A nurse is collecting data from a client who has Parkinson's disease and is experiencing bradykinesia. Which of the following findings should the nurse expect?

A. Intellectual capacity is not affected:

This statement refers to the fact that ALS primarily affects motor neurons, leading to muscle weakness and paralysis, but it typically does not directly impact cognitive function or intellectual capacity. While cognitive impairment is not a hallmark feature of ALS, some individuals may experience changes in cognitive function or behavior, such as executive dysfunction or frontotemporal dementia, in later stages of the disease. However, depression in ALS is not primarily linked to changes in intellectual capacity but rather to other factors such as altered communication, physical limitations, and loss of autonomy.

B. Communication is altered:

ALS can affect the muscles involved in speech and swallowing, leading to difficulties in communicationAs the disease progresses, patients may experience dysarthria (difficulty speaking clearly) and dysphagia (difficulty swallowing), which can impair their ability to communicate effectively with others. Altered communication can result in frustration, social isolation, and feelings of being misunderstood, all of which are risk factors for depression.

C. Mobility is limited:

ALS causes progressive muscle weakness and paralysis, which can significantly impair mobility over time. As the disease advances, individuals with ALS may become increasingly dependent on mobility aids such as wheelchairs or may require assistance with mobility tasks. Limited mobility can lead to feelings of loss of independence, decreased participation in activities, and increased dependence on caregivers, all of which can contribute to depression.

D. Nutritional intake is poor:

ALS can affect the muscles involved in swallowing and chewing, leading to difficulties with eating and drinking. Dysphagia, or difficulty swallowing, is a common symptom in ALS and can result in poor nutritional intake and weight loss. Malnutrition and weight loss are associated with increased morbidity and mortality in ALS, and they can also contribute to feelings of weakness, fatigue, and overall decline in quality of life, which may exacerbate depression.

A. "I will notify my provider before taking any other medications."

This statement demonstrates understanding of the importance of consulting the provider before taking any other medications. It is correct because phenytoin may interact with other drugs, so notifying the provider is essential to avoid potential interactions.

B. "I have made an appointment to see my dentist next week."

This statement indicates that the client understands the importance of dental care while taking phenytoin. Phenytoin can cause gum overgrowth (gingival hyperplasia), so regular dental check-ups are recommended to monitor oral health. This statement is correct.

C. "I will take this medication with meals."

This statement suggests that the client plans to take phenytoin with meals. However, phenytoin should generally be taken on an empty stomach to enhance absorption, unless gastrointestinal upset occurs. Therefore, this statement indicates a need for further teaching.

D. "I'll be glad when my seizures stop so I can quit taking this medicine."

This statement reflects a misconception about the management of epilepsy. Phenytoin is typically used as a long-term treatment to prevent seizures, not as a short-term solution to stop seizures. Therefore, this statement indicates a need for further education about the chronic nature of epilepsy and the need for ongoing medication adherence.

E. “I’ll take this medication before meals.”

This statement correctly indicates the timing of phenytoin administration before meals. Taking phenytoin before meals helps enhance absorption and minimize the risk of gastrointestinal side effects. Therefore, this statement is correct.