A client with Parkinson disease asks the nurse why dopamine is ...

[Shelles]

A client with Parkinson disease asks the nurse why dopamine is not given as a neurotransmitter replacement. Which response by the nurse is the most appropriate?
 
  1. The risk for hypertension is too high with dopamine; therefore, more frequent cardiac monitoring would be required.
  2. Exogenous dopamine cannot cross the bloodbrain barrier and would be of little use.
  3. Exogenous dopamine must be administered via intravenous infusion, which usually requires a central line and continuous cardiac monitoring.
  4. In older clients, the effects of dopamine on urinary function can pose an unacceptable risk for renal failure.

Question 2

Which assessment finding in a client with Alzheimer disease would the nurse directly attribute to the disease's effect on acetylcholine?
 
  1. Darkened urine
  2. Inability to retain new information
  3. Muscle cramps
  4. Vomiting and diarrhea

[perkiness]

Answer to Question 1

Correct Answer: 2
Rationale 1: This is not the reason dopamine is not given to a client with Parkinson disease. Dopamine can be given to raise blood pressure.
Rationale 2: Dopamine does not cross the bloodbrain barrier. Levodopa is the precursor of dopamine and does cross the bloodbrain barrier, where the enzyme dopa decarboxylase converts it to dopamine.
Rationale 3: Dopamine is only given intravenously, but that is not the reason it is not prescribed for clients with Parkinson disease.
Rationale 4: Dopamine receptors are located in the kidney, although improvement in renal function is based on dopamine's effect on increasing cardiac output. This is not the reason dopamine is not given to a client with Parkinson disease.
Global Rationale: Dopamine does not cross the bloodbrain barrier. Levodopa is the precursor of dopamine and does cross the bloodbrain barrier, where the enzyme dopa decarboxylase converts it to dopamine. Dopamine can be given to raise blood pressure, but this is not the reason dopamine is not given to a client with Parkinson disease. Dopamine is only given intravenously, but that is not the reason it is not prescribed for clients with Parkinson disease. Dopamine receptors are located in the kidney, although improvement in renal function is based on dopamine's effect on increasing cardiac output. This is not the reason dopamine is not given to a client with Parkinson disease.

Answer to Question 2

Correct Answer: 2
Rationale 1: Darkened urine does not occur as an effect of the disease on acetylcholine.
Rationale 2: Acetylcholine functions within the hippocampus (an area of the brain responsible for learning and memory) and in other portions of the cerebral cortex. The inability to recall information is among the early symptoms of the disease.
Rationale 3: Muscle cramps do not occur as an effect of the disease on acetylcholine.
Rationale 4: Vomiting and diarrhea do not occur as an effect of the disease on acetylcholine.
Global Rationale: Acetylcholine functions within the hippocampus (an area of the brain responsible for learning and memory) and in other portions of the cerebral cortex. The inability to recall information is among the early symptoms of the disease. Darkened urine, muscle cramps, vomiting, and diarrhea do not occur as an effect of the disease on acetylcholine.

[Shelles]

TYSM

[aruss1303]

Excellent