Nokea
A patient with Parkinson's disease has a nursing diagnosis of impaired physical mobility related to bradykinesia. Which of the following actions should the nurse include in the plan of care?
- A. Instruct the patient in activities that can be done while lying or sitting.
- B. Suggest that the patient rock from side to side to initiate leg movement.
- C. Have the patient take small steps in a straight line directly in front of the feet.
- D. Teach the patient to keep the feet in contact with the floor and slide them forward.
Correct Answer: B
Rationale: Rocking the body from side to side stimulates balance and improves mobility. The patient will be encouraged to continue exercising because this will maintain functional abilities. Maintaining a wide base of support will help with balance. The patient should lift the feet and avoid a shuffling gait.
You may also like to solve these questions
The partner of a patient with Parkinson's disease (PD) is upset and asks the nurse why he is no longer able to read the affectionate notes that the patient writes for him. Which of the following information is the basis for the nurse's response?
- A. Characteristic slow speech makes it difficult for the patient with PD to put his or her thoughts on paper.
- B. Cogwheel rigidity makes it hard for the patient to hold a pen.
- C. Micrographia is common in patients with PD.
- D. Depression often seen in PD leads to denying affectionate feelings.
Correct Answer: C
Rationale: The best answer is that the nurse's response will be based upon the fact that micrographia is handwriting deterioration and often occurs in patients with Parkinson's disease. PD patients have characteristic slow speech but that does not cause illegible writing. Cogwheel rigidity makes it difficult to walk and balance. Although depression is common in PD, this does not directly lead to denying affectionate feelings.
The nurse assesses a patient in the health clinic who has symptoms of a stooped posture, shuffling gait, and pill rolling-type tremor. Which of the following prescriptions would the nurse anticipate?
- A. Oral corticosteroids
- B. Antiparkinsonian drugs
- C. Electroencephalogram (EEG) testing
- D. Magnetic resonance imaging (MRI)
Correct Answer: B
Rationale: The diagnosis of Parkinson's is made when two of the three characteristic signs of tremor, rigidity, and bradykinesia are present. The confirmation of the diagnosis is made on the basis of improvement when antiparkinsonian drugs are administered. This patient has symptoms of tremor and bradykinesia; the next anticipated step will be treatment with medications. MRI and EEG are not useful in diagnosing Parkinson's disease, and corticosteroid therapy is not used to treat it.
The nurse is caring for a patient with Parkinson's disease who has decreased tongue mobility and an inability to move the facial muscles. Which of the following nursing diagnoses is of highest priority?
- A. Activity intolerance related to immobility
- B. Toileting self-care deficit related to impaired mobility
- C. Ineffective health management related to difficulty managing complex treatment regimen
- D. Imbalanced nutrition: less than body requirements related to insufficient dietary intake
Correct Answer: D
Rationale: The data about the patient indicate that poor nutrition will be a concern because of decreased swallowing. The other diagnoses also may be appropriate for a patient with Parkinson's disease, but the data do not indicate they are current problems for this patient.
The nurse is caring for a patient with amyotrophic lateral sclerosis (ALS) who is hospitalized with pneumonia. Which of the following actions should the nurse take?
- A. Assist with active range of motion
- B. Observe for agitation and paranoia
- C. Give muscle relaxants as needed to reduce spasticity
- D. Use simple words and phrases to explain procedures.
Correct Answer: A
Rationale: ALS causes progressive muscle weakness. Patients should be guided to use moderate-intensity, endurance-type exercises for the trunk and limbs, since this may help reduce ALS spasticity. When hospitalized with other health concerns, it is important to complete ROM to maintain strength. Psychotic symptoms such as agitation and paranoia are not associated with ALS. Cognitive function is not affected by ALS, and the patient's ability to understand procedures will not be impaired. Muscle relaxants will further increase muscle weakness and depress respirations.
The nurse is assessing a patient at the health clinic who has a severe migraine headache and tells the nurse about having four similar headaches in the last 3 months. Which of the following actions should the nurse take initially?
- A. Refer the patient for stress counselling.
- B. Ask the patient to keep a headache diary.
- C. Suggest the use of muscle-relaxation techniques.
- D. Teach about the effectiveness of the triptan drugs.
Correct Answer: B
Rationale: The initial nursing action should be further assessment of the precipitating causes of the headaches, quality, and location of pain, etc. Stress reduction, muscle relaxation, and the triptan drugs may be helpful, but more assessment is needed first.