A nurse is teaching a patient newly diagnosed with Parkinson’s disease about the pathophysiology of the condition. Which of the following explanations best describes the underlying cause of Parkinson's disease?
Inflammation of the motor cortex leads to decreased coordination and balance
Degeneration of dopamine producing neurons in the substantia nigra of the brain leads to motor dysfunction
A loss of acetylcholine in the brain leads to memory problems and cognitive decline.
Excess production of dopamine in the basal ganglia leads to tremors and muscle rigidity.
The Correct Answer is B
A. Inflammation of the motor cortex leads to decreased coordination and balance. Parkinson’s disease is not caused by inflammation in the motor cortex; it primarily involves the loss of dopamine-producing neurons.
B. Degeneration of dopamine-producing neurons in the substantia nigra of the brain leads to motor dysfunction. Parkinson’s disease is caused by the degeneration of dopamine-producing neurons in the substantia nigra, leading to motor symptoms such as tremors, rigidity, and bradykinesia.
C. A loss of acetylcholine in the brain leads to memory problems and cognitive decline. While a loss of acetylcholine is associated with Alzheimer’s disease, it is not the primary issue in Parkinson’s disease.
D. Excess production of dopamine in the basal ganglia leads to tremors and muscle rigidity. In Parkinson’s disease, there is a decrease, not an excess, in dopamine production, which contributes to motor symptoms.
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Correct Answer is A
Explanation
A. Reduction of inflammation and suppression of immune responses. Methylprednisolone is a corticosteroid that reduces inflammation and suppresses immune responses, which can help manage the acute exacerbations of MS.
B. Stimulation of nerve regeneration. Methylprednisolone does not stimulate nerve regeneration; it focuses on reducing inflammation.
C. Improvement in cognitive function. Cognitive improvement is not a primary goal of methylprednisolone in MS management, though reducing inflammation may indirectly benefit cognition.
D. Increase in muscle strength and coordination. While reducing inflammation can improve symptoms, methylprednisolone itself does not directly increase muscle strength or coordination.
Correct Answer is A
Explanation
A. Administering mannitol intravenously: Mannitol is an osmotic diuretic that helps reduce ICP by drawing fluid out of brain tissue and decreasing cerebral edema, making it a priority intervention.
B. Encouraging the patient to hyperventilate: Controlled hyperventilation may reduce ICP temporarily by lowering CO₂ levels and causing cerebral vasoconstriction. However, it should only be done cautiously under close monitoring, and other ICP management techniques like mannitol administration take priority.
C. Administering a high-dose corticosteroid: Corticosteroids are generally ineffective for reducing ICP in traumatic brain injury and are typically not recommended in this scenario.
D. Performing a lumbar puncture immediately: Lumbar puncture is contraindicated in cases of increased ICP because it may lead to brain herniation due to the sudden release of pressure.