A nurse provides teaching for a patient who is newly diagnosed with Parkinson's disease. Which statement by the patient indicates understanding of the drug therapy for this disease?

Choice A reason: Preventing constipation is not the primary reason for prescribing metoprolol alongside nifedipine. While managing side effects is important in patient care, metoprolol does not have a notable effect on gastrointestinal motility to address constipation.

Choice B reason: Reducing flushing is not the main purpose of metoprolol. Flushing can sometimes be a side effect of vasodilatory medications, but it is not the specific reason for adding a beta-blocker like metoprolol to a treatment regimen involving a calcium channel blocker like nifedipine.

Choice C reason: Minimizing gingival hyperplasia is not the intended effect of metoprolol. Gingival hyperplasia can be a side effect of certain medications, such as calcium channel blockers like nifedipine, but metoprolol does not specifically counteract this effect.

Choice D reason: Preventing reflex tachycardia is the primary reason for prescribing metoprolol alongside nifedipine. Nifedipine, a calcium channel blocker, can cause vasodilation, which may lead to a reflex increase in heart rate (tachycardia) as the body tries to maintain blood pressure. Metoprolol, a beta-blocker, helps prevent this reflex tachycardia by slowing the heart rate and reducing the workload on the heart, thus complementing the antihypertensive effect of nifedipine.

Choice A reason: Autonomic dysreflexia is a condition that occurs in individuals with spinal cord injuries, typically at or above the T6 level. It is characterized by a sudden and severe increase in blood pressure (hypertension), accompanied by a slowed heart rate (bradycardia) and severe headache. This condition results from an exaggerated autonomic response to stimuli below the level of the spinal cord injury, such as a distended bladder or bowel, leading to the release of catecholamines and subsequent vasoconstriction.

Choice B reason: Hypotension and shock are not characteristic of autonomic dysreflexia. Instead, autonomic dysreflexia involves hypertension. Hypotension and shock are more commonly associated with conditions such as spinal shock or severe blood loss, not the autonomic crisis seen in autonomic dysreflexia.

Choice C reason: Extreme pain below the level of injury can occur in individuals with spinal cord injuries, but it is not a hallmark of autonomic dysreflexia. The condition is primarily marked by the triad of hypertension, bradycardia, and headache. Pain below the level of injury may be related to other complications of spinal cord injury but does not define autonomic dysreflexia.

Choice D reason: Pallor and vasodilation above the level of injury are not typical features of autonomic dysreflexia. In fact, above the level of injury, individuals may experience vasoconstriction and flushing due to the altered autonomic responses. The key symptoms of autonomic dysreflexia are hypertension, bradycardia, and headache.