Parkinsons disease

DEFINITION:

1. Is a progressive disease of the nervous system marked by tremor, muscular

rigidity, and slow, imprecise movement, chiefly affecting middle-aged and elderly
people. It is associated with degeneration of the basal ganglia of the brain and a
deficiency of the neurotransmitter dopamine.

Risk factors:

Age. Young adults rarely experience Parkinson's disease. It ordinarily begins in middle or late life,
and the risk increases with age. People usually develop the disease around age 60 or older.

Heredity.

Sex. Men are more likely to develop Parkinson's disease than are women.

Signs and symptoms: Labs and dx:

Tremors (Pill-rolling) Positive emission tomography

Rigidity (cogwheeling) (evaluating levodopa uptake and
Bradykinesia conversion to dopamine in the corpus
Hypokinesia striatum.
Microphagia Patients history
Dysphonia Physical assessment (stiff arm, slight
Dysphagia limp, tremor, stooped posture)
Depression Neurological examination
Dementia
Nursing intervention:

Improve mobility (progressive program of

Nursing diagnosis: daily exercise)
Enhance self care activities (Environmental
Impaired physical mobility
modifications and client education and
related to muscle rigidity and
support.)
motor weakness Improve bowel elimination (increase fluid
Self-care deficits
intake and high fiber diet. Regular bowel
Constipation related to
routine.)
medication and reduced Improve communication (Speech therapist)
activity Support coping abilities (physiotherapy,
Impaired verbal
psychotherapy and medication therapy and
communication
support group participation)
Ineffective coping related to
depression and dysfunction
Drugs: Pathophysiology

Antiparkinsonian meds
(Levodopa)
Anticholinergic therapy
Destruction of dopaminergic
for tremors and rigidity.
neuronal cells in the substantia
Antiviral (Reduces the
nigra in the basal ganglia
three cardinal signs)
Dopamine antagonist
Monoamine Oxidase
Depletion of dopamine
Inhibitors (inhibits
dopamine breakdown
and slows progression
of disease) Degeneration of the
Antidepressants dopaminergic nigrostriatal
Antihistamines (reduces pathway
tremors)
Imbalance of excitatory (Ach) and
Medical management: inhibiting (dopamine) neurotransmitters
in the corpus striatum.
Surgical:

Stereotactic
Impairment of extrapyramidal tracts
procedures:
controlling complex body
Thalamotomy and
movements
pallidotomy to interrupt
nerve pathways and
alleviate tremor and
rigidity. Tremors
Neural Transplantation- Rigidit Bradykinesi
adrenal medullary
tissue into the corpus
striatum is performed in
an effort to reestablish
normal dopamine
release.
Deep brain stimulation-
pacemaker-like brain