PARKINSON’S DISEASE NURSING INTERVENTIONS

o A degenerative disease caused by the a. Assess neurological status

depletion of dopamine, resulting in a b. Assess ability to swallow and chew
dysfunction of the extrapyramidal system c. Provide calorie, protein, high fiber soft
diet with small, frequent feedings
CAUSES
d. Increase fluid intake to mL/day
a. Unknown e. Thickened Liquid diet
b. Viral Infection f. Aspiration precautions – position while
c. Encephalitis feeding
d. Carbon Monoxide Poisoning g. Instruct the client to wear low-heeled
e. Arteriosclerosis shoes

ASSESSMENT PHARMACOTHERAPY

a. INITIAL SIGN: ANTICHOLINERGICS

b. Bradykinesia, Akinesia
Reduce rigidity and some of the tremors
c. Shuffling, Festinating steps, stooped
position, and a. Artane (Trihexyphenidyl)
d. propulsive gait b. Cogentin (Benztropine)
e. Monotonous speech c. Akineton (Biperiden)
f. Handwriting that becomes d. Kemadrin (Procyclidine)
progressively smaller e. Parsidol (Ethopropazine)
g. Tremors increasing when fatigued f. Norflex (Orphenadrin)
and decreasing with
CONSIDERATIONS:
h. purposeful activity or sleep
f. Rigidity with jerky movements a. Contraindicated in clients with
g. Restlessness and pacing glaucoma
h. Blank facial expression; masklike b. Assess client with chronic obstructive
faces lung disease can develop thick mucus
i. Drooling secretions
j. Difficulty swallowing and speaking
k. Loss of coordination and balance SIDE/ADVERSE EFFECTS
l. Moist and oily skin a. Blurred vision
m. Emotional instability b. Dryness of the nose, mouth, throat, and
n. Fatigue respiratory secretions
c. Increased pulse rate, palpitations, and
dysrhythmias
d. Constipation
e. Urinary retention
f. Restlessness, confusion, depression,
and hallucinations
g. Photophobia

NURSING INTERVENTIONS
a. Monitor vital signs, Urinary output, and
bowel sounds
b. Instruct to avoid alcohol, cigarette,
caffeine and aspirin
c. Instruct the client to increase fluid
intake and increase intake and using ice
chips, hard candy or gum
(anticholinergics decrease salivation)
d. Instruct the client to increase fiber in
the diet
e. Instruct the client to use sunglasses
f. Instruct to void before taking
medications
g. Instruct the client to have routine eye
examinations to assess intraocular
pressure
h. Do not discontinue meds abruptly
DOPAMINERGICS
Improves muscle flexibility
a. Levodopa
 A precursor of dopamine can cross
the bloodbrain barrier
b. Carbidopa with Levodopa (sinemet)
 Reduces destruction of levodopa at
the periphery
INTERVENTIONS
a. Monitor the client’s vital signs and ECG
b. Check for weakness, dizziness or
syncope
c. Advise client to practice gradual change
of position
d. Inform the client that urine may
discolor and will darken (reddish
brown) with exposure to air.
Perspiration may also be discolored.
e. Advise client to avoid the following
drugs:
 Phenothiazines, Reserpine,
pyridoxine (Vit B6) –block the
effects of Levodopa
 Monoamine oxidase inhibitors
(MAOI) Marplan (Isocarboxacid)
a. Parnate (Tranylcypromine)
b. Nardil (Phenelzine)
c. MAOIS enhance
norepinephrine activity
d. MAOIS + Carbidopa-
Levodopa = Hypertensive
crisis
 Aldomet (methydopa) – this
potentiates effect of Carbidopa-
Levodopa
AVOID THE FOLLOWING FOODS WHEN ON
CARBIDOPALEVODOPA THERAPY:
a. Vitamin B6-rich foods: block effects of
Levodopa
- Tuna, pork, dried beans, salmon, beef liver
b. Tyramine-rich food: may cause
hypertensive crisis
- Cheese cream, yogurt, coffee, chocolate,
bananas, raisins, liver, pickled herring,
sausage soy sauce, yeast, beer red wine,
Italian green beans
SIDE EFFECTS OF LEVODOPA
a. Nausea and vomiting
b. Orthostatic Hypotension
c. Insomnia, Agitation
d. Mental Confusion
DOPAMINE AGONISTS
These medications act on the dopamine
receptors and produce improvement in
symptoms of Parkinsonism
a. Symmetrel (Amantadine HCl)
b. Parlodel (Bromocriptine Mesylate)
c. Requip (Ropinirole HCl)
NURSING INTERVENTION
a. Advise the client to report signs of skin
lesions, seizures or depression and
 lightheadedness when changing
positions
b. Avoid alcohol
c. Advise client not to abruptly stop the
drug without notifying the health care
provider.