Professional Documents
Culture Documents
Parkinsondiseases 200825061040
Parkinsondiseases 200825061040
Parkinsondiseases 200825061040
DISEASES
Entacapone Block COMT and slow the breakdown of levodopa, thus prolonging the
Tolcapone action of levodopa
Surgery
Surgery is optional only when medicine doesn't
make the symptoms better.
• Thalatomy - is a surgical procedure in which an
opening is made into the thalamus to improve the
overall brain function.
• Deep brain stimulation – pulse generator, high
frequency electrical impulses to the thalamus and
block the nerve pathway to control tremors
Deep Brain Stimulation
• Deep brain stimulation
(DBS) can be used to
treat tremors and
uncontrolled
movements of
Parkinson’s disease.
Electrodes are surgically
placed in the brain and
connected to a
neurostimulator
(pacemaker device) in
the chest.
Physiotherapy
• A combined approach of physical therapy and
pharmacological intervention plays a key role in
management of the patient.
• Physical therapist should be fully aware of the medications
the patient is taking and its potential adverse effects.
• Optimal performance can be expected at peak dosage (on-
state) whereas worsening performance is associated with
end of dose cycle.
– Exercise training
– Strength training
– Balance training
– Correcting eating impairments.
– Verbal skills practiced with breath control.
NURSING MANAGEMENT
• Nursing Assessment:
• Obtain a history of symptoms and their effect on
functioning, mobility, feeding, communication, and
self-care difficulties.
• Assess cranial nerves, cerebellar function (co-
ordination) and motor function.
• Observe gait and performance of activities.
• Assess speech for clarity and space.
• Assess for sign of depression .
• Assess family supports and access to social service.
NURSING ASSESSMENT
General
• Blank (masked) facial expression, slow and monotonous speech, infrequent
blinking
Integumentary
• Seborrhea, dandruff; ankle Oedema
Cardiovascular
• Postural hypotension
Gastrointestinal
• Drooling
Neurologic
• Tremor at rest, first in hands (pill rolling), later in legs, arms, face, and tongue.
Aggravation of tremor with anxiety, absence in sleep. Poor coordination,
cognitive impairment and dementia, impaired postural reflexes
Musculoskeletal
• Cogwheel rigidity, dysarthria, bradykinesia, contractures, stooped posture,
shuffling gait
Possible Diagnostic Findings
• No specific tests. Diagnosis based on history and physical findings and ruling
out of other diseases
NURSING DIAGNOSIS