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What you Know about Parkinson`S Disease? (Nclex Review)
Description
- Parkinson’s disease is a degenerative disease caused by the depletion of dopamine, which interferes with the inhibition of excitatory impulses, resulting in a dysfunction of the extrapyramidal system.
- It is a slow, progressive disease that results in a crippling disability.
- The debilitation can result in falls, self-care deficits, failure of body systems, and depression.
- Mental deterioration occurs late in the disease.
Assessment
- Bradykinesia, abnormal slowness of movement, and sluggishness of physical and mental responses
- Akinesia
- Monotonous speech
- Handwriting that becomes progressively smaller
- Tremors in hands and fingers at rest (pill rolling)
- Tremors increasing when fatigued and decreasing with purposeful activity or sleep
- Rigidity with jerky movements
- Restlessness and pacing
- Blank facial expression; mask-like facies
- Drooling
- Difficulty swallowing and speaking
- Loss of coordination and balance
- Shuffling steps, stooped position, and propulsive gait
Interventions
- Assess neurological status.
- Assess ability to swallow and chew.
- Provide high-calorie, high-protein, high-fiber soft diet with small, frequent feedings.
- Increase fluid intake to 2000 mL/day.
- Monitor for constipation.
- Promote independence along with safety measures.
- Avoid rushing the client with activities.
- Assist with ambulation and provide assistive devices.
- Instruct the client to rock back and forth to initiate movement.
- Instruct the client to wear low-heeled shoes.
- Encourage the client to lift feet when walking and to avoid prolonged sitting.
- Provide a firm mattress and position the client prone, without a pillow, to facilitate proper posture.
- Instruct in proper posture by teaching the client to hold the hands behind the back to keep the spine and neck erect.
- Promote physical therapy and rehabilitation.
- Administer antiparkinsonian medications to increase the level of dopamine in the CNS.
- Instruct the client to avoid foods high in vitamin B6 because they block the effects of antiparkinsonian medications.
- Instruct the client to avoid monoamine oxidase inhibitors because they will precipitate hypertensive crisis.
