MED SURG FINAL ATI EXAM QUESTION AND ANSWERS.
Deep brain stimulation
● An electrode is implanted in the thalamus.
● A current is delivered through
... [Show More] a small pulse generator
implanted under the skin of the upper chest. Electrical
stimulation from DBS impulses decreases tremors and
involuntary movements, and can decrease medications
required to control PD.
NURSING ACTIONS: Monitor for infection, brain
hemorrhage, or stroke-like symptoms.
INTERPROFESSIONAL CARE
● Because PD is a degenerative neurological disorder,
long-term treatment and care must be accommodated.
● During the later stages of the disorder, the client needs
referrals to and support from disciplines such as speech
therapists, occupational therapists, physical therapists,
and social service/case management.
COMPLICATIONS
Aspiration pneumonia
As PD advances in severity, alterations in chewing and
swallowing worsen, increasing the risk for aspiration.
NURSING ACTIONS
● Use swallowing precautions to decrease the risk for
aspiration.
● Develop individual dietary plan based on the speech
therapist’s recommendations.
● Have a nurse in attendance when the client is eating.
● Encourage the client to eat slowly and chew thoroughly
before swallowing.
● Feed the client in an upright position and have suction
equipment on standby.
● Evaluate need for enteral feedings to maintain weight
and prevent aspiration as PD progresses.
Altered cognition (dementia, memory deficits)
Clients in advanced stages of PD can exhibit altered
cognition in the form of dementia and memory loss.
NURSING ACTIONS
● Acknowledge the client’s feelings.
● Provide for a safe environment.
● Develop a comprehensive plan of care with the family,
client, and interprofessional team.
Application Exercises
1. A nurse is caring for a client
who displays signs of stage III
Parkinson’s disease. Which of the
following actions should the nurse
include in the plan of care?
A. Recommend a community
support group.
B. Integrate a daily
exercise routine.
C. Provide a walker for
ambulation.
D. Perform ADLs for the client.
2. A nurse is developing a plan of
care for the nutritional needs of a
client who has stage IV Parkinson’s
disease. Which actions should
the nurse include in the plan of
care? (Select all that apply.)
A. Provide three large
balanced meals daily.
B. Record diet and fluid
intake daily.
C. Document weight
every other week.
D. Place the client in Fowler’s
position to eat.
E. Offer nutritional supplements
between meals.
3. A nurse is reinforcing teaching with a
client who has Parkinson’s disease and
has a new prescription for bromocriptine.
Which of the following instructions should
the nurse include in the teaching?
A. Rise slowly when standing.
B. Expect urine to become darkcolored.
C. Avoid foods containing
tyramine.
D. Report any skin discoloration.
4. A nurse is assessing a client for
manifestations of Parkinson’s disease. Which
of the following are expected findings?
(Select all that apply.)
A. Decreased vision
B. Pill-rolling tremor of the fingers
C. Shuffling gait
D. Drooling
E. Bilateral ankle edema
F. Lack of facial expression. [Show Less]