Question

scenario: a patient with moderate alzheimer’s disease is taking rivastigmine and reports feeling dizzy and having frequent falls. question: what should the nurse practitioner do next? ○ discontinue rivastigmine immediately. ○ reduce the dose of rivastigmine. ○ switch to donepezil. ○ add a medication to manage dizziness.

Explanation:

Rivastigmine is a cholinesterase inhibitor used for Alzheimer's. Dizziness and falls can be due to adverse effects related to the dose. Discontinuing immediately (first option) is too hasty as the drug has benefits. Switching to donepezil (third option) isn't the first step as dose adjustment of the current drug should be considered first. Adding a medication for dizziness (fourth option) doesn't address the root cause (possible dose - related issue with rivastigmine). Reducing the dose of rivastigmine (second option) is a more appropriate initial step to see if the adverse effects resolve while still maintaining some therapeutic effect.

Answer:

B. Reduce the dose of rivastigmine.