PARKINSON DISEASE
A client has just been diagnosed with Parkinson's disease. The nurse is teaching the client and family about dietary issues related to this diagnosis. Which of the following are risks for this client? Select all that apply.
Choking, dysphagia, constipation
What is PD
Debilitating disease characterized by TRAP
What is Parkinson's
Debilitating disease that affects motor movement and TRAP
NURSING MGMT
Dx based on 4 cardinal signs, risk for falls, orthostatic hypotension, risked for constipation, elevate HOB
A client is admitted to the hospital with pneumonia. He has a history of Parkinson disease, which his family says is worsening. Which assessment should the nurse expect?
Impaired speech
Patho behind PD
Loss of dopamine producing brain cells resulting in a lack of dopamine
Patient education
Med compliance, safety precautions, psychosocial support
Nursing dx; constipation
Risk for constipation due to decreased mobility and side effects from medications
Nursing dx; falls
Risk for falls related to ataxia, muscle rigidity, and orthostatic hypotension
Nursing dx; powerlessness
Risk for powerlessness due to chronic and debilitating disease
Goals of treatment
Slow the disease process, improve quality of life, maximize independence and minimize clinical manifestations
Surgical Intervention
Stereotactic pallidotomy, Thalamotomy, Deep brain stimulation, Fetal tissue transplant
A patient with Parkinson's disease is experiencing an on-off syndrome. What does the nurse recognize that the patient's clinical symptoms will be?
The patient will have periods of near immobility, followed by a sudden return of effectiveness of the medication.
MEDICAL MGMT
Dopamine agonists *Sinemet- COMBO OF LEVODOPA/CARDIOPA) major side effect is dyskinesia, COMT inhibitors block the dopamine blockers, anticholinergics and muscle relaxants, PT/OT yoga, Soft foods and thickened liquid, psychosocial support
Nursing actions 2 (FEC)
Facilitation collaboration within team Encourage self care activities Communication strategies
Risk for
Falls and injury
Patient education; nutrition
Frequent/small meals High protein/calorie Soft food Thicken it Weekly weights
Lab work for PD
Lab work is ordered to rule out other diseases
A client with Parkinson disease is undergoing a swallowing assessment because she has recently developed adventitious lung sounds. The client's nutritional needs should be met by what method?
Semisolid and thickened liquids
A nurse is assessing a client with Parkinson's disease. Which of the following would the nurse expect to find?
Slowing of activity
Assessment
TAP, Swallow and gag, mask like face, mobility, balance, skin
A client with suspected Parkinson disease is initially being assessed by the nurse. When is the best time to assess for the presence of a tremor?
When the patient is resting
An older adult man has been diagnosed with Parkinson's disease and has begun treatment with levodopa and carbidopa. When providing health education about his new medication regimen, what should the nurse teach the man?
"This medication helps significantly but the benefits tend to decrease over time."
Nursing dx; imbalanced nutrition
Risk for imbalanced nutrition due to decreased intake from difficulty chewing and swallowing
How is PD dx?
Physical assessment, there is no diagnostic test
Patho of PD
Loss of dopamine producing cells Depletion of dop pathway
A new ancillary staff member is assisting the nurse with a client diagnosed with Parkinson's disease. The client needs assistance with eating but doesn't require thickened liquids to aid swallowing. Which instruction should the nurse give the ancillary staff member about eating assistance?
Make sure HOB is elevated to 90 degrees
Manifestations of PD (MUD PW)
Mask like face, uncontrolled drooling, Difficulty chewing and swallowing, Problems with manual dexterity, Wide open fixed staring eyes
Nursing actions 1 (FASE)
Facilitate nutritional intake Administer meds as Rx Suction Elevate HOB
What will the nurse look for in the assessment?
TRAP, gag and swallow, mask like face, mobility, bowel and bladder function, skin, balance.
TRAP major manifestations of PD
Tremor, rigidity, akinesia, postural instability