The nurse is caring for a patient with Parkinson’s disease. While writing the care plan for this patient what would be an appropriate nursing diagnosis?

A) Norepinephrine: Norepinephrine is a potent vasoconstrictor primarily used in cases of shock to increase blood pressure by constricting blood vessels. However, it does not have a vasodilatory effect on renal blood vessels. Instead, it tends to decrease renal perfusion due to its strong vasoconstrictor properties, which could worsen renal insufficiency.

B) Dopamine: Dopamine is a catecholamine that has a dose-dependent effect on various receptors. At low doses, dopamine specifically acts on dopaminergic receptors in the kidneys, leading to vasodilation of renal blood vessels, which can improve renal perfusion. This makes it particularly useful in treating shock when there is concern about renal insufficiency or reduced kidney function.

C) Acetylcholine: Acetylcholine is a neurotransmitter of the parasympathetic nervous system, not a catecholamine. It is involved in promoting various physiological effects such as slowing the heart rate and stimulating digestive processes, but it does not have a specific role in vasodilation of renal blood vessels or shock management.

D) Enkephalin: Enkephalins are endogenous peptides involved in the regulation of pain and stress responses. They do not have a direct effect on vasodilation of renal blood vessels. Enkephalins are not typically used to treat shock or manage renal insufficiency.

A) Interferon-B (IFN-B): Interferon-beta is a disease-modifying therapy (DMT) used for multiple sclerosis (MS) to reduce the frequency and severity of attacks and slow disease progression. However, it is not typically used during an acute exacerbation of MS. It is more commonly prescribed for long-term management of the disease.
B) Mitoxantrone: Mitoxantrone is an immunosuppressive agent that is used as a disease-modifying therapy for patients with more aggressive forms of MS. While it can be helpful in reducing the frequency of attacks, it is not the first-line treatment during an acute relapse. Mitoxantrone is often considered for long-term use when other therapies are not effective.
C) Glatiramer acetate (Copaxone): Glatiramer acetate is another disease-modifying therapy for MS. It works by altering the immune response to protect the myelin sheath. Like interferon-beta, it is used for long-term management, not for acute attacks. It is not typically used during an exacerbation of MS.
D) Methylprednisolone (Solu-Medrol): Methylprednisolone, a corticosteroid, is the standard treatment for acute exacerbations of multiple sclerosis. It works by reducing inflammation, which helps to decrease the severity of symptoms during an MS relapse. The nurse would anticipate this drug being prescribed to manage the acute inflammatory episode and speed recovery from the attack. This medication is often administered intravenously in high doses and then tapered as the patient stabilizes.