Page 2029 - Saunders Comprehensive Review For NCLEX-RN

administered and, if weakness is more
severe, the client is overmedicated;
prepare to administer atropine sulfate,
the antidote, as prescribed.
XIII. Parkinson’s Disease
A. Description
1. A degenerative disease caused by the depletion of
dopamine, which interferes with the inhibition of
excitatory impulses, resulting in a dysfunction of the
extrapyramidal system.
2. It is a slow, progressive disease that results in a
crippling disability.
3. The debilitation can result in falls, self-care deficits,
failure of body systems, and depression.
4. Mental deterioration occurs late in the disease.

B. Assessment

1. Bradykinesia, abnormal slowness of movement, and
sluggishness of physical and mental responses
2. Akinesia
3. Monotonous speech
4. Handwriting that becomes progressively smaller
5. Tremors in hands and fingers at rest (pill rolling)
6. Tremors increasing when fatigued and decreasing
with purposeful activity or sleep
7. Rigidity with jerky movements
8. Restlessness and pacing
9. Blank facial expression; mask-like faces
10. Drooling
11. Difficulty swallowing and speaking
12. Loss of coordination and balance
13. Shuffling steps, stooped position, and propulsive gait

C. Interventions

1. Assess neurological status.
2. Assess ability to swallow and chew.
3. Provide high-calorie, high-protein, high-fiber soft diet
with small, frequent feedings.
4. Increase fluid intake to 2000 mL/day.
5. Monitor for constipation.
6. Promote independence along with safety measures.
7. Avoid rushing the client with activities.
8. Assist with ambulation and provide assistive devices.
9. Instruct the client to rock back and forth to initiate
movement.
10. Instruct the client to wear low-heeled shoes.
11. Encourage the client to lift the feet when walking and

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