The nurse is planning discharge teaching for a client newly diagnosed with Parkinson's disease. Which action(s) will be included in discharge teaching? (Select all that apply.)

Choice A rationale Encouraging a client with Parkinson's disease to avoid rest periods is counterproductive and potentially dangerous. Parkinson's is a progressive neurodegenerative disorder characterized by tremors, rigidity, and bradykinesia, which can be physically exhausting. Clients often experience significant fatigue as they work harder to coordinate movements. Adequate rest is essential to manage energy levels and prevent the physical burnout or falls that can occur when the client becomes overly tired or stressed during daily activities. Choice B rationale Promoting independence is a cornerstone of rehabilitation for Parkinson's disease to maintain functional mobility and self esteem. Allowing the client to perform tasks at their own pace helps preserve motor pathways and prevents the secondary complications of disuse. The nurse should encourage the use of assistive devices if necessary, but the goal is to keep the client engaged in their own care for as long as possible to delay the total loss of autonomy. Choice C rationale Safety is a priority due to the gait disturbances and postural instability associated with the disease. Instructing the client to remove throw rugs, install grab bars, and ensure adequate lighting helps prevent falls, which are a leading cause of morbidity in this population. Since the client may experience a shuffling gait or freezing episodes, environmental modifications are necessary to create a predictable and safe path for movement throughout the home to minimize injury. Choice D rationale Limiting fluids is generally inappropriate and could be harmful. Many clients with Parkinson's disease suffer from autonomic dysfunction, which can lead to constipation and orthostatic hypotension. Maintaining adequate hydration is necessary to soften stools and maintain blood pressure. Unless the client has a coexisting condition like heart failure or renal disease that requires fluid restriction, they should be encouraged to drink plenty of water to support overall metabolic function and digestive health. Choice E rationale A structured exercise program is vital for maintaining joint flexibility and reducing the impact of muscle rigidity. Active range of motion exercises help to counteract the stiffness caused by the lack of dopamine in the basal ganglia. Regular physical activity can improve balance, gait, and coordination, which are all compromised as the disease progresses. Involving the client in planning the routine ensures that the exercises are tailored to their specific abilities and personal goals.