Chapter 18: Antidementia Drugs Introductory Clinical Pharmacology 12th Edition by Susan M Ford

Introductory Clinical Pharmacology 12th Edition by Susan M Ford 1. A client with AD is prescribed memantine. Which finding on assessment should the nurse prioritize? a. Confusion b. Dyspepsia c. Muscle cramps d. Vomiting Answer: A Rationale: When administering memantine to a client, a nurse should monitor the client for adverse reactions such as dizziness, headache, or confusion. Dyspepsia is an adverse reaction of rivastigmine; muscle cramps are an adverse reaction of donepezil; and vomiting is an adverse reaction of rivastigmine and galantamine. Question Format: Multiple Choice Chapter: 18 Learning Objective: 2 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 232, Summary Drug Table 2. The nurse is preparing to administer donepezil to a female client. The nurse should question this order if which factor is noted in the client's record? a. Seizure disorder b. Positive pregnancy test c. Asthma d. Bladder obstruction Answer: B Rationale: The administration of donepezil is contraindicated in clients with hypersensitivity to the drug, who are pregnant or are lactating. The drug is used cautiously with renal disease, bladder obstruction, seizure disorders, sick sinus syndrome, GI bleeding, and asthma. Question Format: Multiple Choice Chapter: 18 Learning Objective: 2 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 228, Contraindications and Precautions 3. A nurse is preparing to perform an initial preadministration assessment on a client who is to receive donepezil for AD. The nurse will include which elements in this assessment? a. Sexual habits b. Body weight c. Living situation d. Caregiver capabilities Answer: B Rationale: The nurse should obtain body weight and the vital signs of the client during the initial assessment. The nurse need not monitor the sexual habits, sleeping patterns, or eating habits of the client when administering cholinesterase inhibitors. Physical assessment should include vital signs and weight. The nurse should also assess cognitive function using the MMSE as well as functional ability to include ADLs and self-care. The living situation and caregiver's capabilities are not necessary before giving the medication. Question Format: Multiple Choice Chapter: 18 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 230, Preadministration Assessment 4. The nurse is performing an ongoing assessment on a client who received rivastigmine for AD. Which noted assessment finding should the nurse prioritize? a. Anorexia and nausea b. Cardiovascular dysfunction c. Diabetes mellitus d. Hypertension Answer: A Rationale: General adverse effects associated with the administration of cholinesterase inhibitors include anorexia, nausea, vomiting, diarrhea, dizziness, and headache. Cardiovascular dysfunction such as sick sinus syndrome requires a cautious administration approach. Diabetes mellitus and hypertension are not recognized as adverse effects associated with the administration of cholinesterase inhibitors. Question Format: Multiple Choice Chapter: 18 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 228, Adverse Reactions 5. The nurse notes a client with AD and receiving a cholinesterase inhibitor is losing weight on the ongoing assessment. Which action will the nurse prioritize when providing care to this client? a. Provide nutritious meals three times a day. b. Give foods that have the same consistency. c. Ensure a calm atmosphere during meals. d. Encourage visitors during mealtime. Answer: C Rationale: Meals provided should be simple and calm to promote nutrition. The nurse does not need to provide nutritious meals three times a day; instead, frequent small nutritious meals would be more beneficial. Offering foods of different consistency and flavor is important in case the client can handle one form better than another. The nurse should not encourage visitors during mealtime; mealtime should be simple and calm. Question Format: Multiple Choice Chapter: 18 Learning Objective: 5 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 230, Malnutrition: Less Than Body Requirements 6. The nurse is preparing to administer donepezil to a client with dementia. The nurse will monitor the client for which finding after noting the client is taking celecoxib for a history of arthritis?