Chronic Neurological Problems PDF

Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank Stuvia.com - The Marketplace to Buy and Sell your Study Material Chapter 61: Nursing Management: Chronic Neurological Problems Lewis: Medical-Surgical Nursing in Canada, 5th Canadian Edition MULTIPLE CHOICE 1....

Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank Stuvia.com - The Marketplace to Buy and Sell your Study Material Chapter 61: Nursing Management: Chronic Neurological Problems Lewis: Medical-Surgical Nursing in Canada, 5th Canadian Edition MULTIPLE CHOICE 1. The nurse is teaching a client about management of migraine headaches. Which of the following client statements indicate that the teaching has been effective? a. “I will take the topiramate as soon as any headaches start.” b. “I should avoid taking Aspirin and sumatriptan at the same time.” c. “I will try to lie down someplace dark and quiet when the headaches begin.” d. “A glass of wine might help me relax and prevent headaches from developing.” ANS: C It is recommended that the client with a migraine rest in a dark, quiet area. Topiramate is used to prevent migraines and must be taken for several months to determine effectiveness. Aspirin or other nonsteroidal anti-inflammatory medications can be taken with the triptans. Alcohol may precipitate migraine headaches. DIF: Cognitive Level: Application TOP: Nursing Process: Evaluation 2. Which of the following parameters should the nurse assess when caring for a client who is experiencing a cluster headache? a. Nuchal rigidity b. Projectile vomiting c. Unilateral eyelid swelling I G B.C M d. Throbbing, bilateral facia l p a i n N R U S N T O ANS: C Unilateral eye edema, tearing, and ptosis are characteristics of cluster headaches. Nuchal rigidity suggests meningeal irritation, such as occurs with meningitis. Although nausea and vomiting may occur with migraine headaches, projectile vomiting is more consistent with increases in intracranial pressure (ICP). Unilateral sharp, stabbing pain, rather than throbbing pain, is characteristic of cluster headaches. DIF: Cognitive Level: Comprehension TOP: Nursing Process: Assessment 3. A client has a tonic–clonic seizure while the nurse is in the client’s room. Which of the following actions should the nurse take? a. Insert an oral airway during the seizure to maintain a patent airway. b. Restrain the client’s arms and legs to prevent injury during the seizure. c. Avoid touching the client to prevent further nervous system stimulation. d. Time and observe and record the details of the seizure and postictal state. ANS: D Because diagnosis and treatment of seizures frequently are based on the description of the seizure, recording the length and details of the seizure is important. Insertion of an oral airway and restraining the client during the seizure are contraindicated. The nurse may need to move the client to decrease the risk of injury during the seizure. DIF: Cognitive Level: Application TOP: Nursing Process: Implementation NURSINGTB.COM Downloaded by: shawnma | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank Stuvia.com - The Marketplace to Buy and Sell your Study Material 4. An elementary teacher who has just been diagnosed with epilepsy after having a generalized tonic–clonic seizure tells the nurse, “I cannot teach anymore, it will be too upsetting if I have a seizure at work.” Which of the following responses by the nurse is best? a. “You may want to contact the Epilepsy Foundation for assistance.” b. “You might benefit from some psychological counselling at this time.” c. “The Department of Vocational Rehabilitation can help with work retraining.” d. “Half of all clients with epilepsy are well controlled with antiseizure drugs.” ANS: D The nurse should inform the client that about 50% of clients with seizure disorders are controlled with medication and another 30% have a decrease in the intensity and frequency of seizures. The other information may be necessary if the client’s seizures persist after treatment with antiseizure drugs is implemented. DIF: Cognitive Level: Application TOP: Nursing Process: Implementation 5. Which action will the nurse take when evaluating a client who is taking phenytoin for adverse effects of the medication? a. Inspect the oral mucosa. b. Listen to the lung sounds. c. Auscultate the bowel tones. d. Check pupil reaction to light. ANS: A Phenytoin can cause gingival hyperplasia, but does not affect bowel tones, lung sounds, or pupil reaction to light. NURSINGTB.COM DIF: Cognitive Level: Application TOP: Nursing Process: Evaluation 6. A client found in a tonic–clonic seizure reports afterward that the seizure was preceded by numbness and tingling of the arm. Which of the following types of seizures should the nurse document based upon this finding? a. Atonic b. Partial c. Absence d. Myoclonic ANS: B The initial symptoms of a partial seizure involve clinical manifestations that are localized to a particular part of the body or brain. Symptoms of an absence seizure are staring and a brief loss of consciousness. In an atonic seizure, the client loses muscle tone and (typically) falls to the ground. Myoclonic seizures are characterized by a sudden jerk of the body or extremities. DIF: Cognitive Level: Comprehension TOP: Nursing Process: Assessment 7. The nurse is obtaining a health history and physical assessment from a client with possible multiple sclerosis (MS). Which of the following assessments should the nurse include? a. Assess for the presence of chest pain. b. Inquire about any urinary tract problems. c. Inspect the skin for rashes or discoloration. NURSINGTB.COM Downloaded by: shawnma | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank Stuvia.com - The Marketplace to Buy and Sell your Study Material d. Question the client about any increase in libido. ANS: B Urinary tract problems with incontinence or retention are common symptoms of MS. Chest pain and skin rashes are not symptoms of MS. A decrease in libido is common with MS. DIF: Cognitive Level: Application TOP: Nursing Process: Assessment 8. A female client who has multiple sclerosis (MS) asks the nurse about risks associated with pregnancy. Which of the following responses by the nurse is accurate? a. “MS symptoms may be worse after the pregnancy.” b. “Women with MS frequently have premature labour.” c. “Symptoms of MS are likely to become worse during pregnancy.” d. “MS is associated with a slightly increased risk for congenital defects.” ANS: A During the postpartum period, women with MS are at greater risk for exacerbation of symptoms. There is no increased risk for congenital defects in infants born of mothers with MS. Symptoms of MS may improve during pregnancy. Onset of labour is not affected by MS. DIF: Cognitive Level: Comprehension TOP: Nursing Process: Implementation 9. The nurse is caring for a client with multiple sclerosis (MS) who is to begin treatment with glatiramer acetate. Which of the following information should the nurse include in client teaching? a. Recommendation to drink at least 3–4 L daily b. Need to avoid driving or operating heavy machinery c. How to draw up and admN inisUR terSiI Gtion njec Bs.oC f theMmedication d. Use of contraceptive methods N T O other than oral contraceptives ANS: C Copaxone is administered by self-injection. Oral contraceptives are an appropriate choice for birth control. There is no need to avoid driving or drink large fluid volumes when taking glatiramer. DIF: Cognitive Level: Application TOP: Nursing Process: Implementation 10. The nurse is caring for a client with epilepsy. Which of the following laboratory results should the nurse expect? a. Increased blood glucose b. Decreased BUN c. Increased creatinine d. Decreased liver function tests ANS: C The blood work results of a client with epilepsy would show an increased creatinine level. The other results that would be expected are a decreased blood glucose level, increased BUN, and increased liver function tests. DIF: Cognitive Level: Application TOP: Nursing Process: Assessment NURSINGTB.COM Downloaded by: shawnma | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank Stuvia.com - The Marketplace to Buy and Sell your Study Material 11. The nurse is caring for a client with multiple sclerosis (MS) who has urinary retention caused by a flaccid bladder. Which of the following actions should the nurse plan to take? a. Teach the client how to perform self-catheterization. b. Decrease the client’s fluid intake in the evening. c. Suggest the use of incontinence briefs for nighttime use only. d. Assist the client to the commode every 2 hours during the day. ANS: A Bladder control is a major problem for many clients with MS. Although anticholinergics may be beneficial for some clients to decrease spasticity, other clients may need to be taught self-catheterization. Decreasing fluid intake will not improve bladder emptying and may increase risk for urinary tract infection (UTI) and dehydration. The use of incontinence briefs and frequent toileting will not improve bladder emptying. DIF: Cognitive Level: Application TOP: Nursing Process: Planning 12. A client with Parkinson’s disease has a nursing diagnosis of impaired physical mobility related to bradykinesia. Which of the following actions should the nurse include in the plan of care? a. Instruct the client in activities that can be done while lying or sitting. b. Suggest that the client rock from side to side to initiate leg movement. c. Have the client take small steps in a straight line directly in front of the feet. d. Teach the client to keep the feet in contact with the floor and slide them forward. ANS: B Rocking the body from side to side stimulates balance and improves mobility. The client will be encouraged to continue exercising because this will maintain functional abilities. Maintaining a wide base of sN upUpR orS twIiNllGheTlpBw.iCthObMalance. The client should lift the feet and avoid a shuffling gait. DIF: Cognitive Level: Application TOP: Nursing Process: Planning 13. A client has a new prescription for bromocriptine mesylate to control symptoms of Parkinson’s disease. Which of the following information obtained by the nurse may indicate a need for a decrease in the dose? a. The client has a chronic dry cough. b. The client has four loose stools in a day. c. The client develops a deep vein thrombosis. d. The client’s blood pressure is 90/46 mm Hg. ANS: D Hypotension is an adverse effect of bromocriptine mesylate, and the nurse should check with the health care provider before giving the medication. Diarrhea, cough, and deep vein thrombosis are not associated with bromocriptine mesylate use. DIF: Cognitive Level: Application TOP: Nursing Process: Evaluation 14. The nurse is providing teaching to a client with myasthenia gravis (MG) about management of the disease. Which of the following information should the nurse include in the teaching plan? a. Perform physically demanding activities in the morning. NURSINGTB.COM Downloaded by: shawnma | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank Stuvia.com - The Marketplace to Buy and Sell your Study Material b. Anticipate the need for weekly plasmapheresis treatments. c. Do frequent weight-bearing exercise to prevent muscle atrophy. d. Protect the extremities from injury due to poor sensory perception. ANS: A Muscles are generally strongest in the morning, and activities involving muscle activity should be scheduled then. Plasmapheresis is not routinely scheduled but is used for myasthenia crisis or for situations in which corticosteroid therapy should be discontinued. There is no decrease in sensation with MG, and muscle atrophy does not occur because muscles are used during part of the day. DIF: Cognitive Level: Application TOP: Nursing Process: Implementation 15. The nurse is assessing a client in the outpatient clinic who has restless legs syndrome. Which of the following over-the-counter medications that the client is taking routinely should the nurse discuss with the client? a. Multivitamin b. Acetaminophen c. Ibuprofen d. Diphenhydramine ANS: D Antihistamines can aggravate restless legs syndrome. The other medications will not contribute to the restless legs syndrome. DIF: Cognitive Level: Application TOP: Nursing Process: Implementation 16. The nurse is caring for a clienNt wRi t h I amyGotroBp. hiC c laM teral sclerosis (ALS) who is hospitalized U S N T O with pneumonia. Which of the following actions should be included in the plan of care? a. Assist with active range of motion. b. Observe for agitation and paranoia. c. Give muscle relaxants as needed to reduce spasms. d. Use simple words and phrases to explain procedures. ANS: A ALS causes progressive muscle weakness. Clients should be guide to use moderate-intensity, endurance-type exercises for the trunk and limbs, since this may help reduce ALS spasticity. When hospitalized with other health concerns, it is important to complete ROM to maintain strength. Psychotic symptoms such as agitation and paranoia are not associated with ALS. Cognitive function is not affected by ALS, and the client’s ability to understand procedures will not be impaired. Muscle relaxants will further increase muscle weakness and depress respirations. DIF: Cognitive Level: Application TOP: Nursing Process: Planning 17. The nurse is caring for a client who diagnosed with early Huntington’s disease (HD). Which of the following information should the nurse include in the teaching plan for the client, partner, and children? a. Use of levodopa/carbidopa to help reduce HD symptoms b. Need to take prophylactic antibiotics to decrease the risk for pneumonia. c. Lifestyle changes such as increased exercise that delay disease progression NURSINGTB.COM Downloaded by: shawnma | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank Stuvia.com - The Marketplace to Buy and Sell your Study Material d. Availability of genetic testing to determine the HD risk for the client’s children ANS: D Genetic testing is available to determine whether an asymptomatic individual has the HD gene. The client and family should be informed of the benefits and problems associated with genetic testing. Sinemet will increase symptoms of HD given that HD involves an increase in dopamine. Antibiotic therapy will not reduce the risk for aspiration. There are no effective treatments or lifestyle changes that delay the progression of symptoms in HD. DIF: Cognitive Level: Application TOP: Nursing Process: Implementation 18. The nurse assesses a client in the health clinic who has symptoms of a stooped posture, shuffling gait, and pill rolling-type tremor. Which of the following topics should the nurse include in the plan of care? a. Oral corticosteroids b. Antiparkinsonian drugs c. The purpose of electroencephalogram (EEG) testing d. Preparation for magnetic resonance imaging (MRI) ANS: B The diagnosis of Parkinson’s is made when two of the three characteristic signs of tremor, rigidity, and bradykinesia are present. The confirmation of the diagnosis is made on the basis of improvement when antiparkinsonian drugs are administered. This client has symptoms of tremor and bradykinesia; the next anticipated step will be treatment with medications. MRI and EEG are not useful in diagnosing Parkinson’s disease, and corticosteroid therapy is not used to treat it. DIF: Cognitive Level: ApplicN onRSINGTT atiU OBP:.C N uOrsMing Process: Planning 19. The nurse is assessing a client at the health clinic who has a severe migraine headache and tells the nurse about having four similar headaches in the last 3 months. Which of the following actions should the nurse take initially? a. Refer the client for stress counselling. b. Ask the client to keep a headache diary. c. Suggest the use of muscle-relaxation techniques. d. Teach about the effectiveness of the triptan drugs. ANS: B The initial nursing action should be further assessment of the precipitating causes of the headaches, quality, location of pain, etc. Stress reduction, muscle relaxation, and the triptan drugs may be helpful, but more assessment is needed first. DIF: Cognitive Level: Application TOP: Nursing Process: Implementation 20. The nurse is caring for a hospitalized client who has a moderate bilateral headache that radiates from the base of the skull. Which of the following prescribed PRN medications should the nurse administer initially? a. Lorazepam b. Acetaminophen c. Morphine sulphate d. Butalbital and Aspirin NURSINGTB.COM Downloaded by: shawnma | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank Stuvia.com - The Marketplace to Buy and Sell your Study Material ANS: B The client’s symptoms are consistent with a tension headache, and initial therapy usually involves a nonopioid analgesic such as acetaminophen, sometimes combined with a sedative or muscle relaxant. Lorazepam may be used in conjunction with acetaminophen but would not be appropriate as the initial monotherapy. Morphine sulphate and butalbital and Aspirin would be more appropriate for a headache that did not respond to a nonopioid analgesic. DIF: Cognitive Level: Application TOP: Nursing Process: Implementation 21. A client tells the nurse about using acetaminophen several times every day for recurrent bilateral headaches. Which of the following actions should the nurse take first? a. Discuss the need to stop taking the acetaminophen. b. Suggest the use of biofeedback for headache control. c. Teach the client about magnetic resonance imaging (MRI). d. Describe the use of botulism toxin (BOTOX) for headaches. ANS: A The headache description suggests that the client is experiencing medication overuse headache. The initial action will be withdrawal of the medication. The other actions may be needed if headaches persist. DIF: Cognitive Level: Application TOP: Nursing Process: Planning 22. The health care provider is considering the use of sumatriptan for a client with migraine headaches. Which of the following information obtained by the nurse is most important to report to the health care provider? a. The client has at least one to two cups of coffee daily. b. The client has had migraiN neUhReS adI acNhG esTfB or.3C 0OyeMars. c. The client has a history of a recent acute myocardial infarction. d. The client has been taking topiramate for 2 months. ANS: C The triptans cause coronary artery vasoconstriction and should be avoided in clients with coronary artery disease. The other information will be reported to the health care provider, but none of it is an indication that sumatriptan would be an inappropriate treatment. DIF: Cognitive Level: Application TOP: Nursing Process: Assessment 23. The nurse witnesses a client with a seizure disorder as the client suddenly jerks the arms and legs, falls to the floor, and regains consciousness immediately. Which of the following actions is priority for the nurse to take initially? a. Assess the client for a possible head injury. b. Give the scheduled dose of divalproex. c. Document the timing and description of the seizure. d. Notify the client’s health care provider about the seizure. ANS: A The client who has had a myoclonic seizure and fall is at risk for head injury and should be evaluated and treated for this possible complication first. Documentation of the seizure, notification of the seizure, and administration of antiseizure drugs also are appropriate actions, but the initial action should be assessment for injury. NURSINGTB.COM Downloaded by: shawnma | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank Stuvia.com - The Marketplace to Buy and Sell your Study Material DIF: Cognitive Level: Application TOP: Nursing Process: Implementation 24. Which of the following prescribed interventions will the nurse implement first for a hospitalized client who is experiencing continuous tonic–clonic seizures? a. Give phenytoin 100 mg IV. b. Monitor level of consciousness. c. Obtain computed tomography scan. d. Administer lorazepam 4 mg IV. ANS: D To prevent ongoing seizures, the nurse should administer rapidly acting antiseizure drugs such as the benzodiazepines. A CT scan is appropriate, but prevention of any seizure activity during the CT scan is necessary. Phenytoin also will be administered, but it is not rapidly acting. Clients who are experiencing tonic–clonic seizures are nonresponsive, although the nurse should assess LOC after the seizure. DIF: Cognitive Level: Application TOP: Nursing Process: Implementation 25. The partner of a client with Parkinson’s disease (PD) is upset and asks the nurse why he is no longer able to read the affectionate notes that the client writes for him. Which of the following information is the basis for the nurse’s response? a. Characteristic slow speech makes it difficult for the client with PD to put his/her thoughts on paper b. Cogwheel rigidity makes it hard for the client to hold a pen. c. Micrographia is common in clients with PD. d. Depression often seen in P D l e a d s to denying affectionate feelings. N RU SI NGTB.COM ANS: C The best answer is that the nurse’s response will be based upon the fact that micrographia is handwriting deterioration and often occurs in clients with Parkinson’s disease. PD clients have characteristic slow speech but that does not cause illegible writing. Cogwheel rigidity makes it difficult to walk and balance. Although depression is common in PD, this does not directly lead to denying affectionate feelings. DIF: Cognitive Level: Application TOP: Nursing Process: Implementation 26. Which of the following information about a client who is being treated with carbidopa/levodopa for Parkinson’s disease is most important for the nurse to report to the health care provider? a. Shuffling gait b. Tremor at rest c. Cogwheel rigidity of limbs d. Uncontrolled head movement ANS: D Dyskinesia is an adverse effect of the carbidopa/levodopa, indicating a need for a change in medication or decrease in dose. The other findings are typical with Parkinson’s disease. DIF: Cognitive Level: Application TOP: Nursing Process: Planning NURSINGTB.COM Downloaded by: shawnma | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank Stuvia.com - The Marketplace to Buy and Sell your Study Material 27. The nurse is caring for a client with Parkinson’s disease who has decreased tongue mobility and an inability to move the facial muscles. Which of the following nursing diagnoses is of highest priority? a. Activity intolerance related to immobility b. Toileting self-care deficit related to impaired mobility c. Ineffective health management related to difficulty managing complex treatment regimen d. Imbalanced nutrition: less than body requirements related to insufficient dietary intake ANS: D The data about the client indicate that poor nutrition will be a concern because of decreased swallowing. The other diagnoses also may be appropriate for a client with Parkinson’s disease, but the data do not indicate they are current problems for this client. DIF: Cognitive Level: Application TOP: Nursing Process: Diagnosis 28. The nurse is assessing a client with myasthenia gravis. Which of the following parameters is most important for the nurse to assess? a. Check pupillary size. b. Monitor grip strength. c. Observe respiratory effort. d. Assess level of consciousness. ANS: C Because respiratory insufficiency may be life threatening, it will be most important to monitor respiratory function. The other data also will be assessed but are not as critical. NURSINGTB.COM DIF: Cognitive Level: Application TOP: Nursing Process: Assessment 29. The nurse is caring for a client with myasthenia gravis who has had a thymectomy and receives the usual dose of pyridostigmine. An hour later, the client has nausea and severe abdominal cramps. Which of the following actions should the nurse take first? a. Auscultate the client’s bowel sounds. b. Notify the client’s health care provider. c. Administer the prescribed PRN antiemetic drug. d. Give the scheduled dose of prednisone. ANS: B The client’s history and symptoms indicate a possible cholinergic crisis. The health care provider should be notified immediately, and it is likely that atropine will be prescribed. The other actions will be appropriate if the client is not experiencing a cholinergic crisis. DIF: Cognitive Level: Application TOP: Nursing Process: Implementation 30. The nurse is caring for a client with a history of cluster headache who awakens during the night with a severe stabbing headache. Which of the following actions should the nurse take first? a. Start the prescribed PRN oxygen at 8 L/min. b. Put a moist hot pack on the client’s neck. c. Give the prescribed PRN acetaminophen. NURSINGTB.COM Downloaded by: shawnma | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank Stuvia.com - The Marketplace to Buy and Sell your Study Material d. Notify the client’s health care provider immediately. ANS: A Acute treatment for cluster headache is administration of 100% oxygen at 8–12 L/minute for 15 minutes. If the client obtains relief with the oxygen, there is no immediate need to notify the health care provider. Cluster headaches last only 60–90 minutes, so oral pain medications have minimal effect. Hot packs are helpful for tension headaches but are not as likely to reduce pain associated with a cluster headache. DIF: Cognitive Level: Application TOP: Nursing Process: Implementation 31. The nurse is teaching a client with Parkinson’s disease the preventive measures to reduce the risk of a fall. Which of the following instructions should the nurse include in the teaching session? a. Point the toes downward when stepping. b. Take two steps backward and three steps forward. c. Rock from front to back when walking. d. Drop rice kernels and step over them. ANS: D Clients who are risk for falling and tend to freeze while walking are at risk of falling. Have the client learn to drop rice kernels and focus on stepping over them to help prevent falls. Other measures include pointing the toes upward, taking one step backward and two steps forward; and, rocking from side to side, rather than from front to back. DIF: Cognitive Level: Application TOP: Nursing Process: Implementation 32. The nurse is preparing to a d mNi t aRc l i I GhoBh.asCbeeMn treated for status epilepticus in the ent w U S N T O emergency department. Which of the following equipment should the nurse have available in the room? a. Wrist restraints b. Tongue blade c. Suction tubing d. Nasogastric tube ANS: C The client is at risk for further seizures, and oxygen and suctioning may be needed after any seizures to clear the airway and maximize oxygenation. The bed’s siderails should be padded to minimize the risk for client injury during a seizure but wrist restraints should not be applied. Insertion of a nasogastric (NG) tube is not indicated because the airway problem is not caused by vomiting or abdominal distension. Use of tongue blades during a seizure is contraindicated. DIF: Cognitive Level: Application TOP: Nursing Process: Planning 33. The nurse is caring for a client with Parkinson’s disease who is admitted to the hospital for treatment of an acute infection. Which of the following nursing interventions will be included in the plan of care? a. Implement a bladder training schedule with a commode at the bedside. b. Observe for sudden exacerbation of symptoms. c. Provide high protein foods at each meal. NURSINGTB.COM Downloaded by: shawnma | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank Stuvia.com - The Marketplace to Buy and Sell your Study Material d. Place an arm chair at the client’s bedside. ANS: D An armchair should be used when the client is seated so that the client can use the arms to assist with getting up from the chair. High protein foods will decrease the effectiveness of L-dopa. Parkinson’s is a steadily progressive disease without acute exacerbations. The use of a raised toilet seat is helpful for the client but there is no indication that a bladder training schedule is needed with a commode at the bedside. DIF: Cognitive Level: Application TOP: Nursing Process: Planning NURSINGTB.COM NURSINGTB.COM Downloaded by: shawnma | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?