The nurse assessing the client diagnosed with Parkinson's disease (PD) would expect which of the following assessment findings?

Muscle rigidity and bradykinesia

Facial pain and ptosis

Diarrhea and nausea

Ecchymosis and petechiae

Answer and Explanation

The Correct Answer is A

A. Muscle rigidity and bradykinesia: Parkinson's disease (PD) is characterized by a combination of motor symptoms due to the degeneration of dopamine-producing neurons in the brain. The hallmark motor symptoms include muscle rigidity (stiffness of muscles, making movement difficult) and bradykinesia (slowness of movement). These symptoms are typically present early in the disease and can lead to difficulties with daily activities such as walking, speaking, and performing fine motor tasks. These two signs are primary indicators of Parkinson's disease.

B. Facial pain and ptosis: Facial pain and ptosis (drooping eyelids) are not typical symptoms of Parkinson's disease. PD can affect facial expression (resulting in a masked face), but it does not usually cause facial pain. Ptosis is more commonly seen in conditions like Horner's syndrome, myasthenia gravis, or as a side effect of medications, but it is not a hallmark symptom of Parkinson's disease.

C. Diarrhea and nausea: While gastrointestinal symptoms such as constipation can be seen in Parkinson's disease due to autonomic dysfunction and decreased gut motility, diarrhea and nausea are not typical primary symptoms. In fact, constipation is a more common issue in PD. Nausea could result from the use of medications like levodopa, but it is not a defining feature of the disease itself.

D. Ecchymosis and petechiae: Ecchymosis (bruising) and petechiae (small red or purple spots on the skin) are not characteristic of Parkinson's disease. These findings are more often associated with platelet disorders, bleeding disorders, or vascular conditions. While Parkinson's disease can involve complications like falls (which could lead to bruising), these are not direct symptoms of the disease itself. The primary symptoms involve motor and autonomic dysfunction.

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Correct Answer is B

Explanation

A. and record vital signs every 4 hours:
While vital signs are important, monitoring every 4 hours may not be frequent enough in an intensive care setting, especially for a client requiring mechanical ventilation. Vital signs, including blood pressure, heart rate, respiratory rate, and oxygen saturation, should be monitored more frequently (at least every hour) to detect changes in the patient's condition, particularly since positive pressure ventilation can significantly affect circulatory status.

B. Intake and output hourly:
In acute respiratory distress syndrome (ARDS), the client may require mechanical ventilation to support breathing. Positive pressure ventilation, while essential for improving oxygenation, can increase intrathoracic pressure, which may impair venous return to the heart, decreasing cardiac output. As a result, it is critical to monitor the fluid balance closely, as fluid overload can worsen the patient's condition and contribute to pulmonary edema or other complications. Hourly assessment of intake and output (I&O) helps the nurse monitor renal function, fluid status, and cardiac output. Maintaining a proper balance of fluids is crucial in managing ARDS and its associated complications.

C. Heart and lung sounds every shift:
A shift assessment of heart and lung sounds is useful but is not frequent enough to detect early changes in a client with decreased cardiac output or other complications related to mechanical ventilation. More frequent monitoring of lung sounds and heart function may be necessary, particularly in clients at risk of ventilator-associated complications like ventilator-associated pneumonia (VAP), pulmonary edema, or arrhythmias.

D. Level of consciousness every shift:
Monitoring level of consciousness is important, especially in clients with ARDS and mechanical ventilation, as changes in consciousness can indicate worsening hypoxia or hypercapnia. However, this assessment is less directly related to the immediate concern of decreased cardiac output, which can be more effectively managed through continuous monitoring of fluid status and vital signs rather than consciousness alone. Though consciousness should be monitored regularly, I&O hourly would be more crucial in this context for managing cardiac output.

A. Arrange for social service consult for assistance with medication purchase B. Have the client seen by a nursing assistant 3 times a week for hygiene C. Ensure adequate lighting in areas where the client will ambulate D. Reter the client to a nutritionist to address dietary measures

Correct Answer is C

Explanation

A) Arrange for social service consult for assistance with medication purchase:
While arranging for social service support can be beneficial in ensuring the client has access to necessary medications, this is not directly related to fall prevention at home. Falls in Parkinson's disease are more closely associated with mobility, balance, and environmental factors, which should be the focus of interventions aimed at reducing fall risk. Medication access is important but secondary to safety measures related to physical environment and mobility.

B) Have the client seen by a nursing assistant 3 times a week for hygiene:
While assistance with hygiene can certainly help support the client’s daily needs, the frequency of visits for hygiene care alone does not specifically address fall prevention. Falls are more directly linked to issues such as impaired balance, freezing episodes, and poor mobility—issues that should be addressed through environmental modifications and specific interventions aimed at improving safety during ambulation and transfers.

C) Ensure adequate lighting in areas where the client will ambulate:
Ensuring adequate lighting in areas where the client will ambulate is a critical intervention for fall prevention in individuals with Parkinson's disease. Parkinson's disease often causes balance and coordination problems, and inadequate lighting can increase the risk of tripping or falling, especially at night or in poorly lit areas. Proper lighting helps the client see obstacles and navigate their environment safely. This intervention directly addresses a key factor in fall risk and is an important part of the plan of care.

D) Refer the client to a nutritionist to address dietary measures:
Referral to a nutritionist can be helpful in managing some aspects of Parkinson's disease, particularly for addressing issues like constipation, weight management, or dysphagia. However, dietary measures do not have a direct impact on fall prevention. Fall prevention should focus more on mobility, strength, environmental safety, and managing the symptoms of Parkinson's disease that affect balance and movement.

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The nurse assessing the client diagnosed with Parkinson's disease (PD) would expect which of the following assessment findings?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client diagnosed with acute respiratory distress syndrome (ARDS) who requires mechanical ventilation. A client problem of decreased cardiac output from the positive pressure ventilator has been identified. What should the nurse include in the plan of care? Assess:

Correct Answer is B

Explanation

To achieve the outcome of fall prevention at home in the client diagnosed with Parkinson's Disease (PD), which intervention would the nurse include in the plan of care?

Correct Answer is C

Explanation

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