A nurse is reviewing hematology laboratory results of a client receiving intravenous chemotherapy for leukemia. Which of the following laboratory findings prompts the nurse to initiate neutropenic precautions?

Choice A reason: There is total absence of dopamine at receptors in brain cells controlling motor movement, causing Parkinson symptoms to appear, is not the correct statement. Parkinson disease is not caused by a complete lack of dopamine, but by a gradual loss of dopamine-producing neurons in the substantia nigra, a part of the brain that regulates movement. The symptoms of Parkinson disease, such as tremor, rigidity, and bradykinesia, appear when about 80% of the dopamine neurons are lost.

Choice B reason: There is an excess of dopamine production and deficiency of acetylcholine production, is not the correct statement. Parkinson disease is not caused by an excess of dopamine, but by a deficiency of dopamine. Dopamine is a neurotransmitter that helps to control movement, balance, and coordination. Acetylcholine is another neurotransmitter that works in opposition to dopamine. When dopamine is low, acetylcholine becomes dominant and causes abnormal muscle movements.

Choice C reason: There is a decreased production of dopamine and excess of acetylcholine, is the correct statement. Parkinson disease is caused by a decreased production of dopamine and excess of acetylcholine. This creates an imbalance in the neurotransmitters that regulate movement, leading to the characteristic symptoms of Parkinson disease, such as tremor, rigidity, and bradykinesia.

Choice D reason: There is a deterioration of the myelin sheath of the basal ganglia and the person has tremors, is not the correct statement. Parkinson disease is not caused by a deterioration of the myelin sheath, but by a degeneration of the dopamine neurons. Myelin is a fatty substance that covers the axons of the nerve cells and helps to transmit electrical impulses. The basal ganglia are a group of structures in the brain that are involved in movement, learning, and emotion. Tremors are one of the symptoms of Parkinson disease, but they are not the only or the most specific one.

Choice A reason: Evening is not the best time to visit the patient with myasthenia gravis to help with bathing and exercising. Myasthenia gravis is a condition that causes muscle weakness and fatigue, which worsens as the day progresses. Therefore, the patient may have more difficulty performing these activities in the evening.

Choice B reason: Mid-afternoon is not the best time to visit the patient with myasthenia gravis to help with bathing and exercising. Myasthenia gravis causes muscle weakness and fatigue, which may be aggravated by the heat and humidity of the afternoon. Therefore, the patient may have more difficulty performing these activities in the mid-afternoon.

Choice C reason: Morning is the best time to visit the patient with myasthenia gravis to help with bathing and exercising. Myasthenia gravis causes muscle weakness and fatigue, which are less severe in the morning after a night of rest. Therefore, the patient may have more strength and energy to perform these activities in the morning.

Choice D reason: Before bedtime is not the best time to visit the patient with myasthenia gravis to help with bathing and exercising. Myasthenia gravis causes muscle weakness and fatigue, which are most severe at the end of the day. Therefore, the patient may have more difficulty performing these activities before bedtime.