University:
College
Course:
College Nursing
Academic year:

2023
Views:

187

Pages:

1
Author:

mongolya

#progressive loss of dopaminergic neurons in the substantia nigra Risk Factors ↑ with age (over 50) men 4 risk living in rural area certain occupations exposure to environmental factors likely combo of some cases seem to be hereditary Pathology & Etiology A chronic, progressive, degenerative neurological disorder that primarily affects movement #most common form of parkinsonism Characterized by: Tremors (starts w/ unilateral hand tremor, progresses to bilateral tremor) Muscle Rigidity Bradykinesia (slow movement) Postural instability Onset usually gradual Signs & Symptoms Tremor (trembling of one hand early sign) Rigidity (stiff, jerky movements) Bradykinesia (arrests voluntary & automatic) Postural instability (dropped) Face - mask-like, drooped Speech - soft, low-pitched Postural hypotension Excess perspiration Oily skin, hair, burning Constipation Sexual disturbances Depression, paranoia, mood swings Cognitive impairment (late inds) Seborrhea (skin oily, greasy, itching) Blepharospasm (involuntary contraction of orbicularis oculi muscle) Disease Parkinsons Diagnostics/Labs MRI, CT (will have normal results) DATSCAN allows visualization of neurons using SPECT Blood test to rule out other causes of s/s Medical Management Levodopa & Carbidopa (Sinemet) long-term use leads to dyskinesia Bromocriptine (Parlodel) Ropinirole (Requip) if bad effects to Sinemet Correct imbalance of dopamine must be given ON TIME Nursing Management Monitor pt for changes in symptoms, meds effectiveness Assess for degree of tremor, reliance on caregivers or ability to perform ADLs, ambulate independently Do full neuro exam Assess changes in function Provide encouragement & emotional support Refer pt to speech pathologist to learn swallowing techniques Assess need for physical therapy Patient Education Teach pt to maintain daily & participate in exercise program Encourage pt to take meds as prescribed Teach techniques to reduce tremor while eating Encourage pt to walk daily & participate in exercise program Encourage use of assistive devices Provide information about vocal training, good sleep habits Develop methods of communication Teach energy conservation techniques Develop maintenance of prevent contractures & falls #NO Vitamin B6 It inhibits Levodopa