Read scenario and answer question

Nursing - Intake Form

88 years old female, presenting with cough x3 days and subjective fever. Patient is alert and responsive. She is answering questions and does not is appear confused. She is taking her home medications as prescribed. She was sent by nursing home staff for evaluation.

Upon discharge, of the listed immunizations, select the vaccines to be recommended for this older adult client. Select all that apply.

A) Limit fluid intake:
There is no evidence to suggest that limiting fluid intake is necessary or beneficial for clients with multiple sclerosis (MS). In fact, staying well-hydrated is often encouraged, especially for individuals with bladder dysfunction or those at risk for urinary retention or constipation, which are common symptoms of MS. Restricting fluid intake could exacerbate these issues and is not a priority in MS management.

B) Utilize assistive devices as needed:
The most important aspect of teaching for a client recently diagnosed with multiple sclerosis is to encourage the use of assistive devices as needed. MS often causes mobility issues, weakness, and coordination difficulties due to damage to the nervous system. Using devices like canes, walkers, or wheelchairs can significantly improve independence and safety, helping the client maintain mobility and prevent falls

C) Schedule eye examinations every other year:
Eye problems, such as optic neuritis or diplopia (double vision), are common in MS, but the frequency of eye exams depends on the individual’s symptoms. Regular eye exams are important, but every other year is generally not frequent enough. Most MS patients are advised to have annual eye exams or as recommended by their ophthalmologist, especially if they experience any changes in vision.

D) Double up on any missed scheduled medications:
Doubling up on missed medications is not recommended, as it can lead to overdose or increase the risk of side effects. It is important to follow the prescribed medication regimen and use strategies to help the client remember their medications, such as setting reminders or using a medication organizer.

A) Improved bladder function:
Diphenhydramine, an antihistamine, has anticholinergic properties, meaning it blocks acetylcholine, which can cause side effects like urinary retention and dry mouth. While it may increase urinary retention, it is not primarily used to treat bladder function issues in Parkinson's disease.

B) Relief of depression:
Diphenhydramine is not prescribed for the treatment of depression in Parkinson's disease. It is an antihistamine used to treat allergic reactions and motion sickness, and sometimes for its anticholinergic effects in Parkinson's disease. While it may cause sedation, it does not address the neurochemical imbalances in the brain that cause depression, which is often treated with antidepressants such as SSRIs or SNRIs.

C) Decreased tremors:
Diphenhydramine has anticholinergic properties, which can help reduce tremors in patients with Parkinson's disease. Parkinson's disease is associated with a dopamine deficit, but acetylcholine also plays a role in motor control. The use of anticholinergic medications, such as diphenhydramine, can help restore balance between dopamine and acetylcholine in the brain, leading to decreased tremors.

D) Delay in disease progression:
There is no evidence that diphenhydramine can delay the progression of Parkinson's disease. The disease is caused by the degeneration of dopamine-producing neurons in the brain, and current treatments, such as levodopa/carbidopa or dopamine agonists, primarily aim to manage symptoms rather than prevent progression.