The telephone triage nurse receives a call from a patient asking for a prescription for a narcotic to manage his surgical pain.
The nurse explains that narcotic prescriptions must be written and cannot be called in to the pharmacy.
The patient says, “Why are narcotics so difficult to get a prescription for?” What is the nurse’s best response?

Choice A rationale

Constipation can be a side effect of Parkinson's disease and dopaminergic medications, but it is not a primary safety concern compared to the risk of injury.

Choice B rationale

Risk for injuries related to cardiovascular effects and peripheral vascular disease is a concern, but the risk of orthostatic hypotension presents a more immediate danger for falls.

Choice C rationale

Parkinson's disease and its treatments can cause orthostatic hypotension, significantly increasing the risk of falls and injury. This risk needs to be carefully managed in the patient's care plan.

Choice D rationale

Diarrhea is not commonly associated with Parkinson's disease or its treatments. Constipation is more prevalent due to both the disease and dopaminergic medication effects.

Choice A rationale

Cardiac glycosides are not known for increasing heart rate. Instead, they tend to decrease heart rate by enhancing vagal tone and increasing the refractory period of the atrioventricular node, which helps in controlling heart rate, especially in atrial fibrillation.

Choice B rationale

Cardiac glycosides actually increase the force of myocardial contractions. They inhibit the sodium-potassium ATPase pump, which leads to an increase in intracellular sodium and calcium levels in the myocardial cells, thus increasing the force of contraction.

Choice C rationale

Cardiac glycosides do not significantly decrease conduction velocity. They primarily affect the contractility and heart rate but their influence on conduction velocity is relatively mild.

Choice D rationale

Cardiac glycosides improve renal blood flow and increase urine output by increasing the cardiac output and reducing the activation of the renin-angiotensin-aldosterone system. This helps in relieving symptoms of heart failure.