The nurse is preparing to administer a first dose of benztropine (Cogentin) to a patient diagnosed with parkinsonism. The nurse would notify the patient’s provider if the patient had a history of which condition?

A) Tell the spouse that medication therapy can be curative if drugs are begun in time: Medication for Parkinson's disease (PD), such as levodopa, can help manage symptoms, but it is not curative. PD is a progressive neurodegenerative disease, and while medications can improve quality of life by alleviating symptoms, they do not stop the disease’s progression. Therefore, suggesting that medication therapy can be curative would be misleading.
B) Recommend exercise, nutritional counseling, and group support to help manage the disease: This is the most accurate and appropriate response. While medications are an important part of managing Parkinson's disease, non-pharmacological approaches, such as exercise, nutritional counseling, and support groups, play a critical role in improving overall function, mobility, and quality of life. Exercise, in particular, can help maintain mobility and reduce rigidity, while a balanced diet can assist in managing issues like constipation or swallowing difficulties. Group support can provide emotional support and help the patient and family navigate the challenges of living with PD.
C) Tell the spouse that the disease will not progress if mild symptoms are treated early: Parkinson's disease is a chronic, progressive condition, and while early treatment can help manage symptoms, it does not prevent the disease from progressing. Suggesting that the disease will not progress if symptoms are treated early would be unrealistic and could create false hope.
D) Counsel the spouse that parkinsonism is a normal part of the aging process in some people: While Parkinson's disease symptoms may appear in older adults, it is not a normal part of aging. Parkinson’s disease is a specific neurodegenerative condition, and its symptoms, such as tremor, bradykinesia, and rigidity, go beyond normal age-related changes. Misleading the spouse by categorizing it as "normal aging" would undermine the importance of proper diagnosis, treatment, and care.

A) Stop taking the medication immediately: Abruptly stopping amitriptyline without the guidance of a healthcare provider can cause withdrawal symptoms and other complications. Discontinuing this medication should only be done under medical supervision.

B) Increase fluid intake: Amitriptyline can cause anticholinergic side effects such as dry mouth and constipation. Increasing fluid intake helps manage dry mouth by stimulating salivation and helps alleviate constipation by promoting bowel regularity.

C) Request another antidepressant: While amitriptyline can cause side effects like dry mouth and constipation, switching medications should not be the first step. These side effects are often manageable with lifestyle modifications, such as increasing fluid and fiber intake, and adjustments to the treatment plan can be considered if the symptoms are severe or persistent.

D) Notify the provider: While it is important for the nurse to document and inform the provider about any significant side effects, this instruction alone does not provide immediate relief to the patient. It is more appropriate to first recommend increasing fluid intake, and then the nurse can discuss with the provider if the symptoms persist or worsen.