The clinic nurse notes that a client with Parkinson's disease has been taking levodopa and carbidopa (Sinemet) for 10 years. Which assessment finding would indicate the client is experiencing a side effect of this medication?
Dyskinesias
Dyspnea
Hypertension
Cold intolerance
The Correct Answer is A
Choice A reason: Dyskinesias, which are involuntary, erratic, writhing movements of the face, arms, legs, or trunk, are common side effects of long-term use of levodopa and carbidopa, especially after many years of therapy.
Choice B reason: Dyspnea, or difficulty breathing, is not commonly associated as a side effect of levodopa and carbidopa.
Choice C reason: Hypertension is not typically a side effect of levodopa and carbidopa; these medications can sometimes cause low blood pressure, particularly upon standing.
Choice D reason: Cold intolerance is not a recognized side effect of levodopa and carbidopa.
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Related Questions
Correct Answer is D
Explanation
Choice A reason: Hyperglycemia is not typically a nonmotor symptom of Parkinson's disease. It is more commonly associated with metabolic conditions such as diabetes.
Choice B reason: Hypertension is not a nonmotor symptom specific to Parkinson's disease, although it can be present in many other conditions.
Choice C reason: Diarrhea is not commonly a nonmotor symptom of Parkinson's disease. Gastrointestinal symptoms like constipation are more prevalent.
Choice D reason: Depression is a recognized nonmotor symptom of Parkinson's disease. It can significantly affect the quality of life and is often underdiagnosed in these patients.
Correct Answer is B
Explanation
Choice A reason: A soft diet with thin liquids may be recommended for patients with Parkinson's disease who have difficulty swallowing (dysphagia), but it is not the most appropriate intervention for all patients. Dysphagia is common in Parkinson's disease due to impaired muscle movement, and a soft diet can help prevent choking and aspiration.
Choice B reason: Assessing for orthostatic hypotension is crucial in the care of patients with Parkinson's disease. Orthostatic hypotension is a common non-motor symptom where there is a significant drop in blood pressure upon standing. Normal blood pressure should not drop more than 20 mm Hg systolic or 10 mm Hg diastolic within 2 to 5 minutes of standing². This condition can increase the risk of falls, which is a significant concern in this population.
Choice C reason: Exophthalmos, the bulging of the eyes, is not associated with Parkinson's disease. It is typically related to thyroid eye disease, such as Graves' disease, and would not be a relevant assessment for a Parkinson's patient unless there is a known co-existing thyroid condition.
Choice D reason: Limiting fluids to prevent urinary incontinence is not an appropriate intervention for Parkinson's disease. Adequate hydration is essential, and urinary incontinence should be managed with other strategies, such as bladder training, scheduled toileting, and possibly medication, depending on the cause.
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