The nurse is caring for four clients with Parkinson's disease. Which client receiving carbidopa/levodopa should the nurse assess first?

A. A client who is confused and attempting to get out of bed unassisted: This client is at the highest risk for falls due to confusion, impaired mobility, and Parkinsonian rigidity. Immediate assessment and intervention are necessary to prevent injury. Safety concerns take priority over medication effectiveness or minor adverse effects. B. A client who states the medication is not helping as much as before: This may indicate “wearing-off” periods or fluctuating response to carbidopa/levodopa, which requires evaluation and possible dose adjustment. While important, it is not as immediately urgent as a client at risk for falls. C. A client who has not had a bowel movement in three days: Constipation is a common side effect of Parkinson’s disease and carbidopa/levodopa therapy. It is uncomfortable and requires intervention, but it does not present an immediate threat to safety. D. A client who complains of dry mouth and decreased appetite: These are minor anticholinergic effects associated with carbidopa/levodopa. They warrant monitoring and supportive care but are not life-threatening or urgent.