Which intervention best demonstrates the nurse's understanding of safe medication administration of rivastigmine (Exelon) to the older client experiencing symptoms of Alzheimer's disease?
a. The client's cognitive status is evaluated weekly against baseline abilities
b. Rivastigmine route of administration will affect the presence of side effects
c. The client is carefully monitored for side effects before the medication dose is increased
d. The use of a patch delivery system is discussed with the physician and phar-macist
ANS: C
Recommendations to start at low doses with slow titration to decrease side effects provides the safest means of delivering this medication because of the alterations in the metabolism of the older adult client. The fact that rivastigmine (Exelon) is now available in a patch which may be more convenient to use, have fewer side effects, and provides a consistent day-long dose has less impact on the client's safety than does the correct option.
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