The client diagnosed with Parkinson's Disease (PD) is being admitted with a fever and patchy infiltrates in the lung fields on the chest x-ray. Which clinical manifestations of PD would explain this assessment data?

Mask-like face and shuffling gait

Lack of arm swing and bradykinesia

Pill rolling of fingers and flat affect

Difficulty swallowing and immobility

Answer and Explanation

The Correct Answer is D

A) Mask-like face and shuffling gait:
While the mask-like face and shuffling gait are common clinical features of Parkinson's Disease (PD), they do not directly explain the fever or the patchy infiltrates seen on the chest x-ray. The mask-like face is due to reduced facial muscle activity and is associated with the motor symptoms of PD, while the shuffling gait results from bradykinesia (slowness of movement).

B) Lack of arm swing and bradykinesia:
Lack of arm swing and bradykinesia are motor symptoms of PD that are indicative of decreased movement and muscle rigidity. While they impact a patient’s mobility and dexterity, they are not directly associated with lung infiltrates or fever.

C) Pill rolling of fingers and flat affect:
Pill rolling (a characteristic tremor where patients move their fingers as if rolling a pill) and flat affect (a reduced emotional expression) are hallmark features of Parkinson's Disease, but again, they do not explain the fever or lung infiltrates.

D) Difficulty swallowing and immobility:
Difficulty swallowing (dysphagia) is a common and serious symptom in patients with Parkinson's Disease. Due to the loss of control over the muscles involved in swallowing, patients with PD are at high risk for aspiration (food, liquids, or saliva entering the lungs), which can lead to aspiration pneumonia. This condition often presents with fever, chest infiltrates, and respiratory distress, which directly correlates with the patient's fever and lung infiltrates seen on the chest x-ray.

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Correct Answer is D

Explanation

A) Measure heart chamber pressures to assess for heart failure:
Measuring heart chamber pressures is an important diagnostic tool in assessing heart failure, but it is not the primary goal in the case of a STEMI (ST-Elevation Myocardial Infarction). In STEMI, the primary goal is to identify and treat the blockage in the coronary arteries that is causing the heart attack.

B) Determine cardiac output during the procedure:
Cardiac output is a useful measurement for assessing heart function, but it is not the main focus during the treatment of STEMI. While monitoring cardiac output may be part of the overall care, the urgent priority in STEMI management is to restore blood flow to the affected myocardial tissue as quickly as possible to minimize damage, not to measure cardiac output.

C) Evaluate the extent of the occlusion of the coronary arteries involved:
While evaluating the extent of coronary artery occlusion is part of the process during a cardiac catheterization, the immediate priority for a patient with STEMI is to treat the blockage, not just evaluate it. While the angiogram will reveal the blockage, the treatment goal is to restore perfusion to the affected area of the heart through procedures such as balloon angioplasty or stent placement.

D) Prevent extensive myocardial damage:
This is the correct answer. The main goal of treatment for STEMI is to prevent extensive myocardial damage. In a STEMI, the coronary artery is blocked, depriving the heart muscle of oxygen, which can cause significant damage or death of the myocardial tissue. The most effective way to limit the extent of damage is to restore blood flow as quickly as possible, often through emergent procedures like percutaneous coronary intervention (PCI) or fibrinolytic therapy.

A. Unstable B. Variant C. Chronic stable D. Nocturnal

Correct Answer is A

Explanation

A) Unstable:
Unstable angina is the type of angina most closely related to an impending myocardial infarction (MI). It is characterized by unpredictable chest pain that occurs at rest or with minimal exertion, or that increases in severity or frequency. Unstable angina represents a medical emergency and can progress to an MI if not promptly treated. It occurs when there is increased myocardial oxygen demand and a partially occluded coronary artery, often due to a ruptured atherosclerotic plaque.

B) Variant (Prinzmetal's) angina:
Variant angina, also known as Prinzmetal's angina, is caused by a spasm of the coronary artery, which temporarily narrows or obstructs blood flow. Although it can be severe and may occur at rest, it is typically transient and is not directly related to the development of an MI. Variant angina usually responds to medications such as nitrates or calcium channel blockers, and while it can be dangerous, it is not the most likely type of angina associated with a myocardial infarction.

C) Chronic stable angina:
Chronic stable angina occurs with predictable patterns, typically with exertion or stress, and resolves with rest or nitroglycerin. It does not usually indicate an impending MI, as it is a chronic condition caused by atherosclerosis that limits the heart's blood supply under stress. While chronic stable angina increases the risk of MI over time, it is not directly associated with an imminent heart attack.

D) Nocturnal angina:
Nocturnal angina refers to chest pain that occurs during the night or early morning hours, often during sleep. It may be associated with sleep apnea, GERD, or increased sympathetic tone during sleep. This type of angina is less commonly linked to an impending MI compared to unstable angina, although it should still be evaluated for any underlying cardiovascular issues.

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The client diagnosed with Parkinson's Disease (PD) is being admitted with a fever and patchy infiltrates in the lung fields on the chest x-ray. Which clinical manifestations of PD would explain this assessment data?

Nursing Test Bank

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A client admitted to the Emergency Department with a suspected STEM. The nurse anticipates that this client will be immediately prepared for the cardiac catheterization laboratory as the goal of treatment is to:

Correct Answer is D

Explanation

The nurse knows which of the following types of angina is most closely related with an impending myocardial infarction (MI)?

Correct Answer is A

Explanation

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