A nurse assesses a client who presents to the provider's office to evaluate multiple nevi. Which finding should the nurse identify to the provider as possible sign of malignancy?

A) Improved bladder function:
Diphenhydramine, an antihistamine, has anticholinergic properties, meaning it blocks acetylcholine, which can cause side effects like urinary retention and dry mouth. While it may increase urinary retention, it is not primarily used to treat bladder function issues in Parkinson's disease.

B) Relief of depression:
Diphenhydramine is not prescribed for the treatment of depression in Parkinson's disease. It is an antihistamine used to treat allergic reactions and motion sickness, and sometimes for its anticholinergic effects in Parkinson's disease. While it may cause sedation, it does not address the neurochemical imbalances in the brain that cause depression, which is often treated with antidepressants such as SSRIs or SNRIs.

C) Decreased tremors:
Diphenhydramine has anticholinergic properties, which can help reduce tremors in patients with Parkinson's disease. Parkinson's disease is associated with a dopamine deficit, but acetylcholine also plays a role in motor control. The use of anticholinergic medications, such as diphenhydramine, can help restore balance between dopamine and acetylcholine in the brain, leading to decreased tremors.

D) Delay in disease progression:
There is no evidence that diphenhydramine can delay the progression of Parkinson's disease. The disease is caused by the degeneration of dopamine-producing neurons in the brain, and current treatments, such as levodopa/carbidopa or dopamine agonists, primarily aim to manage symptoms rather than prevent progression.

A) Sodium 136 mEq/L:
A sodium level of 136 mEq/L is within the normal reference range of 135–145 mEq/L. While clients with heart failure may experience fluid shifts and altered sodium levels, this result does not immediately require reporting to the provider. Sodium at this level is considered normal.

B) Potassium 4.5 mEq/L:
A potassium level of 4.5 mEq/L is within the normal range of 3.5–5.0 mEq/L, making it a safe and appropriate level. There is no immediate concern regarding potassium levels here, so no action is required. This value does not need to be reported to the provider.

C) Calcium 10 mg/dL:
The normal range for calcium is generally between 8.5–10.5 mg/dL. A calcium level of 10 mg/dL is within this normal range, so this finding does not require further action. No reporting is necessary to the provider.

D) Potassium 2.9 mEq/L:
A potassium level of 2.9 mEq/L is below the normal range (3.5–5.0 mEq/L) and is considered hypokalemia. Furosemide is a loop diuretic that can cause potassium depletion by increasing renal excretion of potassium. This is a serious concern because hypokalemia can lead to dangerous cardiac arrhythmias, muscle weakness, and other complications. The nurse should immediately report this low potassium level to the provider so that potassium supplementation or adjustments in diuretic therapy can be made.