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Nure 231-9

The document discusses the assessment of clients taking various medications, including amantadine hydrochloride for Parkinson's disease, imipramine for depression, and lithium carbonate for manic-depressive illness. It highlights potential adverse effects, dietary recommendations for osteoporosis, and the appropriate nursing responses to laboratory results and client complaints. Key findings include recognizing bilateral lung wheezes as a sign of possible adverse effects from amantadine and documenting normal serum levels of imipramine and side effects from lithium.

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George
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37 views1 page

Nure 231-9

The document discusses the assessment of clients taking various medications, including amantadine hydrochloride for Parkinson's disease, imipramine for depression, and lithium carbonate for manic-depressive illness. It highlights potential adverse effects, dietary recommendations for osteoporosis, and the appropriate nursing responses to laboratory results and client complaints. Key findings include recognizing bilateral lung wheezes as a sign of possible adverse effects from amantadine and documenting normal serum levels of imipramine and side effects from lithium.

Uploaded by

George
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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A nurse is assessing a client who has been taking amantadine hydrochloride for the treatment of

Parkinson's disease. Which finding from the history and physical examination would cause the nurse to
determine that the client may be experiencing an adverse effect of the medication?

Bilateral lung wheezes

Rationale: Amantadine hydrochloride is an antiparkinson agent that potentiates the action of dopamine
in the central nervous system (CNS). The medication is used to treat rigidity and akinesia. Insomnia and
orthostatic hypotension are side effects of the medication. Adverse effects include congestive heart
failure (evidenced by bilateral lung wheezes), leukopenia, neutropenia, hyperexcitability, convulsions,
and ventricular dysrhythmias.

A nurse is providing instruction to a client with osteoporosis regarding appropriate foods to include in
the diet. The nurse tells the client that one food item high in calcium is:

Sardines

Rationale: Osteoporosis is a chronic metabolic disease in which bone loss results in decreased density
and sometimes fractures. Foods high in calcium include milk and milk products, dark-green leafy
vegetables, tofu and other soy products, sardines, and hard water. Corn, cocoa, and peaches do not
contain appreciable amounts of calcium.

The blood serum level of imipramine is determined in a client who is being treated for depression. The
laboratory test indicates a concentration of 250 ng/mL. On the basis of this result, the nurse should:

Document the laboratory result in the client's record

Rationale: Imipramine is a tricyclic antidepressant that is often used to treat depression. The therapeutic
blood serum level is between 225 and 300 ng/mL, so the nurse would simply document the laboratory
result in the client's record. Asking the laboratory to recheck the level and withholding the next dose of
the imipramine and contacting the health care provider are unnecessary.

A client who is taking lithium carbonate complains of mild nausea, voiding in large volumes, and thirst.
On assessment, the nurse notes that the client is complaining of mild thirst. On the basis of these
findings, the nurse should:

Document the findings

Rationale: Lithium carbonate is a mood stabilizer that is used to treat manic-depressive illness. Side
effects include polyuria, mild thirst, and mild nausea, and therefore the nurse would simply document
the findings. Because the client's complaints are side effects, not toxic effects, contacting the health care
provider, instituting seizure precautions, and having a specimen drawn immediately for a serum lithium
determination are all unnecessary. Vomiting, diarrhea, muscle weakness, tremors, drowsiness, and
ataxia are signs of toxicity and if these occur the health care provider needs to be notified.

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