Description of the Diseases

- a brain disorder that causes unintended or uncontrollable movements, such as shaking,

stiffness, and difficulty with balance and coordination

Signs and Symptoms

Blinking less often than usual

Cramped or small handwriting

Drooling

Mass-like facial expression

Difficulty swallowing (dysphagia), chewing, and speaking

Unusually soft speaking voice (hypophonia)

Urinary problems or constipation

Skin problem

Diagnosis

- Blood tests
- CT scan
- Genetic testing
- MRI
- PET scan

Pharmacological Treament

6 main types of medication available to treat symptoms of Parkinson’s disease

- Levodopa
- Dopamine agonists
- Inhibitors of enzymes that inactive dopamine
- Anticholinergic drugs
- Amantadine

Medical Management

- Most people with Parkinson's disease eventually need a medication called Levodopa. Levodopa
is absorbed by the nerve cells in your brain and turned into the chemical dopamine, which is
used to transmit messages between the parts of the brain and nerves that control movement.

Surgical Management

- Deep brain stimulation (DBS) is the most common surgical treatment for Parkinson's disease and
aims to help treat movement disorders. The procedure involves using implanted electrodes to
interrupt disorganized electrical signals in the brain that cause movement symptoms such as
tremors.
Nursing Responsibilities

a. Pharmacological –
Levodopa
• Advise the client that levodopa tablet should be dissolved entirely on the tongue before
swallowing.
• Advise the client that levodopa can swallowed with or without food.
• If the client have trouble in swallowing, the capsule can be open up and sprinkle the
contents over the food and remind the patient to consume it immediately.

Dopamine antagonist

• Assess patient BP, heart rate, ecg, heart sounds, and report if therapy is successful
• Monitor fluid intake and output and urine appearance
• Check for signs of peripheral vasoconstriction like cyanosis and muscle cramping
• Monitor injection site for any irritation
• Instruct patient to report any adverse effects of the drug like severe headache, dilated
pupils, nausea, and vomiting

Anticholinergic drugs

• Instruct patient to report any adverse effects of the drug like severe headache, dilated
pupils, nausea, and vomiting
• Do not give to pregnant clients as it can cross the placenta and cause adverse effects to
the fetus
• Adjust dosage for geriatric clients as they are more prone to adverse drug toxicity and
experience renal or hepatic impairments
• Assess for allergic reactions to any component of the drug
• Monitor lab results
Amantadine
• Advice the patient to take the capsule once a day at bedtime and same time every day
• Amantadine should be taken with or without food at bedtime.
• Advise the client not to crush or chew or cut the cupsules.
• If the client have trouble swallowing, the capsule can be open and sprinkle the
medication onto 1 tablespoonful of soft food, like applesauce.

b. Medical
• Control patient tremor and rigidity by administration of prescribed medications
• Assess drug tolerance with long term use of some medicines like levodopa; symptoms
include hallucinations, confusion, and lowered drug effectiveness.
• Treat drug tolerance by changing the dosage of medications
• Plan a physical and occupational therapy consultation to reduce flexion contractures and
advertise an active lifestyle
 • Perform passive and active ROM and muscle exercises to promote activation of the
Musculo-skeletal system; practice speech therapy to aid with talking and swallowing
• Promote ambulation with the help of ambulatory equipment such as canes and walkers

c. Surgical

- Pre operative

• Assess patient’s neurological status and maintain patient’s baseline hemodynamic status
• Give emotional support to client and family members to ease anxiety
• Assess patient’s ability to swallow and chew food
• Organize an appropriate diet plan for patient composed of soft foods that are high in
calorie, fiber, and protein in small and frequent feedings

- Post operative

• Monitor patient’s health status post-operation

• Watch out for signs of side effects of drugs that were given and give pain or anti-nausea
medication
• Instruct the client to wear shoes with no heels
• Encourage the patient to avoid prolonged sitting
• Have the client sleep on a firm mattress in a prone position with no pillow
• Suggest physical therapy and rehabilitation as well as teach proper massage and
relaxation techniques