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. Hyperventilate the client: Controlled hyperventilation reduces carbon dioxide levels, leading to cerebral vasoconstriction and decreased intracranial pressure, making it a temporary emergency measure in brain herniation.
B. Decrease sedation: Sedation is often maintained to reduce metabolic demand and intracranial pressure. Decreasing it could cause agitation and increase ICP.
C. Lower blood pressure: Lowering blood pressure could reduce cerebral perfusion, worsening ischemia. In brain herniation, maintaining adequate perfusion pressure is essential.
D. Reduce the temperature in the room: Mild hypothermia may be therapeutic, but adjusting room temperature is not an effective or immediate treatment for brain herniation.

A. Cessation of hormonal supplements B. Dietary and fluid restrictions C. Cessation of intravenous (IV) drug use D. Encouraging increased mobility

Correct Answer is B

Explanation

A. Cessation of hormonal supplements: While hormonal supplements may be relevant in some heart failure cases, they are not typically the primary focus of discharge teaching for heart failure management. The main areas of concern are fluid management and diet.
B. Dietary and fluid restrictions: In heart failure, dietary restrictions, especially low-sodium diets, and fluid restrictions are crucial for preventing fluid overload and managing the symptoms of heart failure. Teaching clients to monitor their fluid intake and avoid excessive salt is essential for managing the condition.
C. Cessation of intravenous (IV) drug use: While avoiding IV drug use is generally beneficial for health, it is not specifically related to heart failure management. The primary focus should be on managing the fluid and dietary intake to prevent exacerbations of heart failure.
D. Encouraging increased mobility: While moderate exercise may be encouraged for heart failure patients, it should be done cautiously. Encouraging increased mobility without considering the client’s current condition could lead to overexertion and worsen symptoms. The priority is dietary and fluid management.

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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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