Chapter 53 and 54 part 2

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Questions and Answers

What should a patient wear at night following cataract surgery?

An eye patch

An eye shield on the operative eye (correct)

No eye covering

A regular sleep mask

Which action should be avoided after cataract surgery to promote healing?

Reading books

Practicing breathing exercises

Bending or stooping (correct)

Walking slowly

Which symptom may indicate a need for glaucoma testing?

Erythema of the conjunctiva

Presence of floaters

Halos around lights (correct)

Increased tearing

What is a likely cause of recent hearing loss in an adult patient?

Fluid in the ear Signup and view all the answers

What should a nurse advise a patient experiencing severe dizziness?

Avoid sudden movements Signup and view all the answers

What should the nurse include in the care plan for a blind patient with heart failure?

Ensure all personnel announce themselves when entering the room Signup and view all the answers

Which early symptom of cataracts should a patient with a family history be cautious of?

Blurred vision Signup and view all the answers

Which nursing intervention is appropriate for a patient with a suspected hearing deficit?

Speak clearly toward the patient’s face with a louder voice Signup and view all the answers

Which foods should a patient with Parkinson's disease consume to prevent nausea and assist with the absorption of carbidopa/levodopa?

Steak sandwich, green salad, iced tea Signup and view all the answers

What is the first-line medication to improve muscular coordination in a patient with Parkinson's disease?

Carbidopa/Levodopa Signup and view all the answers

What should the nurse do first if a patient with Parkinson's disease shows dark yellow urine despite adequate fluid intake?

Ask the patient how much fluid he is drinking Signup and view all the answers

What is the most important piece of history to relay to the healthcare provider for a patient starting riluzole?

Alanine aminotransferase (ALT) level is 300 units per liter Signup and view all the answers

Which laboratory results are crucial to monitor for a patient taking dopamine agonists?

Complete blood counts Signup and view all the answers

Which nursing intervention is critical before administering donepezil (Aricept)?

Ask about symptoms of GI bleeding Signup and view all the answers

Which of the following lifestyle factors should be considered when prescribing medication for a patient with ALS?

Use of alcohol with dinner Signup and view all the answers

For a patient newly diagnosed with Parkinson’s disease, which symptom is commonly improved by initial treatment?

Muscular coordination Signup and view all the answers

Which substances are responsible for the transmission of impulses between synapses?

Neurotransmitters Signup and view all the answers

What is the triad of signs associated with Parkinson disease?

Tremors, rigidity, bradykinesia Signup and view all the answers

What is the appropriate position for a patient with decreased consciousness following a fall?

Head raised slightly with hips flexed Signup and view all the answers

Which question would likely yield the most valid response regarding a neurologic issue?

Can you describe the sensations you are having? Signup and view all the answers

What is the cardinal sign of increased intracranial pressure in a brain injured patient?

Decrease in the level of consciousness Signup and view all the answers

How would you best describe a patient's inability to assess the spatial position of their body?

Proprioception Signup and view all the answers

What nursing action should be taken prior to a myelogram?

Obtain an allergy history before the test Signup and view all the answers

Which of the following structures does NOT belong to the divisions of the nervous system?

Cerebellum Signup and view all the answers

What should the nurse instruct a patient to do if they experience vertigo?

Prioritize safety to prevent falls. Signup and view all the answers

Which instruction is appropriate for a patient undergoing a stapedectomy regarding ear care?

Change cotton in the external ear canal hourly. Signup and view all the answers

How should a nurse instruct a patient to communicate effectively if they are hearing impaired?

Face the patient while speaking. Signup and view all the answers

What is the initial action for a patient who has splashed a chemical in their eyes?

Irrigate the eye with water for 20 minutes. Signup and view all the answers

What should the nurse advise a patient during a vision test with a Snellen chart?

Cover one eye while testing the other. Signup and view all the answers

In which condition would a patient commonly report progressive loss of vision in the center of their visual field?

Macular degeneration. Signup and view all the answers

What is the most appropriate nursing action for a patient who reports sudden sharp pain in the operative eye after cataract surgery?

Call the surgeon immediately. Signup and view all the answers

Which statement by a patient indicates understanding of the surgical procedure for treating otosclerosis?

It corrects issues with the stapes bone. Signup and view all the answers

Why is otitis media more frequently found in children aged 6 to 36 months?

Eustachian tubes in children are shorter and straighter. Signup and view all the answers

What is indicated by a patient having 20/40 vision?

The patient can see at 20 ft what the normal eye can see at 40 ft. Signup and view all the answers

What is a common mistake that hinders communication with the hearing impaired?

Overaccentuating words. Signup and view all the answers

What does a tympanoplasty correct?

Conductive hearing loss. Signup and view all the answers

What is the process when the lens of the eye changes its curvature to focus on the retina?

Accommodation. Signup and view all the answers

What is the first priority if a chemical is splashed in a person's eyes?

Irrigate with normal saline solution for 20 minutes. Signup and view all the answers

What surgical method is used to repair a retinal detachment using a bubble?

Pneumatic retinopexy. Signup and view all the answers

Four hours after a stapedectomy, a patient is not experiencing improved hearing. What should the nurse inform the patient?

Hearing will not return until edema subsides. Signup and view all the answers

Which neurotransmitter is thought to be deficient in Alzheimer's disease?

Acetylcholine Signup and view all the answers

What is the most common expected side effect associated with rivastigmine (Exelon)?

Headaches Signup and view all the answers

Which cardiac side effect could occur when taking a cholinesterase inhibitor like donepezil (Aricept)?

Heart block Signup and view all the answers

Which of the following is an expected side effect of memantine (Namenda)?

Dizziness Signup and view all the answers

Which traditional antiepileptic drug is recommended for use during pregnancy?

Carbamazepine Signup and view all the answers

Which foods are appropriate for a patient with Parkinson's disease to take to prevent nausea and assist with the absorption of carbidopa/levodopa?

Oatmeal, orange juice, toast with butter and jam Signup and view all the answers

What medication is most likely to be prescribed first to improve muscular coordination in a newly diagnosed Parkinson's disease patient?

Pramipexole Signup and view all the answers

What is the best first action for a nurse to take when a patient with Parkinson's disease has dark yellow urine despite adequate fluid intake?

Ask the patient how much fluid he is drinking Signup and view all the answers

What essential element of a patient's history should be communicated to the healthcare provider when starting riluzole for ALS?

Alanine aminotransferase (ALT) level is 300 units per liter Signup and view all the answers

Which laboratory results are most crucial to monitor for a patient taking dopamine agonists?

Liver function studies Signup and view all the answers

Which medication is typically prescribed first for a patient with Parkinson's disease?

Carbidopa/levodopa Signup and view all the answers

Which symptom of Parkinson's disease poses the greatest safety risk during Mr. Moor's daily activities?

Shuffling gait Signup and view all the answers

What should the nurse explain as the reason for frequent blood sugar checks in Mr. Moor?

Your diabetes might worsen with the onset of Parkinson's disease. Signup and view all the answers

Which adverse effect is most commonly associated with increasing doses of dopamine agonists?

Involuntary muscle movements (dyskinesia) Signup and view all the answers

Which priority strategy should be included in Mr. Moor's care plan to prevent falls?

Remove scatter and throw rugs. Signup and view all the answers

What behavior should the nurse observe in a patient that could indicate worsening Parkinson's disease?

Freezing in place Signup and view all the answers

Which of these is NOT a significant side effect to discuss as dopamine agonist doses increase?

Feeling more energized than usual Signup and view all the answers

In managing Mr. Moor's Parkinson's symptoms, which dietary consideration is least relevant?

Ensuring a high sugar diet for energy. Signup and view all the answers

Which symptom is least likely to be considered a direct result of Parkinson's disease progression?

Short-term memory loss Signup and view all the answers

What is a common misconception regarding Parkinson's disease medications and their effects?

They can cause long-term memory loss. Signup and view all the answers

Study Notes

Parkinson's Disease Medications and Diet

Carbidopa/levodopa is commonly prescribed for Parkinson's disease to improve coordination.
Entacapone enhances the effectiveness of carbidopa/levodopa and should be taken with meals to prevent nausea.
Foods that may help with nausea and absorption include scrambled eggs, oatmeal, and banana, while avoiding high-fat meals like cheeseburgers may improve drug efficacy.

Initial Drug Prescriptions

The first-line medication for Parkinson's treatment likely includes carbidopa/levodopa.
Pramipexole may also be prescribed for its dopaminergic effects.

Urine Changes in Parkinson's Disease

Dark yellow urine in patients taking carbidopa/levodopa and entacapone can indicate dehydration.
Best first action is to evaluate fluid intake to ensure hydration status.

Monitoring in Patients Using Dopamine Agonists

Monitoring for complete blood counts and liver function studies is crucial due to potential side effects of dopamine agonists.

Donepezil Administration Considerations

Prior to administering donepezil (Aricept), assess the patient’s weight, history of GI bleeding, and obtain a 12-lead ECG to ensure safety.

Post-Cataract Surgery Care

Important discharge instructions include wearing an eye shield at night, avoiding bending or lifting, and using prescribed eye drops correctly.

Glaucoma Assessment Indicators

Significant symptoms necessitating glaucoma testing include halos around lights, progressive peripheral vision loss, and inability to adapt to darkness.

Communication Strategies for Hearing Impairment

Effective communication strategies include facing the patient while speaking, avoiding overaccentuated speech, and minimizing background noise.

Safety in Vertigo Management

Safety is the priority concern for patients experiencing vertigo, necessitating interventions to prevent falls.

Eye Injury Response Protocol

Initial response to a chemical splash in the eye includes immediate irrigation with water for at least 20 minutes to reduce damage.

Vision Tests Guidelines

During a Snellen eye chart vision test, instruct patients to cover one eye while ensuring they read with the other eye to accurately assess visual acuity.

A patient reporting progressive loss of central vision likely indicates macular degeneration, a common age-related eye disease.

A correct understanding of otosclerosis surgery includes knowing it’s not an external repair but involves interventions to improve hearing loss from stapes ankylosis.

Understanding Otitis Media in Young Children

Otitis media is more prevalent in children aged 6 to 36 months due to their shorter, more horizontal Eustachian tubes, which are prone to blockages.

Neurological Assessments and Interventions

Decreased consciousness with slow reacting pupils post-fall reflects potential increased intracranial pressure requiring immediate assessment and possibly positioning the patient with the neck in a neutral position.
Post-stroke patients demonstrating difficulty with body positioning may experience proprioception issues requiring specialized rehabilitation.

Myelogram Preparations

Before a myelogram procedure, obtaining a thorough allergy history is imperative to anticipate potential reactions to contrast materials used in the exam.

Understanding Eye Accommodation Mechanism

The lens curvature change to focus on the retina is specifically known as accommodation, a vital aspect of visual processing.

Post-Operative Stapedectomy Care

Postoperative instructions for patients who underwent stapedectomy include avoiding forceful actions like blowing the nose and maintaining a sterile environment in the ear canal to promote healing.

Parkinson's Disease Management

Carbidopa/Levodopa and Entacapone are primary medications to manage symptoms.
Nausea can be prevented with certain foods taken with medications; recommended options include scrambled eggs, bacon, oatmeal, orange juice, and toast.
Pramipexole is typically the first-line medication for improving muscle coordination.
Dark yellow urine in patients may indicate dehydration; assess fluid intake before further testing.

Amyotrophic Lateral Sclerosis (ALS) Considerations

Riluzole is a common medication for ALS; elevated alanine aminotransferase (ALT) levels should be reported due to the risk of liver toxicity.

Monitoring for Dopamine Agonist Therapy

Key lab results for patients on dopamine agonists include complete blood counts and liver function studies.

Donepezil (Aricept) Administration

Before administering donepezil, it is essential to assess for GI bleeding history and obtain an ECG.
Acetylcholine deficiency is linked to Alzheimer's disease.

Rivastigmine (Exelon) Side Effects

Common side effects include gastrointestinal issues, specifically flulike symptoms.

Cardiac Effects of Cholinesterase Inhibitors

Potential cardiac side effects of donepezil include bradycardia, hypotension, and heart block. Increased saliva often accompanies these medications.

Memantine (Namenda) Side Effects

Side effects often associated with memantine include headache, dizziness, and possible hallucinations.

Antiepileptic Drugs

Carbamazepine is recommended during pregnancy, while lamotrigine may cause rashes and potential overdose, especially in pregnant women.

Risk of Psychological Dependency

Medications high in risk for dependency include carbamazepine, lacosamide, and phenobarbital.

Multiple Sclerosis

Drugs like alemtuzumab and natalizumab can increase the risk of infections.

Parkinson's Disease Case Study

Initial medication for Mr. Moor may include carbidopa/levodopa or pramipexole.
Safety risks involve shuffling gait, freezing, and swallowing difficulties.
Monitor for adverse effects as treatment escalates, such as hallucinations and dyskinesia.

Cataract Surgery Aftercare

Patients should wear eye shields, avoid bending or stooping, and instill prescribed eye drops.

Glaucoma Assessment

Watch for halos around lights, progressive peripheral vision loss, and adaptation issues to darkness.

Hearing Impairment

Possible causes of hearing loss often include cerumen buildup or eustachian tube dysfunction.

Patient Safety and Awareness

Advise patients with dizziness to avoid sudden movements and maintain hydration.

Assessing Cognition

Asking about the current U.S. president assesses orientation in a cognitive evaluation.

Glasgow Coma Scale (GCS)

A patient with spontaneous eye opening, incomprehensible speech, and obeying commands would typically score a total of 11 on the GCS.

Spinal Cord Injury Awareness

Flaccid paralysis can signal temporary conditions but may also indicate a serious prognosis; continuous monitoring for recovery is needed.

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Description

This quiz focuses on the dietary management of patients with Parkinson's disease, particularly regarding the timing and selection of foods consumed with their medications. The correct choices are essential for minimizing nausea and optimizing drug absorption for those taking carbidopa/levodopa and entacapone. Test your knowledge on appropriate food pairings and nursing interventions in this context.