Parkinson Disease

The nurse is assessing an older adult client. Which finding should cause the nurse to suspect the client has Parkinson disease (PD)? (Select all that​ apply.) A. The client has hand tremors at rest. B. The client does not remember what he ate for breakfast. C. The​ client's blood pressure increases when the client stands up. D. The client has a slurred speech. E. The​ client's facial expression shows no emotion.

A, B, D, E

Which health promotion activity should be the focus of teaching for a client with Parkinson disease (PD)? (Select all that apply.) A. Participating in occupational therapy B. Improving balance C. Avoiding exercise D. Preventing injury from falls E. Promoting independence

A,B, D, E Avoiding exercise is the only incorrect answer. Clients should be taught to participate in exercise to optimize mobility not avoid it

A patient with Parkinson Disease is experiencing weight loss due to difficulty chewing and swallowing. Which meal option below is the best for this patient?

A. Scrambled eggs with a side of cottage cheese The patient should have a diet of soft foods that are easy to swallow and chew.

A client with Parkinson disease (PD) is prescribed an anticholinergic agent to treat tremors and rigidity. The nurse should teach the clien t abou t which adverse effect they may experience from this medication? (Select all that apply.) A . Drooling B . Dry Mouth C . Rigidity D . Loss of perspiration E . Tremors

Anticholinergic medications can cause a decrease in salivation and sweating which causes dry mouth and can lead to problems with temperature control because they cannot perspire cool off

A patient with Parkinson's Disease has slow movements that affects their swallowing, facial expressions, and ability to coordinate movements. As the nurse you will document the patient has:

Bradykinesia

A patient is prescribed to take Carbidopa/Levodopa (Sinemet). As the nurse you know that which statement is incorrect about this medication: A. It can take up to 3 weeks for the patient to notice a decrease in signs and symptoms when beginning treatment with this medication. B. Body fluids can turn a dark color and stain clothes. C. This medication is most commonly prescribed with a vitamin B6 supplement. D. Carbidopa helps to prevent Levodopa from being broken down in the blood before it enters the brain. Hence, levodopa is able to enter the brain.

C. This medication is most commonly prescribed with a vitamin B6 supplement. All the other options are CORRECT about this medication. However, the patient should avoid foods and supplements high in vitamin B 6 because it decreases the effectiveness of this medication.

While assessing a patient with Parkinson's Disease, you note the patient's arms slightly jerk as you passively move them toward the patient's body. This is known as:

Cogwheel Rigidity This is known as cogwheel rigidity, and occurs when the arms are passively moved, which will cause them to jerk slightly.

When planning care for a patient diagnosed with Parkinson disease, which of these patient outcomes should receive priority in the patient's plan of care? A. Taking a daily walk around the neighborhood. B. Taking a daily MVI supplement. C. Working on a favorite hobby. D. Ability to bath independently.

D. Ability to bath independently.

Which is the main pathology of Parkinson disease that causes changes in muscular and sensory​ function?

Reduction of dopamine in the brain

As the home health nurse you are helping a patient with Parkinson's Disease get dressed. What item gathered by the patient to wear should NOT be worn?

Rubber sole shoes

A physician orders a patient to take Benztropine (Cogentin). The patient has never taken this medication before and is due to take the first dose at 1000. What statement by the patient requires you to hold the dose and notify the physician? A. "I forgot to tell the doctor I take eye drops for my glaucoma." B. "I had a PET scan last week." C. "I take aspirin once day." D. "My hands are experiencing tremors at rest."

The answer is A. This medication is contraindicated for patients with glaucoma.

While providing discharge teaching to a patient prescribed Ropinirole (Requip), you make it priority to teach the patient about what side effect? A. Drowsiness B. Dry mouth C. Coughing D. Dark sweat or saliva

The answer is A. This medication is known to cause sudden drowsiness that can cause a person to randomly fall asleep. Therefore, it is PRIORITY to teach the patient to not take this medication when they be driving or operating machinery etc...to prevent injury.

You're caring for a patient with Parkinson's Disease that has tremors. Select the option that is INCORRECT about tremors experienced in this disease: A. The tremors are most likely to occur with purposeful movements. B. A common term used to describe the tremors in the hands and fingers is called "pill-rolling". C. Tremors are one of the most common signs and symptoms in Parkinson's Disease. D. Tremors in this disease can occur in the hands, fingers, arms, legs and even the lips and tongue.

The answer is A. This option is the only one that is INCORRECT. Tremors in Parkinson's Disease tend to occurs at rest and will actually improve with movement.

You're patient with Parkinson's Disease has been taking Carbidopa/Levodopa for several years. The patient reports that his signs and symptoms actually become worse before the next dose of medication is due. As the nurse, you know what medication can be prescribed with this medication to help decrease this for happening? A. Anticholinergic (Benztropine) B. Dopamine agonists (Ropinirole) C. COMT Inhibitor (Entacapone) D: Beta blockers (Metoprolol)

The answer is C. Entacapone "Comtan" (is a catechol-O-methyltransferase inhibitors) and is used with levodopa/carbidopa to prevent the "wearing off" of the drug before the next dose is due. It blocks the COMT enzyme that will break down the levodopa in the blood to allow it to last longer.

True or False: Parkinson's Disease most commonly affects patients in young adulthood, and there is currently no cure for the disease.

The answer is FALSE. Parkinson's Disease most commonly affects patients in OLDER adulthood (60 or older), and there is currently no cure for the disease.

A spouse of a husband who has Parkinson's Disease explains to you that her husband experiences episodes while walking where he freezes and can't move. She asks what can be done to help with these types of episodes to prevent injury. Select all the options that are correct: A. Have the husband try to change direction of movement by moving in the opposite direction when the freeze ups occur. B. Use a cane with a laser point while walking. C. Have the husband try to push through the freeze ups. D. Encourage the husband to consciously lift the legs while walking (as with marching).

The answers are A, B, D. These are correct teaching points on how to deal with freeze ups in Parkinson's Disease.

You're providing free education to a local community group about the signs and symptoms of Parkinson's Disease. Select all the signs and symptoms a patient could experience with this disease: a.Constipation b.Tremors with purposeful movement c.Shuffling of gait d.Freezing of extremities e.Euphoria

The answers are A, C, D. These are all signs and symptoms experienced with PD (they vary among patients). There are tremors at REST (not movement) along with depression rather the euphoria.

You're providing diet education to a patient with Parkinson's Disease. Which statement below demonstrates the patient understood your teaching? Select all that apply: A. "I will limit foods high in fiber like fruits and vegetables in my diet." B. "I will be sure to drink 2 Liter of fluid per day." C. "It is very common for me to experience diarrhea with this disease." D. "I will avoid taking Carbidopa/Levodopa with a protein rich meal."

The answers are B and D. Constipation (not diarrhea) is a common symptom with Parkinson's Disease. Therefore, the patient should be vigilant about preventing constipation by EATING foods high in fiber like fruits/vegetable and drinking 2 L of fluid per day (unless contraindicated). In addition, diet teaching should be included with the medication Carbidopa/Levodopa. The patient should NOT take this medication with a protein rich meal because levodopa competes with protein in the small intestine (hence decreasing it absorption).

You're providing free education to a local community group about the signs and symptoms of Parkinson's Disease. Select all the signs and symptoms a patient could experience with this disease: A. Increased Salivation B. Loss of smell C. Constipation D. Tremors with purposeful movement E. Shuffling of gait F. Freezing of extremities G. Euphoria H. Coordination issues

The answers are B, C, E, F, H. These are all signs and symptoms experienced with PD (they vary among patients). There is NOT increased salivation (although drooling occurs...this is due to the decreased ability to swallow. There are tremors at REST (not movement) along with depression rather the euphoria.

A patient is taking Rasagiline "Azilect" for treatment of Parkinson's Disease. What foods do the patient want to limit in their diet? Select all that apply: A. Liver B. Aged Cheese C. Sweetbread D. Beer E. Fermented foods F. Shellfish

The answers are B, D, and E. Rasagiline "Azilect" is a MAO Inhibitor Type B (Monoamine Oxidase Inhibitor). The patient should avoid foods high in tyramine which can cause a hypertensive crisis. This includes: aged cheese, smoked/cured meats, fermented food, beer.

The nurse is instructing a client with Parkinson's disease about preventing falls. Which client statement reflects a need for further teaching? a."I can sit down to put on my pants and shoes." b."I try to exercise every day and rest when I'm tired." c."My son removed all loose rugs from my bedroom." d. "I don't need to use my walker to get to the bathroom."

The client with Parkinson's disease should be instructed regarding safety measures in the home. The client should use her or his walker as support to get to the bathroom because of bradykinesia. The client should sit down to put on pants and shoes to prevent falling. The client should exercise every day in the morning when energy levels are highest. The client should have all loose rugs in the home removed to prevent falling.

Which clinical manifestation would be required to confirm the diagnosis of Parkinson​ disease?

Tremors at rest and bradykinesia

The nurse is conducting a support group for clients diagnosed with Parkinson's disease and their significant others. Which information regarding psychosocial needs should be included in the discussion? a.The client should discuss feelings about being placed on a ventilator. b.The client may have rapid mood swings and become easily upset. c.Pill-rolling tremors will become worse when the medication is wearing off. d.The client may automatically start to repeat what another person says.

b.The client may have rapid mood swings and become easily upset.

As the nurse you know that Parkinson's Disease tends to affect the _____________ of the midbrain, which leads to the depletion of the neurotransmitter ________________.

substantia nigra, dopamine