A nurse is providing teaching to a patient newly diagnosed with Parkinson's Disease (PD) who is prescribed carbidopa/levodopa. What should be included in teaching?

A. Teach the importance of hot showers to help relax: While hot showers may help some people relax, they can also increase fatigue or exacerbate symptoms in conditions like MS or MG. Heat intolerance is a common symptom of MS, and in MG, fatigue can be worsened by hot environments. Therefore, hot showers may not be advisable for these patients.

B. Have the patient prioritize activities early in the day: Fatigue is a hallmark symptom in both Multiple Sclerosis (MS) and Myasthenia Gravis (MG), and patients often experience more energy in the morning. For this reason, it's crucial to schedule the most important and energy-demanding activities early in the day when the patient has more strength and stamina. This helps conserve energy throughout the day and manage fatigue more effectively.

C. Schedule activities late in day and in the evening: Fatigue typically worsens as the day goes on for patients with MS or MG, so scheduling activities later in the day when the patient’s energy levels are lower can worsen the fatigue and make it harder to complete tasks.

D. Provide supplemental oxygen when fatigued: Providing supplemental oxygen is generally reserved for patients who are experiencing hypoxemia or respiratory distress. Fatigue in MS or MG is usually not related to oxygen deficiency, so supplemental oxygen is not an appropriate intervention for general fatigue in these conditions.

A. Change position slowly to prevent orthostatic hypotension.: One of the common side effects of carbidopa/levodopa is orthostatic hypotension, which is a drop in blood pressure when standing up from a sitting or lying position. Patients should be taught to change positions slowly to help prevent dizziness or fainting.

B. Decrease the dose as muscle tremors subside.: The dose of carbidopa/levodopa should not be reduced without a physician's guidance, even if symptoms such as muscle tremors subside. This medication is used to help manage symptoms of Parkinson's disease, and any changes in dosage should be made under the supervision of a healthcare provider.

C. This is a safe medication associated with minimal side effects.: Carbidopa/levodopa is a commonly used medication for Parkinson's disease, but it is associated with several potential side effects, such as nausea, dizziness, dyskinesia (involuntary movements), and orthostatic hypotension. It is important to discuss these potential side effects with the patient.

D. Double the dose the next scheduled time if a dose is missed.: If a dose of carbidopa/levodopa is missed, the patient should not double the next dose. They should follow the instructions provided by their healthcare provider or pharmacist, typically taking the missed dose as soon as they remember, unless it is almost time for the next dose.