A patient has a decreased step height and length with increased step speed. He appears to hesitate both in initiating and in terminating ambulation. Which pathology is he most likely experiencing?
a. multiple sclerosis c. cerebellar disease
b. Parkinson's disease d. Alzheimer's disease
B
A patient with Parkinson's disease has a decreased step height and length, but increased step speed, resulting in shuffling. The posture is stooped. There is a hesitation to begin to terminate walking. The patient assumes a rigid body posture, with flexion of the knees during standing and ambulation. The gait of a patient with multiple sclerosis is called a scissors gait: adduction at the knee level produces short, slow steps; gait is uncoordinated, stiff, and jerky; foot is dragged across the floor in a semicircle. A patient with cerebellar disease has a broad-based gait that is uncoordinated, and he appears to stagger and sway during ambulation. The patient with Alzheimer's disease has difficulty with walking despite intact motor and sensory systems. The patient is unable to initiate walking, as if stuck to the floor. After walking is initiated, the gait is slow and shuffling.
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A nurse is educating a woman who is 38 years old and experiencing her first pregnancy. When planning care for this woman, what information does the nurse take into consideration? (Select all that apply.)
A. Chronic health conditions are more likely in this age group. B. Genetic screening is not recommended for women over age 30. C. Gestational diabetes is seen more frequently in this age group. D. Multiple gestations are rarely seen in women over age 35. E. Older primigravidas are at higher risk for cesarean birth.
During physical examination of a client with a suspected endocrine disorder, the nurse assesses the body structures. The nurse gathers this data based on the understanding that it is an important aid in which of the following?
A) Detecting evidence of hormone hypersecretion B) Detecting information about possible tumor growth C) Determining the presence or absence of testosterone levels D) Determining the size of the organs and location
The nurse is suctioning a patient with an endotracheal tube. Which action should the nurse take when the patient develops respiratory distress?
a. Quickly remove the catheter and carefully reinsert it. b. Continue to apply intermittent suction to remove thick secretions. c. Administer oxygen directly through the suction catheter. d. Withdraw the catheter and encourage the patient to cough and deep-breathe.
A patient has a systemic BP of 108/51 mm Hg and an intracranial pressure (ICP) of 14 mm Hg. Which action should the nurse take first?
a. Elevate the head of the patient's bed to 60 degrees. b. Document the BP and ICP in the patient's record. c. Report the BP and ICP to the health care provider. d. Continue to monitor the patient's vital signs and ICP.