Reference no: EM133592323

Question 1. As a home health nurse, you are visiting your patient, Mrs. Jones, who is an 80-year-old female newly diagnosed with Alzheimer's disease (AD). Mrs. Jones' children are at her house and have questions related to the treatment of her disease. She has been started on donepezil (Aricept).

a) Mrs. Jones' children ask what the benefit of taking donepezil for her AD will be and does it cure the disease? They also want to know if she can take the maximum dose for the medication to get the best effects.

b) What teaching plan can you design for this patient and her family related to administration of donepezil? Include in this any concerns with administration, side effects and adverse reactions.

c) Compare and contrast the individual cholinesterase inhibitors. Mrs. Jones has progressed to a moderate stage in her AD. Her healthcare provider has now prescribed memantine (Namenda).

d) What benefits will memantine add with this patient's disease progression?

e) Mrs. Jones' daughter asks if her donepezil will now be discontinued. What is the nurse's best response?

Question 2. You are the pediatric nurse caring for Jill, an 8-year-old with partial seizures that are newly diagnosed with epilepsy. Jill will be hospitalized for at least 3 more days. Jill has been prescribed carbamazepine. You have been assigned to develop the initial teaching plan for Jill and her parents. How will you best prepare to answer these questions?

a) Does the patient need to follow the time frame established for administration of the drugs used in her treatment?
b) How can Jill and her parents assist the healthcare team in determining how her seizures can best be treated?
c) What are the actions, side effects, and precautions needed for carbamazepine?

Jill has another seizure and the healthcare provider wants to add phenytoin (Dilantin).

d) Are there any concerns with adding this medication to Jill's regimen?
A second patient on the unit who is diagnosed with generalized seizures begins to have seizure activity that is classified as status epilepticus.
e) What does this mean and how will the nurse anticipate treating the patient with status epilepticus?

Question 3. You have been assigned to care for Jim. He is 29 years old and has been diagnosed with schizophrenia. Jim has been prescribed chlorpromazine [Thorazine]. He lives with his parents.
You have been asked to talk with Jim's family about his medication. While Jim is in a group session, you meet with his parents.
a) The mother asks what Jim's physicians mean when they say chlorpromazine causes extrapyramidal symptoms (EPS). She says that if these symptoms create problems, she wants to know what can be done to help the situation. How should you answer her questions?
b) Jim's father asks about the long-term effects of taking antipsychotic drugs. He states, "I read that the extrapyramidal symptoms only get worse. How can they get worse than the ones you talked about? With all the research going on, what can be done to help this?" What is your response?
c) Jim's mother states that she is concerned. "I understand that Jim will need to take the medication for the rest of his life. How am I ever going to get him to take these pills if the side effects are so bad?" What is your response?
d) Jim's father states that he has read that clozapine (Clozaril) is a better drug to prescribe for people with schizophrenia. What is the nurse's best response?

e) What other teaching points would be important to discuss regarding Jim's drug therapy for schizophrenia?

cover each topic thoroughly

each response should have a citation in the past 5 years