PARKINSON’S PARKINSON’S DISEASEDISEASE

•Parkinson’s disease or paralysis agitants, is a neurologic disorder that normally occurs after the age of 50, and increases in incidence with age,

Most occurences of the disease are primary parkinsonism in which the basal ganglia of the extrapyramidal system modify the system that controls voluntary motor function.

•Cell loss occurs in the substantial Nigra which in turn decreases the level of striatal dopamine, and this results in illness.

The disease is progressive and characterized by slowing and weakening of movements, tremors, rigidity and continues to a state of the patient’s complete dependence on others for care.

Neuromuscular and motor function changes eventually result in respiratory mobility, elimination and nutritional impairments.

•A second form of parkinson’s disease is a secondary parkinsonism which occurs as a result of other causes.

Causes of secondary parkinsonism include viral encephalities, atherosclerosis, methydopa,meperidine analog, carbon monoxide, manganese, hypothyroidism, basal ganglia brain tumors, head trauma and dementia-type illnesses. Striatal dopamine defienciency.

•Death usually occurs from 7-10 years after the beginning of neurologic symptoms and is a result of dysrhythmia, sleep apnea or pulmonary emboli.

MEDICAL CARE:LaboratoryCT ScanMRIPositron emission tomography ScanSurgeryMedicines

NURSING DIAGNOSES• Ineffective airway clearance related to:• Parkinsonian changes in Musculature,

Tracheobronchial Obstruction, Aspiration, Infection, Truncal Rigidity, Bronchospasms ,Fatigue, Increase Work Breathing

Defining Characteristics:

• Dyspnea , Tachypnea, Bradypnea, Bronchospasms, Increase work of breathing, Use of accessory muscles, Increased Mucos Production.

DISTURBED THOUGHT PROCESSES

• Related to: use of parkinsonian medications, psychological causes depression .incorrect belief system, chronic illness , misperceptions.

• Defining Characteristics:• Inaccurate interpretation of

environment, changes in lifestyle, loss of significant other, egocentricity, distractibility, inappropriate thinking.

DEFICIENT KNOWLEDGE

• Related to: Lack of knowledge about Parkinson’s disease, stigma of disease, difficulty understanding about disease process, lack of coping skills, cognitive impairment.

DEFINING CHARACTERISTICS:

• Verbalization of questions, verbalization of incorrect information, Noncompliant behaviour, Presence of Preventable Complications, Inability to follow instructions.

OUTCOME CRITERIA• Patient/Family will be able to

exhibit understanding of disease process, medication regimen , and treatment plan of care.

INTERVENTIONS• Assess patient’s understanding of

disease process. Consider the older patient’s life experiences.

• Instruct Patient/Family regarding medications and need for compliance with dosages, scheduling and physician

• Provide time for questions and concerns to be voiced and answer questions honestly. if possible, give patient/family written materials to refer later.

• Instruct patient /family regarding need for long-term planning and potential for end of life care decisions.