A nurse is planning care for a client who has Parkinson's disease (PD) and experiences freezing episodes. Which of the following interventions should the nurse include in the plan of care?

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 an incorrect answer. The caregiver does not need further teaching if they say that memantine will help reduce the amount of glutamate in their loved one's brain. Memantine is an N-methyl-D-aspartate (NMDA) receptor antagonist that works by blocking the excessive stimulation of glutamate, which is a neurotransmitter that is involved in learning, memory, and cognition. Glutamate can be toxic to nerve cells if it accumulates in high levels in AD.

Choice B reason:

This is an incorrect answer. The caregiver does not need further teaching if they say that memantine will help improve their loved one's memory and attention span. Memantine can improve some aspects of cognitive function in clients who have moderate to severe AD by enhancing nerve communication and preventing nerve damage.

Choice C reason:

This is a correct answer. The caregiver needs further teaching if they say that memantine will help prevent their loved one from having seizures or hallucinations. This is not the purpose or effect of memantine, but rather anticonvulsants or antipsychotics, which are medications used to treat seizures or psychosis, respectively. Seizures or hallucinations are not common symptoms of AD, but rather complications that may occur in advanced stages of the disease.

Choice D reason:

This is an incorrect answer. The caregiver does not need further teaching if they say that memantine will help slow down the decline of their loved one's cognitive function. Memantine can slow down the progression of AD and delay the need for institutionalization by preserving some cognitive abilities and daily functioning.