A client with a history of benign prostatic hyperplasia (BPH), gout, hyperlipidemia, and palpitations is being seen for symptoms of narcolepsy
Before starting on methylphenidate (Concerta) for treatment of narcolepsy, which testing would the nurse anticipate?
1. A PSA and digital prostate exam
2. A 12-lead EKG and further cardiac workup pending results
3. Urinalysis and lab tests to determine control of gout
4. Labs for cholesterol and triglyceride levels
Correct Answer: 2
Rationale 1: There is no documentation indicating that Concerta creates anticholinergic activity that is contraindicated in BPH.
Rationale 2: Clients should be screened for preexisting cardiac disease before starting this medication, as sudden unexplained cardiac death has occurred in some people taking this medication.
Rationale 3: Gout is not affected by treatment with Concerta.
Rationale 4: Concerta does not affect lipid levels.
Global Rationale: Clients should be screened for preexisting cardiac disease before starting this medication, as sudden unexplained cardiac death has occurred in some people taking this medication. There is no documentation indicating that Concerta creates anticholinergic activity that is contraindicated in BPH. Gout is not affected by treatment with Concerta. Concerta does not affect lipid levels.
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