Medical Surgical Parkinson’s Disease PD #6

Question

The nurse is caring for a client with Parkinson’s disease and prioritizes which intervention in the plan of care?

Answers

  1. Instruct the client to eat foods high in phosphorus which helps mental clarity
    • Rationale:

      This answer is not correct because although diet is important for maintaining good health, there is no evidence that foods high in phosphorus aid in mental clarity. Elevation of the legs is the priority to decrease edema.

  2. Place client on bedpan every 3 hours to establish voiding
    • Rationale:

      This answer is not correct because clients should maintain as much independence as possible, even with bathroom activities. Also, mobility offers strategy against pedal edema, which can be common in Parkinson’s clients due to their challenges in ambulation.

  3. Elevate client's legs when sitting to avoid edema
    • Rationale:

      This answer is correct because in Parkinson’s disease (PD), there is decline in movement which makes the client at more risk of fluid build up. Slowness and mobility alterations found in PD may predispose the client for increased edema. Elevation of the legs is important to decrease edema.

  4. Use armless chair to increase leg strength when getting up
    • Rationale:

      This answer is not correct because this poses a fall risk situation for the client. Due to the chairs not having arms, the client is unable to stabilize himself while attempting to rise.

Overview

Slowness and mobility alterations found in PD may predispose the client for increased edema. Elevation of the legs is important to decrease edema.

Explanation

Learning Outcomes

Parkinson’s disease (PD) is a neurological disorder that affects the central nervous system. Neurons (nerve cells) are damaged due to the decreased level of dopamine in the brain. This causes various movement problems, including weakness, stiffness, balance issues, tremors, and slow movement (bradykinesia). Due to the difficulty in client mobility, the client can experience edema in the lower extremities. Elevation of the client’s legs when sitting will help decrease edema. Careful, (possibly assisted) mobility will also help decrease edema in the lower extremities.

Test Taking Tip

Remember the ABCs of triage/prioritization. Also important is to refer back to Maslow’s Hierarchy of Needs to consider safety risks associated with edema in a PD client.

Video Rationale