A nurse is assessing a client who has Parkinson's disease (PD). Which of the following findings should the nurse expect? (Select all that apply.)

Choice A reason:

This is an incorrect answer. Instructing the client to lift their feet and take big steps when walking is not an effective intervention for a client who has PD and experiences freezing episodes. Freezing episodes are sudden and brief periods of inability to move or initiate movement, especially when starting to walk, turning, or crossing a threshold. Lifting the feet and taking big steps may be difficult or impossible for the client during a freezing episode and may increase the risk of falls or injuries.

Choice B reason:

This is an incorrect answer. Instructing the client to use a walker or cane for support and stability is not an effective intervention for a client who has PD and experiences freezing episodes. A walker or cane may actually trigger or worsen freezing episodes by creating a visual cue that interferes with the initiation of movement. A walker or cane may also reduce the client's confidence and independence in walking.

Choice C reason:

This is a correct answer. Instructing the client to focus on an object or a line on the floor ahead of them is an effective intervention for a client who has PD and experiences freezing episodes. Focusing on an external cue can help the client overcome the internal blockage that prevents them from moving or initiating movement. Focusing on an object or a line can also help the client maintain their balance and direction while walking.

Choice D reason:

This is an incorrect answer. Instructing the client to hum or sing a song while walking is not an effective intervention for a client who has PD and experiences freezing episodes. Humming or singing a song may distract the client from their walking and cause them to lose their rhythm or coordination. Humming or singing a song may also increase the risk of aspiration or choking if the client has dysphagia, which is difficulty swallowing due to impaired muscle control in PD.

Choice A reason:

This is a correct answer. The nurse should advise the client and their caregiver to maintain a consistent daily routine and environment, as this can help reduce anxiety, agitation, or disorientation in clients who have AD. AD is a progressive neurodegenerative disorder that affects memory, language, reasoning, judgment, and other cognitive abilities. Maintaining a consistent daily routine and environment can provide structure, familiarity, and security for the client.

Choice B reason:

This is a correct answer. The nurse should advise the client and their caregiver to use memory aids such as calendars, clocks, or lists, as this can help enhance memory and orientation in clients who have AD. Memory aids can provide cues or reminders for the client about important information such as dates, events, tasks, or names.

Choice C reason:

This is a correct answer. The nurse should advise the client and their caregiver to engage in physical and mental activities that are enjoyable and stimulating, as this can help preserve cognitive function and well-being in clients who have AD. Physical and mental activities can improve blood flow and oxygen delivery to the brain, stimulate neural connections, enhance mood and self-esteem, and prevent boredom and depression.

Choice D reason:

This is an incorrect answer. The nurse should not advise the client and their caregiver to avoid social interactions that may cause stress or confusion, as this can have negative effects on cognitive function and well-being in clients who have AD. Social interactions can provide emotional support, companionship, communication skills, and cognitive stimulation for the client. The nurse should encourage the client and their caregiver to maintain social contacts and participate in activities that are appropriate for the client's level of functioning and interest.

Choice E reason:

This is an incorrect answer. The nurse should not advise the client and their caregiver to limit fluid intake and caffeine consumption, as this can have negative effects on cognitive function and well-being in clients who have AD. Fluid intake and caffeine consumption are not directly related to the cause or progression of AD, and limiting them can cause dehydration, constipation, or headaches. The nurse should advise the client and their caregiver to ensure adequate hydration and nutrition for the client and avoid substances that may interfere with sleep quality or medication effectiveness, such as alcohol or nicotine.