The nurse is caring for a client who was recently diagnosed with ALS (Amyotrophic lateral sclerosis). Which of the following signs and symptoms is MOST important for the nurse to assess for?

Inability to void

Unable to eat without thickening meals

Loss of function in the lower extremity

Difficulty breathing

Answer and Explanation

The Correct Answer is D

A) Inability to void:
While urinary retention or difficulties with voiding can occur in ALS patients due to weakened muscles affecting the bladder, it is not the most immediate or life-threatening symptom that requires urgent attention. ALS primarily affects motor neurons and the voluntary muscles, and while autonomic dysfunction can lead to bladder or bowel issues, these are typically not the first concern in the acute phase of ALS unless they are severe.

B) Unable to eat without thickening meals:
Dysphagia (difficulty swallowing) is a common symptom in ALS, especially as the disease progresses and affects the muscles of the throat. While this symptom is important to address, it is manageable with interventions like speech therapy, modified diets, and thickened liquids

C) Loss of function in the lower extremity:
Loss of function in the lower extremities is a hallmark symptom of ALS as the disease progresses, but it is not an acute or life-threatening situation on its own. ALS leads to gradual muscle weakness and atrophy, particularly affecting voluntary motor functions.

D) Difficulty breathing:
As ALS progresses, respiratory muscles, including the diaphragm and intercostal muscles, weaken, which can lead to respiratory failure. The inability to breathe adequately can be life-threatening and may require interventions like mechanical ventilation, non-invasive positive pressure ventilation (BiPAP), or even a tracheostomy.

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Correct Answer is C

Explanation

A) Improved bladder function:
Diphenhydramine, an antihistamine, has anticholinergic properties, meaning it blocks acetylcholine, which can cause side effects like urinary retention and dry mouth. While it may increase urinary retention, it is not primarily used to treat bladder function issues in Parkinson's disease.

B) Relief of depression:
Diphenhydramine is not prescribed for the treatment of depression in Parkinson's disease. It is an antihistamine used to treat allergic reactions and motion sickness, and sometimes for its anticholinergic effects in Parkinson's disease. While it may cause sedation, it does not address the neurochemical imbalances in the brain that cause depression, which is often treated with antidepressants such as SSRIs or SNRIs.

C) Decreased tremors:
Diphenhydramine has anticholinergic properties, which can help reduce tremors in patients with Parkinson's disease. Parkinson's disease is associated with a dopamine deficit, but acetylcholine also plays a role in motor control. The use of anticholinergic medications, such as diphenhydramine, can help restore balance between dopamine and acetylcholine in the brain, leading to decreased tremors.

D) Delay in disease progression:
There is no evidence that diphenhydramine can delay the progression of Parkinson's disease. The disease is caused by the degeneration of dopamine-producing neurons in the brain, and current treatments, such as levodopa/carbidopa or dopamine agonists, primarily aim to manage symptoms rather than prevent progression.

A. Bradycardia B. Excess salivation C. Urinary retention D. Diarrhea

Correct Answer is C

Explanation

A) Bradycardia:
Benztropine is an anticholinergic medication used to manage the symptoms of Parkinson's disease by blocking the action of acetylcholine. While anticholinergic medications can affect heart rate, bradycardia is not a common side effect of benztropine. In fact, benztropine may have the opposite effect, potentially causing tachycardia (increased heart rate).

B) Excess salivation:
Excessive salivation is typically a symptom of Parkinson's disease itself, due to difficulty swallowing, rather than a side effect of benztropine. In fact, benztropine, as an anticholinergic agent, generally reduces salivation (anticholinergic effect), so this side effect is unlikely to occur with benztropine therapy.

C) Urinary retention:
Benztropine, being an anticholinergic drug, can inhibit the action of acetylcholine at muscarinic receptors in the bladder, leading to urinary retention. This is a common and serious side effect of anticholinergic drugs like benztropine. Urinary retention can lead to discomfort, urinary tract infections (UTIs), and kidney problems if not addressed.

D) Diarrhea:
Benztropine is more likely to cause constipation rather than diarrhea due to its anticholinergic effects. Anticholinergic medications often slow down gastrointestinal motility, leading to constipation.

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The nurse is caring for a client who was recently diagnosed with ALS (Amyotrophic lateral sclerosis). Which of the following signs and symptoms is MOST important for the nurse to assess for?

Nursing Test Bank

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Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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