papillary constriction. decreased GI absorption, nausea, heartburn, and hypotension. skin rashes, decreased urinary output, constipation, and increased WBCs. ✅dry mouth, urinary retention, constipation, and increased pulse rate. Anticholinergic drugs may cause blurred vision, dry mouth, tachycardia, and urinary retention. They also decrease sweating and may cause fever or heatstroke. Fever may occur in any age group, but heatstroke is more likely to occur in older adults, especial ly with cardiovascular disease, strenuous activity, and high environmental temperatures. When centrally active anticholinergics are given for Parkinson's disease, agitation, mental confusion, hallucinations, and psychosis may occur. A client's dose of Sinemet has recently been increased due to an exacerbation of the client's parkinsonian symptoms. What assessment finding would suggest that the client is experiencing adverse effects? The client is retaining urine and has required a urinary catheter The client's blood pressure is 152/93 mm Hg and the client has no history of hypertension The client is diaphoretic despite being afebrile The client has had diarrhea twice in the past two days ✅The client is retaining urine and has required a urinary catheter Adverse effects of levodopa include urinary retention. Diarrhea, increased blood pressure and diaphoresis would likely be attributable to other factors. A nurse is educating a client who has Parkinson's disease and family regarding possible adverse effects of carbidopa -levodopa. The nurse emphasizes which should be a closely monitored effect? involuntary movements. perspiration. appetite or thirst. mobility. ✅involuntary movements Abnormal and involuntary movements are among the most common and serious adverse effects of carbidopa -levodopa therapy. Increased appetite, thirst, and perspiration are not common adverse effects, and increased mobility is a desired outcome of treatment. A client who sustained a complete C6 spinal cord injury 6 months ago has been admitted to the hospital for pneumonia. The nurse observes the client with diaphoresis above the level of C6 and the blood pressure is 260/140 mm Hg. What is the first interventi on the nurse should provide? Elevate the head of the bed. Disimpact the stool from the anal vault. Insert an indwelling catheter. Give the client some orange juice and sugar. ✅Elevate the head of the bed. Autonomic dysreflexia is a clinical emergency, and without prompt and adequate treatment, convulsions, loss of consciousness, and even death can occur. The major components of treatment include monitoring blood pressure while removing or correcting the ini tiating cause or stimulus. The person should be placed in an upright position, and all support hose or binders should be removed to promote venous pooling of blood and reduce venous return. Indications for use of anticholinergic drugs in the treatment for Parkinsonism include to: decrease headaches. improve blurred vision. decrease salivation, spasticity, and tremors. decrease motor movement. ✅decrease salivation, spasticity, and tremors. Anticholinergic drugs are used in idiopathic parkinsonism to decrease salivation, spasticity, and tremors. They are used primarily in people who have minimal symptoms or who cannot tolerate levodopa, or in combination with other antiparkinson drugs. A nurse is caring for 70 -year-old patient who is undergoing anticholinergic drug therapy. The nurse should assess for which condition when caring for this elderly patient? Confusion and disorientation Choreiform movements Suicidal tendencies Psychotic episodes ✅Confusion and disorientation The nurse should assess for confusion and disorientation when caring for this elderly patient undergoing anticholinergic drug therapy. Individuals older than 60 years frequently develop increased sensitivity to anticholinergic drugs and require careful monitoring. Lower doses may also be required in such cases. Choreiform movements, suicidal tendencies, and psychotic episodes are serious adverse reactions associated with the use of levodopa, which is a dopaminergic drug. A client diagnosed with Parkinson's disease has been prescribed rasagiline. When educating this client on this medication, which herbal supplement should be identified as having the potential to produce hyperpyrexia and death? ginger dextromethorphan garlic St. John's wort ✅St. John's wort Rasagiline administered with the herbal supplement St. John's wort will enhance the stimulation of serotonergic receptors to cause hyperpyrexia and death. Dextromethorphan can produce the same reaction but is not an herbal supplement. Ginger and garlic are herbal supplements but will not produce hyperpyrexia and death. Which of the following is the earliest sign of increasing intracranial pressure (ICP)? Change in level of consciousness (LOC) Seizures Restlessness Pupil changes ✅Change in level of consciousness (LOC) The earliest sign of increasing ICP is a change in LOC. Any changes in LOC should be reported immediately. Seizures, restlessness, and pupil changes may occur, but these are not the earliest signs. The home care nurse is caring for an 80 -year-old patient who is receiving carbidopa -
levodopa, a dopaminergic drug used to treat Parkinson's disease. The nurse knows that this drug may place the patient at increased risk for: infection. falls. excessive sedation. uncontrolled bleeding. ✅falls. Adverse effects of dopaminergic drugs such as carbidopa -levodopa include orthostatic hypotension. The dizziness and potential for fainting associated with this effect can increase the risk of falls. The nurse caring for a client, who has been treated for a hip fracture, instructs the client not to cross their legs and to have someone assist with tying their shoes. Which additional instruction should the nurse provide to client? Do not flex the hip more than 30 degrees. Do not flex the hip more than 60 degrees. Do not flex the hip more than 90 degrees. Do not flex the hip more than 120 degrees. ✅Do not flex the hip more than 90 degrees. Proper alignment and supported abduction are encouraged for hip repairs. Flexion of the hip more than 90 degrees can cause damage to the a repaired hip fracture. A client with a closed reduction of a wrist fracture has a plaster cast applied. Which nursing intervention is the highest priorityimmediately after the procedure? Elevating the extremity on a pillow Performing a peripheral circulation assessment Immobilizing the arm in a sling Handling the cast with the palms of the hands ✅Performing a peripheral circulation assessment Complications of fractures include compartment syndrome (when swelling after the injury impairs blood and nerve function), delayed healing, infection, and emboli. Of these conditions, compartment syndrome has the earliest onset and is monitored by peripher al circulation assessment. This includes capillary refill, temperature of the distal extremity, and sensation and the ability to move fingertips. A client sustains an injury to the ligaments surrounding a joint. What will the nurse identify this injury as? Strain Contusion Sprain Fracture ✅Sprain A sprain is an injury to the ligaments surrounding a joint. A strain is an injury to a muscle when it is stretched or pulled beyond its capacity. A contusion is a soft tissue injury resulting from a blow or blunt trauma. A fracture is a break in the contin uity of a bone. A client comes to the emergency department and reports localized pain and swelling in the lower leg. Ecchymotic areas are noted. History reveals that the client got hit in the leg with a baseball bat. What will the nurse most likely suspect? Fracture Contusion Sprain Strain ✅Contusion The client's description of blunt trauma by a baseball bat and localized pain in conjunction with swelling and ecchymosis would most likely suggest a contusion. A
