Parkinson's Disease Analysis

Parkinson’s disease (PD) is a neurodegenerative brain disease that results in a loss of dopamine producing brain cells responsible for coordinating movement. The exact cause of PD is not known but according to National Parkinson Foundation (NPF) (2015), “most experts agree that the condition is caused by a combination of genetic and environmental factors (chemicals, viruses, injuries)”, with some experts explaining it this way “genes load the gun and environment pulls the trigger” (Environmental Factors and Parkinson’s section, para. 1). The NPF argues that PD is not fatal but disease progresses to serious complications. Signs and symptoms of PD are tremor, rigidity, bradykinesia, or akinesia, and postural instability (Ignatavicius & Workman,

Medications, physical therapy, occupational therapy, speech and language therapy, and surgical procedures can all help alleviate symptoms that interfere with ADL’s. The main drugs of choice used to treat PD symptoms are levodopa and carbidopa (Lynn, 2012). Dopamine agonists, COMT inhibitors, and monoamine oxidase type-B inhibitors are also used in the treatment of PD. Lynn (2012) emphasizes the need to educate patients, including the family on the use of these drugs. Lynn goes on to discuss that nurses be aware of how these drugs work and their side effects when teaching patients. Lynn also highlights the need for nurses to stress the importance of taking these medications on a strict schedule as well as contraindications. L-dopa is best taken on an empty stomach but if patients take this drug with food a low protein meal is best because L-dopa competes with amino acids for absorption (Lynn, 2012). When educating the newly diagnosed patient ensure that they are aware of the disease progression and the possibility of needing to add or change medications in the future (Lynn, 2012). Ignatavicius and Workman (2013) discuss that additional medications may be needed for drooling, muscle spasms, and insomnia. Sublingual atropine sulfate is used for drooling, baclofen for muscle spasms, and zolpidem tartrate for

For patients with impaired physical mobility Gulanick and Myers (2014) suggest nurses assess the extent of tremors, the patient’s posture, ambulation, and bradykinesia. The nurse should encourage the following: daily ROM to all joints “to reduce muscle rigidity”, supervision/assistance with ambulation, and larger steps when walking because “a broad-based gait helps improve balance and reduces shuffling” (Gulanick & Myers, 2014, p.547). The family should allow the patient extra time when performing ADLs rather than doing it themselves. “The goal is to help the patient maintain functional independence as long as possible” (Gulanick & Myers, 2014, p.547). Nurses should refer patients to physical and occupational therapist about aids to facilitate ADLs and safe ambulation and to promote muscle strengthening. “Aids can increase mobility and allow the patient some control over the