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. Blood pressure is 92/50: Nitroglycerin is a vasodilator, and one of its common side effects is a reduction in blood pressure. A blood pressure of 92/50 indicates hypotension, which could be dangerous, especially in a patient with a myocardial infarction. The nurse should report this immediately as further reduction in blood pressure could lead to inadequate perfusion of vital organs, including the heart, and worsen the patient’s condition.

B. Serum potassium is 5.1 mEq/L: A serum potassium level of 5.1 mEq/L is within the normal range (3.5–5.0 mEq/L). While potassium imbalances can affect cardiac function, this level is not dangerously high and would not warrant immediate intervention.

C. Heart rate is 90 beats/minute: A heart rate of 90 beats per minute is within normal limits for an adult. It does not require immediate intervention in the context of a myocardial infarction unless there are signs of arrhythmias or other concerning changes.

D. T wave depression on the electrocardiogram: T wave depression can be a normal finding in patients with myocardial infarction, especially in the early stages. While it can indicate ischemia, it does not require immediate reporting unless there are more severe changes on the ECG or the patient’s condition deteriorates.

A. Encourage the patient to write questions on a white erase board: While writing on a whiteboard can be a helpful method of communication for some patients with ALS, it may not be effective as the disease progresses. In the later stages of ALS, patients often lose the ability to use their hands or arms, making writing impossible.

B. Use pre-arranged eye signals because eye muscles remain intact: In the later stages of ALS, most voluntary muscle function is lost, except for eye muscles. Using eye movements or pre-arranged eye signals (e.g., blinking or moving eyes up or down) is an effective way to communicate with patients who can no longer speak or write. The nurse can establish a system of eye signals to communicate with the patient.

C. Speak slow and repeat phrases due to cognitive decline: ALS typically does not cause cognitive decline. It primarily affects motor function. Speaking slowly and repeating phrases may be helpful if the patient is struggling with speech, but cognitive impairment is not a common symptom in ALS.

D. Have the patient squeeze the nurse's hand when intubated and on the ventilator: When a patient is intubated and on a ventilator, they may not be able to effectively squeeze the nurse's hand due to the presence of a tube in their airway. Additionally, the ability to use hand movements may be lost in advanced ALS, making this method of communication unreliable.