The nurse is performing a medication history on a patient who reports taking lorazepam (Ativan) for the past 6 months to treat an anxiety disorder. The patient states that the medication is not working as well as previously. The nurse will

A) Norepinephrine, dopamine, and serotonin:
Depression has been strongly linked to deficiencies in certain neurotransmitters in the brain, specifically norepinephrine, dopamine, and serotonin. These neurotransmitters play significant roles in regulating mood, emotions, and behavior. When their levels are low, individuals may experience symptoms of depression, such as sadness, low energy, anhedonia (inability to feel pleasure), and difficulty concentrating. Antidepressant medications often work by increasing the availability of these neurotransmitters in the brain.

B) Epinephrine, Norepinephrine, and Acetylcholine:
While norepinephrine plays a key role in depression, epinephrine and acetylcholine are not typically highlighted as the primary neurotransmitters involved in depression. Epinephrine (also known as adrenaline) is more associated with the body’s stress response and fight-or-flight reaction. Acetylcholine is involved in memory and learning processes, but it is not the primary neurotransmitter related to depression.

C) Acetylcholine, gamma-aminobutyric acid, and serotonin:
Acetylcholine and gamma-aminobutyric acid (GABA) are involved in many brain functions, but they are not the primary neurotransmitters linked to depression. While GABA may play a role in mood regulation, it is not typically associated with depression in the same way that serotonin, norepinephrine, and dopamine are. Serotonin is the exception in this answer

D) Gamma-aminobutyric acid, dopamine, and epinephrine:
Although dopamine is involved in depression, gamma-aminobutyric acid (GABA) and epinephrine are not the key neurotransmitters associated with the pathophysiology of depression. Epinephrine primarily affects the stress response, and while GABA does influence mood and anxiety, it is not the main neurotransmitter linked to depression itself.

A) Tell the spouse that medication therapy can be curative if drugs are begun in time: Medication for Parkinson's disease (PD), such as levodopa, can help manage symptoms, but it is not curative. PD is a progressive neurodegenerative disease, and while medications can improve quality of life by alleviating symptoms, they do not stop the disease’s progression. Therefore, suggesting that medication therapy can be curative would be misleading.
B) Recommend exercise, nutritional counseling, and group support to help manage the disease: This is the most accurate and appropriate response. While medications are an important part of managing Parkinson's disease, non-pharmacological approaches, such as exercise, nutritional counseling, and support groups, play a critical role in improving overall function, mobility, and quality of life. Exercise, in particular, can help maintain mobility and reduce rigidity, while a balanced diet can assist in managing issues like constipation or swallowing difficulties. Group support can provide emotional support and help the patient and family navigate the challenges of living with PD.
C) Tell the spouse that the disease will not progress if mild symptoms are treated early: Parkinson's disease is a chronic, progressive condition, and while early treatment can help manage symptoms, it does not prevent the disease from progressing. Suggesting that the disease will not progress if symptoms are treated early would be unrealistic and could create false hope.
D) Counsel the spouse that parkinsonism is a normal part of the aging process in some people: While Parkinson's disease symptoms may appear in older adults, it is not a normal part of aging. Parkinson’s disease is a specific neurodegenerative condition, and its symptoms, such as tremor, bradykinesia, and rigidity, go beyond normal age-related changes. Misleading the spouse by categorizing it as "normal aging" would undermine the importance of proper diagnosis, treatment, and care.