An 82-year-old client with advanced Parkinson's disease is admitted for severe dehydration and profound weight loss. Assessment reveals pronounced bradykinesia, freezing of gait episodes, and prominent dysphagia with coughing during meals. When prioritizing the daily basic care, mobility, and comfort needs for this client, which of the following evidence-based interventions should be incorporated? Select all that apply.
- Schedule energy-intensive activities such as bathing and hallway ambulation precisely during the peak action of the client's dopaminergic medications.Cevap
- BDelegate the initial bedside swallow screening to the unlicensed assistive personnel (UAP) before offering the first oral fluid trial.
- Teach the client to consciously lift the toes and visualize stepping over a target on the floor to overcome episodes of gait freezing.Cevap
- DPlace the client in a high-Fowler's position with the neck slightly hyperextended to facilitate gravity-assisted esophageal emptying during meals.
- EApply soft bilateral wrist restraints at night to prevent the dislodgment of the prescribed continuous intravenous fluid infusion.
- FDocument the sudden onset of nighttime disorientation and new urinary incontinence as expected physiological age-related progression of the neurological disease.
Cevap
The correct interventions are scheduling activities during peak medication times and teaching the client to visualize stepping over a target to overcome freezing of gait.
For clients with Parkinson's disease, coordinating energy-intensive activities like hygiene and ambulation with the peak effect of dopaminergic medications ensures optimal muscle function and reduces injury risk. Furthermore, teaching the client to visualize and step over an imaginary target effectively utilizes intact neural pathways in the frontal cortex to overcome the freezing of gait caused by basal ganglia dysfunction.
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Basic Care and Comfort: Complex Mobility, Nutrition, and Safety in Neurological Degeneration