Impaired speech-rationale: in parkinsons disease, dysarthria, or impaired speech, results from a disturbance in muscle control. muscle rigidity, not flaccidity, causes resistance to passive muscle stretching. the client may exhibit a masklike appearance rather than a pleasant and smiling demeanor. tremors should decrease, not increase, with purposeful movement and sleep.client needs category: physiological integrityclient needs subcategory: physiological adaptationcognitive level: applicationreference: smeltzer, s.c., et al. brunner & suddarths textbook of medical surgical-nursing, 11th ed. philadelphia: lippincott williams & wilkins, 2008, p. 2313.
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