A nurse is providing discharge teaching to a client who has Parkinson's disease. Which of the following instructions should the nurse include? (Select All that Apply.)

Take small bites of food.

Liquids should be thickened.

Sit slightly forward when eating.

Chew food thoroughly before swallowing.

Avoid having conversations while eating.

Answer and Explanation

Correct Answer : A,C,D

A. Take small bites of food: Taking small bites of food is important for clients with Parkinson's disease to reduce the risk of choking and aspiration. It allows better control of swallowing and reduces the likelihood of difficulty swallowing, which is common in Parkinson’s disease due to dysphagia (swallowing difficulty).
B. Liquids should be thickened: While thickening liquids is often recommended for clients with swallowing difficulties, it is not universally required for all Parkinson's patients. It would depend on the specific swallowing assessment and the client’s condition. Therefore, this is not an essential recommendation for every client.
C. Sit slightly forward when eating: Sitting slightly forward helps clients with Parkinson's disease improve their swallowing and reduce the risk of aspiration. This posture encourages a safer swallowing reflex and reduces the likelihood of food or liquids going into the airway.
D. Chew food thoroughly before swallowing: Thoroughly chewing food is vital for clients with Parkinson’s disease because it reduces the risk of choking and aspiration. This allows the food to break down into smaller pieces, making it easier to swallow and less likely to cause blockages in the throat.
E. Avoid having conversations while eating: While it is important to focus on eating to prevent choking, there is no strict guideline that clients with Parkinson’s must avoid conversation entirely. Talking while eating may be challenging for some, but it is not universally harmful. However, the client should be reminded to focus on swallowing to prevent aspiration.

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Correct Answer is A

Explanation

A. Tachycardia: Elevated T3 and T4 levels with suppressed TSH indicate hyperthyroidism, which increases metabolic rate and sympathetic nervous system activity. This often results in tachycardia due to increased cardiac demand and heightened sensitivity to catecholamines.
B. Decreased body temperature: Hyperthyroidism typically causes increased heat production and heat intolerance. Clients often feel warm or overheated, not cold, so a drop in body temperature would be unexpected.
C. Slow respiratory rate: Increased metabolism usually raises oxygen demand, leading to a normal or increased respiratory rate. A slow respiratory rate is not characteristic of hyperthyroid states.
D. Hypotension: Hyperthyroidism often causes systolic hypertension due to increased cardiac output. While some clients may experience normal blood pressure, persistent hypotension is not a common finding.

A. "Clients who have BRCA1 or BRCA2 gene changes have a decreased risk of breast cancer." B. "Clients should begin screening mammography annually by the age of 30 years old." C. "Breastfeeding increases the risk of breast cancer in women over 40 years of age." D. "Breast cancer can occur in any part of the breast, but ductal breast cancer is most common."

Correct Answer is D

Explanation

A. "Clients who have BRCA1 or BRCA2 gene changes have a decreased risk of breast cancer.":
Individuals with BRCA1 or BRCA2 mutations actually have an increased risk of developing breast cancer, not a decreased one. These gene mutations significantly increase the likelihood of breast and ovarian cancers.
B. "Clients should begin screening mammography annually by the age of 30 years old.":
The general recommendation is to begin annual mammography screenings at age 40 for average-risk women, with earlier screening only recommended for those at high risk due to family history or genetic factors.
C. "Breastfeeding increases the risk of breast cancer in women over 40 years of age.":
Breastfeeding has been shown to lower the risk of breast cancer, especially for women who breastfeed for longer durations. It does not increase the risk of developing breast cancer.
D. "Breast cancer can occur in any part of the breast, but ductal breast cancer is most common.":
Breast cancer can develop in any part of the breast, but ductal carcinoma, which originates in the milk ducts, is the most common form of breast cancer.

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A nurse is providing discharge teaching to a client who has Parkinson's disease. Which of the following instructions should the nurse include? (Select All that Apply.)

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