Parkinson's Disease

Subject: Medical and Surgical Nursing I (Theory)

Overview

To put it simply, Parkinson's disease is a degenerative neurological ailment that causes a wide range of mobility issues over time. Oftentimes, it manifests first as a little shaking in one hand. You may walk with your arms at your sides or find that your arms don't swing as you move, both early symptoms of Parkinson's disease. Its symptoms include tremors, sluggish movement (bradykinesia), muscular rigidity, poor posture and balance, and so on. Idiopathic, genetic, toxic, etc. are all potential reasons. Brain scans using CT and MRI technologies often show no abnormalities in persons with PD. Although there is currently no treatment for Parkinson's disease, drugs can significantly reduce the severity of its symptoms. Later on, surgical intervention may be recommended. Patient weight is a significant indicator of health and should be monitored. Some persons with PD may gain weight due to decreased activity, but the vast majority actually lose weight. A regimen of physical treatment designed to preserve the health and performance of one's muscles.

To put it simply, Parkinson's disease is a degenerative neurological disorder that causes a wide range of mobility issues over time. Oftentimes, it appears first as a little shaking in one hand. Although tremor is the most noticeable symptom of Parkinson's disease, stiffness or slowness of movement are also common.

You may walk with your arms at your sides or find that your arms don't swing as you move, both early symptoms of Parkinson's disease. Your voice might weaken or become slurred. The symptoms of Parkinson's disease tend to worsen over time.

Symptoms

The manifestations of Parkinson's disease in any one individual are not fixed.

There are a variety of symptoms that might indicate Parkinson's disease.

  • Tremor.
  • Slowed movement (bradykinesia).
  • Hard, rigid muscles.
  • Impaired posture and balance.
  • The inability to do routine physical tasks without conscious effort.
  • Speech changes.
  • Changes in writing. Writing may look small and challenging.

Causes

  • Idiopathic
  • Genetic
  • Idiopathic
  • Head trauma
  • Cerebral anoxia and drug-induced.

Types of Parkinson's disease:

  1. Idiopathic Parkinson's disease, sometimes known simply as primary PD, is the most common form of the illness.
  2. Toxic exposure, especially to medications, brain injury, or another medical condition can all lead to a form of Parkinson's disease known as secondary Parkinson's disease.

Tests and diagnosis:

  • A reduction in dopamine activity in the basal ganglia, as shown on an 18F PET scan, is a pattern that can be used to diagnose PD.
  • Scans of the brain using CT or MRI are often normal in persons with PD.
  • There is currently no validated blood or laboratory test for diagnosing PD.
  • thus, neurological testing is the basis for the diagnosis.


medications and treatments

Although there is currently no treatment for Parkinson's disease, drugs can significantly reduce the severity of its symptoms. Later on, surgical intervention may be recommended.

Medications

  1. Medication that boosts dopamine levels in the brain can be useful for those with difficulties with walking, movement, and tremor. However, dopamine can't be administered directly since it isn't brain-accessible.
  2. This is a combination of carbidopa and levodopa. The brain absorbs levodopa, a natural molecule, and converts it to the neurotransmitter dopamine, making it the most effective treatment for Parkinson's disease.
  3. Dopamine agonists. Dopamine agonists aren't converted into dopamine like levodopa is. They act in the brain in a manner similar to that of dopamine.
  4. As in, anticholinergics. These drugs have been around for a while, and they assist with the tremor that comes with Parkinson's disease.
  5. Planned physical therapy; to maintain normal muscle tone and function.

Nursing care

  • Impact on cognition and social functioning Many persons with PD exhibit moderate cognitive changes, such as a reduced capacity to multitask or finish difficult tasks. Many people with PD find it helpful to plan ahead and divide up large, daunting tasks into smaller, more manageable chunks.
  • Up to 70% of people with PD are believed to experience despair, therefore gauging their emotional state is important. Depression screenings should be a routine element of any nursing care plan.

Communication, speech, and swallow:

  • Slurred speech and decreased loudness are common symptoms. Helpful techniques include the use of a pacing board and the encouragement of the patient to utilize loud speech or short sentences.

PD can also have an impact on the ability to swallow and produce saliva. The swallowing process may be more laborious for a person with PD, and the complexity of this action means that it will require focused attention.


Nutrition and elimination

  • Keeping an eye on a patient's weight is a crucial intervention. Some persons with PD may gain weight due to decreased activity, but the vast majority actually lose weight.
  • Dopamine replacement treatment efficacy may be influenced by dietary protein intake.


Blood pressure and postural hypotension 

  • Low blood pressure, often known as postural hypotension, is a common side effect of several medications. As a result of their condition, the patient may experience dizziness when they change their posture.
  • If the patient is on anti-hypertensive medication, monitoring this condition requires regular sitting and standing blood pressure assessments. Medication to maintain healthy blood pressure may be necessary for some patients. 


References

https://quizlet.com/71336239/brain-vocabulary-flash-cards/
https://oxfordrecoverycenter.com/parkinsons-disease/\swww.theneurologicalinstitute.com/index.php/parkinsons-disease/\swww.pdf.org/about pd
Course Hero: MA, MA, MA - Rasmussen College 278
G. Mandal (August 2013).
Adult Health Nursing: A Textbook (2nd ed.). Kathmandu, Nepal: Makalu Publishing House, Dilllibazar. Obtainable as of August 2013
https://prezi.com/19sdmbkrduu1/parkinsons-diease/

Things to remember
  • To put it simply, Parkinson's disease is a degenerative neurological ailment that causes a wide range of mobility issues over time.
  • Movement stiffness or slowness is a frequent symptom of Parkinson's disease.
  • The manifestations of Parkinson's disease in any one individual are not fixed.
  • There is currently no validated blood or laboratory test for diagnosing PD.
  • Although there is currently no treatment that will reverse the effects of Parkinson's disease, medicines can assist manage the symptoms.
  • Medication that boosts dopamine levels in the brain can be useful for those with difficulties with walking, movement, and tremor.
  • Helpful techniques include the use of a pacing board and the encouragement of the patient to utilize loud speech or short sentences.
Questions and Answers

Definition

Parkinson's disease is a degenerative nervous system condition that impairs mobility. It begins gradually, maybe with a tremor that is barely perceptible in one hand. Although a tremor may be the most well-known symptom of Parkinson's disease, stiffness or slowing of movement are other common symptoms of the condition.

Symptoms

Parkinson's disease symptoms and signs may vary from person to person. Parkinson's signs and symptoms may include:

  • Tremor.
  • Slowed movement (bradykinesia).
  • Rigid muscles.
  • Impaired posture and balance.
  • Loss of automatic movements.
  • Speech changes.
  • Writing changes: Writing may appear small and become difficult.

Causes

  • Idiopathic,
  • Genetic,
  • Toxins,
  • Head trauma,
  • Crebral anoxia and drug induced.

 

 

Nursing Care

  • Cognitive and Psycho Social Impact
    • Many people living with PD experience some mild cognitive changes such as a diminished ability to multitask or complete complex task. Planning ahead and breaking complex task into small manageable sections is a valuable strategy used by many people living with PD.
    • Mood should be assessed in PD, it is though up to 70% of patient are affected by depression. Screening for sadness is an essential and ongoing part of nursing care.
  • Communication, Speech and Swallow
    • Many people living with PD are affected by difficulties with communication. Speech may become slurred and often volume is affected. Using strategies such as pacing board and encouraging the patient to shout or use short sentence will help.
    • Swallow and saliva can also be affected by PD. The person living with PD may have slower swallow and as this a a complex movement, the person with PD will need concentration.
  • Nutrition and Elimination
    • Monitoring the weight of patient is an important intervention. Reduced movement may cause some patient to weight gain, however most people living with PD lose weight.
    • As the effect of dopamine replacement therapy can be impact upon by protein in the diet.
  • Blood Pressure and Postural Hypotension
    • A common symptom which is exacerbated bg medication is a loweriwof blood pressure over time. The patient may complaint of dizziness which changing position.
    • Regular sitting and standing blood pressure assessment to monitor for this is important especially if the patients is on anti hypertensive medication. Some patient may require medication to support blood pressure.

 

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