The home health nurse is caring for a client with Parkinson's disease who is beginning to experience swallowing difficulties. Which intervention should the nurse include in this client's plan of care?

Tell the client to lay on the left side to prevent the tongue from falling back into the mouth.

Teach the client to take medication an hour before meals to enhance the swallowing reflex.

Prepare the client and family for the future need of a gastrostomy tube for feeding.

Encourage the client and family to provide a semi-solid diet with thick liquids.

Answer and Explanation

The Correct Answer is D

Choice A reason: Telling the client to lay on the left side to prevent the tongue from falling back into the mouth is not a standard intervention for managing swallowing difficulties in Parkinson's disease. The focus should be on dietary modifications and safe swallowing techniques.

Choice B reason: Teaching the client to take medication an hour before meals to enhance the swallowing reflex is not a widely recognized intervention for managing swallowing difficulties. While timing of medication can be important, dietary adjustments are more immediately effective.

Choice C reason: Preparing the client and family for the future need of a gastrostomy tube for feeding might be necessary if swallowing difficulties progress significantly. However, it is not the first line of intervention and should be considered only after other measures have been tried.

Choice D reason: Encouraging the client and family to provide a semi-solid diet with thick liquids is the most appropriate intervention. Semi-solid and thickened liquids are easier to swallow and less likely to cause choking or aspiration, which is crucial for managing dysphagia in clients with Parkinson's disease.

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Correct Answer is D

Explanation

Choice A reason: Serum potassium of 5.0 me/L and serum sodium of 138 me/L are within normal ranges and do not reflect the expected electrolyte imbalances due to dehydration from vomiting and diarrhea.

Choice B reason: Serum potassium of 4.5 me/L and serum sodium of 140 me/L are also within normal ranges. This does not reflect the typical imbalance caused by dehydration.

Choice C reason: Serum potassium of 3.5 me/L and serum sodium of 142 me/L are normal values. They do not indicate the electrolyte disturbances expected with dehydration from vomiting and diarrhea.

Choice D reason: Serum potassium of 3.0 me/L indicates hypokalaemia (low potassium), and serum sodium of 149 me/L indicates hypernatremia (high sodium). These imbalances are expected in a client with a history of fever, vomiting, and diarrhea, as these conditions can lead to loss of potassium and concentration of sodium due to dehydration.

A. Degree of skin elasticity. B. Length of capillary refill. C. Rhythm of apical pulse. D. Volume of pedal pulses.

Correct Answer is C

Explanation

Choice A reason: The degree of skin elasticity is a measure often used to assess hydration status, especially in older adults. However, it does not provide direct information about the client's cardiac function or the cause of their current symptoms.

Choice B reason: The length of capillary refill is useful for assessing peripheral perfusion and overall circulatory status. While prolonged capillary refill can indicate poor perfusion, it does not provide specific information about heart rhythm or the cause of palpitations and faintness in a client with heart failure.

Choice C reason: The rhythm of the apical pulse is the most important assessment data to obtain in this scenario. The client's complaint of a fast-beating heart and feeling faint suggests a possible arrhythmia, which could be detected by assessing the rhythm of the apical pulse. This assessment can help identify irregular heartbeats, tachycardia, or other abnormalities that may require immediate intervention.

Choice D reason: The volume of pedal pulses can provide information about peripheral circulation, but it is not as crucial as assessing the heart rhythm in a client experiencing palpitations and faintness. Peripheral pulse volume may not change significantly with certain arrhythmias or cardiac issues that affect the central circulation more directly.

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The home health nurse is caring for a client with Parkinson's disease who is beginning to experience swallowing difficulties. Which intervention should the nurse include in this client's plan of care?

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Naxlex Comprehensive Predictor Exams

A client reports a 2-day history of fever, vomiting, and diarrhea. The healthcare provider prescribes serum electrolyte levels to be obtained. Which laboratory results should the nurse expect?

Correct Answer is D

Explanation

A client with heart failure (HF) is waiting in the preoperative area for a scheduled procedure and tells the nurse, "My heart feels like it is beating too fast and I feel faint." After initiating a call for an electrocardiogram (ECG), which assessment data is most important for the nurse to obtain?

Correct Answer is C

Explanation

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