A nurse is providing discharge instruction to the family of a client who has Parkinson's disease and is a fall risk. Which of the following information should the nurse provide?
(Select All that Apply.)
Obtain a hospital bed and keep all four siderails up.
Remove all throw rugs from the home.
Install handrails in the bathroom.
Ensure adequate lighting along walking spaces.
Keep walking areas free of clutter.
Correct Answer : B,C,D,E
Choice A Reason:
Obtaining a hospital bed and keeping all four siderails up, may not be the best choice. While a hospital bed with siderails may be appropriate for some individuals with Parkinson's disease who are at high risk of falls, keeping all four siderails up continuously can potentially restrict mobility and independence. It's important to balance safety with the client's comfort and ability to move independently.
Choice B Reason:
Removing all throw rugs from the home is correct. Throw rugs can be tripping hazards, especially for individuals with mobility issues or balance problems. Removing throw rugs can reduce the risk of trips and falls within the home.
Choice C Reason:
Installing handrails in the bathroom is correct. Installing handrails in the bathroom, especially near the toilet and shower, can provide additional support and stability for individuals with Parkinson's disease when performing daily activities. This can help prevent falls in a potentially slippery environment.
Choice D Reason:
Ensuring adequate lighting along walking spaces is correct. Good lighting is crucial for individuals with Parkinson's disease to see obstacles and hazards clearly. Adequate lighting along walking spaces helps improve visibility and reduces the risk of falls, especially during nighttime or low-light conditions.
Choice E Reason:
Keeping walking areas free of clutter is correct. Clutter and obstacles in walking areas increase the risk of tripping and falling, particularly for individuals with Parkinson's disease who may have difficulty with balance and coordination. Keeping walking areas clear of clutter helps create a safer environment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D"]
Explanation
Choice A Reason:
Temperature 36.3°C (97.4°F) is correct. Hypothermia is a characteristic finding in neurogenic shock due to the loss of sympathetic control over temperature regulation and peripheral vasodilation. This can lead to heat loss from the skin surface and a decrease in core body temperature.
Choice B Reason:
Respirations 12/min is incorrect. Respiratory rate is usually not significantly affected in neurogenic shock. However, individuals with high cervical or upper thoracic spinal cord injuries may experience respiratory compromise due to paralysis of respiratory muscles, but this is not a typical feature of neurogenic shock.
Choice C Reason:
Incorrect: Neurogenic shock typically results inhypotension(low blood pressure) due to vasodilation. The given blood pressure reading is elevated, which is not consistent with neurogenic shock.
Choice D Reason:
Heart rate 54/min is correct. Bradycardia is a common finding in neurogenic shock due to unopposed parasympathetic activity resulting from the loss of sympathetic tone. The heart rate may be slow and may decrease further over time.
Choice E Reason:
Calcium level 7.0 mg/dL is incorrect, Calcium levels are not directly related to neurogenic shock. Neurogenic shock primarily involves the loss of sympathetic tone and the resulting hemodynamic changes, rather than alterations in calcium metabolism.
Correct Answer is C
Explanation
Choice A Reason:
Decreased mucus production contributes to airway constriction: This statement is incorrect. Bronchospasm does not decrease mucus production; instead, it primarily affects the smooth muscles surrounding the bronchioles, leading to their constriction and narrowing of the airways. Increased mucus production, often accompanied by inflammation, can contribute to airway obstruction in conditions like asthma.
Choice B Reason:
Inflammation is reduced due to airway diameter: This statement is incorrect. Bronchospasm typically occurs in the setting of inflammation in conditions such as asthma. Constriction of the airways during bronchospasm exacerbates the inflammation and can further narrow the airways, leading to symptoms such as wheezing and dyspnea.
Choice C Reason:
Bronchospasm occurs when there is inflammation, edema, and excess mucus: This statement is partially correct. Bronchospasm often occurs in the presence of inflammation, edema, and excess mucus production, as seen in conditions like asthma. These factors contribute to airway hyperresponsiveness, leading to bronchospasm and airway narrowing.
Choice D Reason:
Airway obstruction occurs due to thinning mucus: This statement is incorrect. Airway obstruction in conditions like asthma is primarily due to bronchospasm, inflammation, and excessive mucus production, rather than thinning mucus. Thinning of mucus would not typically contribute to airway obstruction.
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