The nurse is caring for a client with Parkinson's disease. The nurse understands the client is on both levodopa and carbidopa for which of the following reasons?

A. Significant impairments from dyskinesia are typically a side effect of long-term levodopa therapy, not an expected outcome following deep brain stimulation. DBS is intended to reduce dyskinesias.
B. The presence of significant tremors post-procedure would indicate that the DBS may not be effectively managing the Parkinson's symptoms. Successful DBS typically reduces tremors.
C. One of the benefits of DBS is that it often allows for a reduction in the dosage of levodopa, not an increase.
D. Improving tremor and rigidity is an expected outcome of DBS. This surgical procedure delivers electrical impulses to targeted areas in the brain, which helps regulate abnormal brain activity and significantly reduces motor symptoms such as tremor, rigidity, and bradykinesia in clients with Parkinson’s Disease.

A. While morphine may be indicated for pain management, particularly if the pain is severe, the priority is first to assess the cause of the chest pain. Chest pain in a patient with myxedema could be related to a number of serious conditions, such as a myocardial infarction or worsening cardiovascular issues, so it is important to assess the pain thoroughly before administering any medications.
B. Stopping thyroid hormone administration is not the correct action. Myxedema is a severe form of hypothyroidism, and thyroid hormone therapy is essential in treating this condition. However, if there is a concern about the cause of the chest pain (such as a heart attack), stopping the thyroid hormone might not be appropriate unless directly indicated by a physician.
C. While obtaining cardiac enzymes can be an important diagnostic step if the chest pain is suspected to be related to a cardiac event, the priority at this moment is to assess the pain and clinical presentation more thoroughly. Cardiac enzymes can be checked after a full assessment of the symptoms.
D. The first priority is to complete a comprehensive pain assessment. The nurse should assess the quality, intensity, and duration of the chest pain and ask relevant questions to determine if the pain is cardiac in nature (e.g., tightness, radiating to left arm, sweating) or possibly related to the thyroid condition (e.g., could be related to complications of myxedema, such as hypothyroid-induced cardiac dysfunction). This step is critical to understanding the cause and ensuring appropriate next steps for care.