A patient with Parkinson's disease is experiencing "freezing" episodes. What should the nurse prioritize during these episodes?

Appeared in: RML MAINS 2025

Explanation

Freezing of gait is a sudden, temporary inability to move, which creates an immediate and significant risk of falls and injury.
The primary nursing principle in any acute situation is to ensure patient safety and prevent harm.
Providing physical support and ensuring a safe environment directly addresses the most immediate threat to the patient during a freezing episode.
Falls are a major source of morbidity in patients with Parkinson's disease, especially as the disease progresses and balance becomes more impaired.

Option A: Administering medication is not the first-line, immediate response to a motor block. The physical risk of falling must be addressed first.
Option B: This action is dangerous and contraindicated. Forcing movement or encouraging speed can disrupt balance further and directly increases the risk of a fall.
Option D: Physical therapy is a crucial long-term strategy for managing Parkinson's symptoms, but it is not an appropriate intervention during an acute, active freezing episode.

Clinical Relevance

Nursing practice connection: Use the key finding related to Nursing priorities for acute motor symptoms in Parkinson's disease to guide bedside assessment, documentation, and the next nursing action.
Nurses must be vigilant in implementing fall prevention strategies for all patients with Parkinson's disease, as freezing can occur without warning.
Patient and family education is critical and should include techniques to manage freezing episodes at home, such as environmental modifications (removing rugs, ensuring clear pathways) and using sensory cues (e.g., humming, counting, using a laser pointer).
What if the patient is in a crowded or stimulating environment when they freeze? The nurse's priority would be to first ensure immediate stability, then guide the patient to a quieter, less stimulating area to reduce anxiety and help them reset before attempting to walk again.

How to Approach the Question

First, identify the core of the question: it asks for the nursing priority during an acute event (a freezing episode).
Next, analyze the patient's condition and the primary risk associated with it. For freezing of gait in Parkinson's, the most immediate and severe risk is falling.
Apply a prioritization framework. The principle of 'Safety and Risk Reduction' is most applicable here. The goal is to prevent physical harm.
Evaluate each option based on this framework. Does it directly address the immediate risk of falling?
Option A (medication) is a secondary consideration. Option B (walking fast) increases risk. Option D (PT) is a long-term, not acute, intervention.
Conclude that ensuring safety and providing support is the only option that directly mitigates the immediate danger.

Concept Tested & Keywords

Concept Tested: Nursing priorities for acute motor symptoms in Parkinson's disease.
Stem keywords: Parkinson's disease, freezing episodes, prioritize
Lead-in keywords: prioritize

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E6 Medicine Harrison 22e Part 1 pp. 219-221, 222-224

E6 Medicine Harrison 22e Part 2 p. 1411-1413

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Attempt every question from this paper in a timed mock, then review the full solution for each one.