Parkinson's Disease - Gradual Onset

Parkinson's Disease - Gradual onset Affects more men than women Cardinal Signs: must have 2 of the 4 signs Tremor Bradykinesia/akinesia rigidity postural instability Confirmed by Levadopa trial Associated with decrease in dopamine Clinical symptoms do not appear until 40% of pigmented neurons are lost and striatal dopamine level is decreased by 80% -Pt stands with head bent forward and walks with propulsive gait -Forward flexion of neck, hips, Krees, elbow's - Difficulty in pivoting, causes loss of balance Constipation causes Weakness of muscles used fordefication lack of exercise inade quate fluid intake decreased autonomic nervous system activity LAXATIVES should be Avoided En hancing Swallowing Sit up right Semisolid diet - thick liquids Late Stages of Parkinson's Disease At risk for psychiatric dis turbances such as hallucinations, psychosis, paranoid delusions AVOID dopamine depleting drugs Nursing interventions. Keep walking as long as possible Look foward horizon, not floor Walk to marching music Trapeze over bed Swallowing Sit upright, Chew one side then the other Other Symptoms excessive uncontrolled sweating drooling paroxysmal flushing orthostatic hypotension gastric and urinary retention Constipation Sexual dysfunction Dysphagia Benzotropine Counterad action of acetylocholine Contraindicated in patients with glaucoma Conscious effort must be made to swing arms, raise feet while walking and use beel to toe placement of feet with long strides