Mr. X has been diagnosed to have Parkinson's disease. He complains that the resting tremors he is experiencing in his right hand are very frustrating. What advice to be given to him by the attending nurse?

1. A

   To take a warm bath

2. B

   To hold an object

3. C

   To practice deep breathing

4. D

   To give diazepam as needed

Appeared in: BHU NO - 2015

Explanation

• Parkinson's disease is characterized by resting tremors, which occur when the muscles are relaxed and the limb is not actively in use.
• A key feature of these tremors is that they decrease or stop entirely during voluntary, purposeful movement.
• Advising the patient to hold an object provides a simple, purposeful action that engages the hand muscles.
• This voluntary muscle engagement directly counteracts the mechanism of the resting tremor, leading to its temporary cessation and providing relief from the frustrating symptom.

Why Other Options Were Wrong

• Option A: While a warm bath can promote general relaxation and may slightly reduce muscle rigidity, it is not a specific or immediate intervention to stop an active resting tremor in the hand.
• Option C: Deep breathing is an excellent technique for managing the anxiety and frustration associated with chronic illness symptoms. However, it does not directly stop the neurological mechanism causing the physical tremor.
• Option D: Diazepam is a benzodiazepine, a prescription medication that requires a physician's order. It is not an independent nursing action to advise its use. Furthermore, it is not a first-line treatment for Parkinson's tremors and carries risks of sedation, dependence, and worsening balance.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Non-pharmacological management of resting tremors in Parkinson's disease to guide bedside assessment, documentation, and the next nursing action.
• Empowering patients with simple, non-pharmacological coping strategies is a key nursing role in managing chronic neurological conditions like Parkinson's disease.
• These techniques improve the patient's quality of life and sense of self-efficacy by giving them immediate tools to manage distressing symptoms.
• Nurses must educate patients to distinguish between strategies that manage the physical symptom (like holding an object) and those that manage the emotional response (like deep breathing).

How to Approach the Question

• First, identify the key diagnosis and symptom in the question: Parkinson's disease and 'resting tremors'.
• Recall the pathophysiology of a resting tremor: it is present at rest and diminishes with voluntary action.
• Evaluate each option based on this principle. Ask yourself, 'Does this option involve a voluntary, purposeful action of the affected limb?'
• Option A (warm bath) and C (deep breathing) are general relaxation techniques, not specific voluntary actions of the hand.
• Option D (diazepam) is a pharmacological intervention and outside the scope of independent nursing advice.
• Option B (holding an object) is a direct, purposeful action involving the hand, which directly aligns with the method for suppressing a resting tremor. This makes it the most appropriate answer.

Concept Tested & Keywords

• Concept Tested: Non-pharmacological management of resting tremors in Parkinson's disease.
• Stem keywords: Parkinson's disease, resting tremors, frustrating, advice
• Lead-in keywords: What advice
• Clinical cues: The key clinical cue is 'resting tremors', which have a specific pathophysiology that informs the correct intervention.

Question ID

QFSyHV-sI2GTq3N-dEwP2b

Copy ID

Reference Book

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