The nurse assessing the client diagnosed with Parkinson's disease (PD) would expect which of the following assessment findings?

Muscle rigidity and bradykinesia

Facial pain and ptosis

Diarrhea and nausea

Ecchymosis and petechiae

Answer and Explanation

The Correct Answer is A

A. Muscle rigidity and bradykinesia: Parkinson's disease (PD) is characterized by a combination of motor symptoms due to the degeneration of dopamine-producing neurons in the brain. The hallmark motor symptoms include muscle rigidity (stiffness of muscles, making movement difficult) and bradykinesia (slowness of movement). These symptoms are typically present early in the disease and can lead to difficulties with daily activities such as walking, speaking, and performing fine motor tasks. These two signs are primary indicators of Parkinson's disease.

B. Facial pain and ptosis: Facial pain and ptosis (drooping eyelids) are not typical symptoms of Parkinson's disease. PD can affect facial expression (resulting in a masked face), but it does not usually cause facial pain. Ptosis is more commonly seen in conditions like Horner's syndrome, myasthenia gravis, or as a side effect of medications, but it is not a hallmark symptom of Parkinson's disease.

C. Diarrhea and nausea: While gastrointestinal symptoms such as constipation can be seen in Parkinson's disease due to autonomic dysfunction and decreased gut motility, diarrhea and nausea are not typical primary symptoms. In fact, constipation is a more common issue in PD. Nausea could result from the use of medications like levodopa, but it is not a defining feature of the disease itself.

D. Ecchymosis and petechiae: Ecchymosis (bruising) and petechiae (small red or purple spots on the skin) are not characteristic of Parkinson's disease. These findings are more often associated with platelet disorders, bleeding disorders, or vascular conditions. While Parkinson's disease can involve complications like falls (which could lead to bruising), these are not direct symptoms of the disease itself. The primary symptoms involve motor and autonomic dysfunction.

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Correct Answer is C

Explanation

A. pH 7.33, PaCO2 35 mmHg, PaO2 78 mmHg, HCO3 20 mEq/L:
This answer choice indicates respiratory acidosis (pH < 7.35, low bicarbonate), but the goal in acute respiratory failure is not just to adjust the pH alone; the more immediate concern is correcting oxygenation. The PaO2 of 78 mmHg is below the normal range (80-100 mmHg), indicating hypoxemia that should be corrected first. The goal should be to improve PaO2 to acceptable levels (≥80 mmHg) and achieve adequate oxygen saturation. This ABG result does not fully align with the immediate goals of treatment.

B. Heart rate 80 and respiratory rate 20:
While normal vital signs like heart rate and respiratory rate are important, they are not the primary goal of treatment in acute respiratory failure. The focus during ventilator support is to improve oxygenation and ventilation rather than simply achieving normal heart and respiratory rates. In acute respiratory failure, abnormal heart and respiratory rates are often a result of hypoxia or hypercapnia (high CO2), so normalizing oxygenation and carbon dioxide levels is more critical initially.

C. O2 saturation of at least 94%:
The primary goal in acute respiratory failure is to maintain adequate oxygenation. In this context, the goal of ventilator support is to correct hypoxemia (low blood oxygen levels) and restore normal oxygen saturation. A target oxygen saturation of at least 94% is commonly considered appropriate for most patients in acute respiratory failure to ensure that tissues are receiving enough oxygen to prevent organ damage. This is a key aspect of managing respiratory failure and ensuring adequate tissue perfusion. Oxygen saturation below 90% is typically considered to indicate a severe level of hypoxemia, requiring prompt intervention.

D. Sodium 135 mg/dL and potassium 4.8 mg/dL:
While electrolyte levels are important to monitor in any critically ill patient, the main goal of treatment in acute respiratory failure is improving oxygenation and ventilation rather than focusing specifically on normalizing sodium or potassium levels. Correcting imbalances in electrolytes can be part of overall care, but it is not the primary objective in this situation. Oxygenation (as measured by PaO2 and O2 saturation) takes priority over correcting individual electrolytes.

A. allowing undamaged areas in the lower part of the lungs to be ventilated." B. relieving pressure on the diaphragm and allowing expansion." C. decreasing pressure to the back of the rib cage." D. snifting fluid into the back area of the lungs.'

Correct Answer is A

Explanation

A. Allowing undamaged areas in the lower part of the lungs to be ventilated: The prone position is commonly used in patients with acute respiratory distress syndrome (ARDS) to improve oxygenation and ventilation. In ARDS, the lung tissue is often damaged, particularly in the dorsal (back) regions of the lungs, due to gravity and ventilation-perfusion mismatch. By placing the patient in the prone position, gravity helps redistribute the blood flow and improve ventilation to the posterior (lower) parts of the lungs, which are typically under-ventilated in the supine position. This positioning allows healthier or less-damaged areas of the lungs to receive better airflow, improving overall oxygenation.

B. Relieving pressure on the diaphragm and allowing expansion: While the prone position does shift pressure away from certain areas, its primary benefit is not related to relieving pressure on the diaphragm. The diaphragm, while somewhat affected by body position, is not the key structure being targeted for ventilation improvement. The main goal of prone positioning is to improve lung aeration in areas affected by ARDS, not directly to relieve diaphragm pressure.

C. Decreasing pressure to the back of the rib cage: The prone position does not specifically target reducing pressure to the back of the rib cage. Although it changes how pressure is distributed across the body, the main goal is to facilitate better ventilation and perfusion to the posterior lung regions, not necessarily to reduce pressure on the rib cage itself.

D. Sniffing fluid into the back area of the lungs: This option is unclear and not accurate. The prone position does not "sniff" fluid into the lungs; rather, it helps to redistribute fluid and improve the ventilation of the lung areas that are less affected by edema or inflammation in ARDS. The goal is to improve the ventilation/perfusion ratio and prevent further collapse of lung tissue.

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Arterial Blood Gases
pH	7.35-7.45
PaCO2	35-45mmHg
PaO2	80-100mmHg
HCO3-	22-26 mEq/L
O2 Saturation	>95%
Chemistry
BUN	8-21mg/dl
Creatinine	0.5-1.2mg/dl
Na	135-145 mEq/L
K	3.5-5.3 mEq/L
Cl	97-107 mEq/L
CO2	22-26 mEq/L
Ca	8.2-10.2 mg/dl
Glucose	65-99 mg/dl
Mg	1.7-2.2 mg/dl
PO4	2.5-4.5 mg/dl

The nurse assessing the client diagnosed with Parkinson's disease (PD) would expect which of the following assessment findings?

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

A client with a medical diagnosis of acute respiratory distress syndrome (ARDS) is being placed in the prone position. The nurse explains to family members that, "This will help improve ventilation by:

Correct Answer is A

Explanation

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