The nurse is planning care for a client diagnosed with Parkinson's disease. The client is able to communicate with the nurse to discuss their nutritional needs. The nurse includes the nursing diagnosis risk for aspiration in the plan of care. What is the best intervention for the nurse to include in the care plan to prevent aspiration?

Rationale:

A. Baclofen is a centrally acting muscle relaxant used to treat spasticity in MS, not fatigue. While it reduces muscle stiffness, it can cause sedation and weakness, which may worsen fatigue rather than improve it.

B. Tizanidine is also a muscle relaxant for spasticity management. Like baclofen, it can lead to drowsiness, hypotension, and generalized weakness, making it unsuitable for treating fatigue in MS.

C. Amantadine is used specifically for MS-related fatigue. It has stimulant-like properties that help improve energy levels and enhance the ability to perform ADLs. It does not treat spasticity but directly addresses one of the most disabling symptoms of MS.

D. Dantrolene is a peripherally acting muscle relaxant used for severe spasticity or muscle rigidity. It works by reducing calcium release in muscle fibers, but it does not treat fatigue and may also cause generalized weakness, which could worsen functional limitations in MS patients.

Rationale:

A. This combination is classic for DKA, which is a life-threatening complication of type 1 diabetes mellitus caused by absolute insulin deficiency. Pathophysiology includes: Hyperglycemia: Without insulin, glucose cannot enter cells, leading to elevated serum glucose (>250 mg/dL), Ketosis: Cells utilize fat for energy, producing ketone bodies (acetoacetate, beta-hydroxybutyrate, and acetone), detectable in urine and blood., Metabolic acidosis: Accumulation of ketone bodies lowers blood pH (<7.3) and bicarbonate (<18 mEq/L).

The clinical manifestations, polyuria, polydipsia, dehydration, orthostatic hypotension, warm dry skin, and acetone breath, correlate with this lab pattern. This makes fluid replacement, insulin administration, and electrolyte management the top priorities.

B. This indicates hypoglycemia with a normal to slightly alkalotic pH. DKA is characterized by hyperglycemia and metabolic acidosis, so low glucose rules out DKA. Hypoglycemia typically presents with tremors, diaphoresis, confusion, and possible seizures, which are different from DKA symptoms.

C. This represents normoglycemia and normal pH, indicating no metabolic derangement. DKA requires both elevated glucose and acidosis, so this finding is inconsistent with the diagnosis.

D. Although glucose is slightly elevated, the absence of ketones and likely normal pH means the client does not have DKA. Hyperglycemia alone does not constitute DKA; ketone production and acidosis are necessary components.