A nurse is assessing a client who has Parkinson's disease.
Which of the following manifestations should the nurse expect?

Choice A rationale

Encouraging wide-grip utensils does not address homonymous hemianopsia, which is a visual field deficit. Wide-grip utensils are typically used for clients with motor deficits or grip issues, not visual field cuts. This action would not help the client locate food within their blind visual field.

Choice B rationale

Encouraging the client to use their right hand, which is typically affected by a right-sided stroke, would be counterproductive and likely lead to frustration and difficulty with self-feeding. The left side of the body is often weaker or paralyzed after a right-sided stroke.

Choice C rationale

Homonymous hemianopsia involves a loss of half of the visual field in both eyes, contralateral to the stroke. For a right-sided stroke, the client will have left homonymous hemianopsia, meaning they cannot see things on their left side. Reminding them to look for food on the left side of the tray helps compensate for this visual deficit by prompting them to scan their blind field.

Choice D rationale

Providing a nonskid mat addresses plate movement, which can be helpful for clients with tremors or coordination issues, but it does not directly address the visual field deficit of homonymous hemianopsia. The primary problem here is not the plate moving, but the client's inability to see part of the plate.

Choice A rationale

Pruritus, or itching, is not a typical manifestation of Parkinson's disease. Parkinson's primarily affects the motor system due to degeneration of dopaminergic neurons in the substantia nigra, leading to movement disorders rather than dermatological symptoms.

Choice B rationale

Bradykinesia, characterized by slowness of movement, is a cardinal manifestation of Parkinson's disease. It results from reduced dopamine levels, impairing the basal ganglia's ability to facilitate smooth and rapid motor control, making daily activities challenging.

Choice C rationale

Hypertension, or high blood pressure, is not a direct or consistent manifestation of Parkinson's disease. While some autonomic dysregulation can occur, it typically leads to orthostatic hypotension rather than sustained hypertension, especially in later stages. Normal blood pressure is typically below 120/80 mmHg.

Choice D rationale

Xerostomia, or dry mouth, is not a primary manifestation of Parkinson's disease. It can be a side effect of some medications used to treat Parkinson's, such as anticholinergics, but it is not a direct symptom of the disease itself.