The spouse of a patient newly diagnosed with mild, unilateral symptoms of Parkinson disease (PD) asks the nurse what, besides medication, can be done to manage the disease. The nurse will:

A) A patient with hypotension:
Patients with hypotension may have reduced blood flow to organs, which could potentially decrease the absorption and effectiveness of many medications, including opioids. As a result, the need for a higher dose is not typical. Instead, careful dosing and monitoring are required to avoid further lowering blood pressure, which could lead to more complications.

B) A patient with a concussion:
Concussions affect the brain and can lead to symptoms like dizziness, confusion, or nausea, which may alter how medications are metabolized or tolerated. However, a concussion does not typically require higher opioid doses. In fact, opioids should be used cautiously in such patients due to the risk of exacerbating neurological symptoms or respiratory depression.

C) A patient 3 days after surgery:
Patients recovering from surgery may require pain management, but the opioid dose typically adjusts based on their pain levels and recovery stage. While some patients may still need opioids for pain control, they may not require higher-than-expected doses. Over time, doses are often tapered as healing progresses, and pain lessens.

D) A patient with cancer:
Cancer patients, particularly those with advanced stages or chronic pain, may develop increased opioid tolerance. This means that over time, they may require higher doses to achieve the same level of pain relief. This phenomenon is known as "opioid tolerance," where the body becomes less responsive to the drug, necessitating dose adjustments.

A) Increased calcium: Sympathetic activation typically does not cause a direct increase in calcium levels. Calcium levels are more influenced by factors like parathyroid hormone (PTH) and vitamin D, or conditions such as bone disease or renal issues. Although some stress responses can lead to changes in calcium metabolism, an increase in calcium is not a typical response to sympathetic activation.

B) Decreased sodium: While sodium imbalances can occur in various conditions, the sympathetic nervous system does not directly cause a decrease in sodium. The body's handling of sodium is more influenced by factors like kidney function and the renin-angiotensin-aldosterone system. Stress-related changes in sodium levels are less likely to cause a significant decrease in sodium, making this an unlikely focus in monitoring.

C) Decreased potassium: During stress, the body releases catecholamines (like epinephrine) as part of the sympathetic nervous response, which stimulates the movement of potassium into cells. This can result in a transient decrease in serum potassium levels (hypokalemia). Monitoring for decreased potassium is important, as low potassium can lead to cardiac arrhythmias and muscle weakness, which are particularly concerning after surgery or trauma.

D) Increased chloride: Chloride is typically maintained in balance with sodium, and while it may shift in certain conditions, sympathetic activation does not directly lead to increased chloride levels. Most chloride imbalances are secondary to changes in sodium, acid-base disturbances, or kidney function. Therefore, an increase in chloride is less likely in this scenario.