NURSING

PROCESS
THE PATIENT WITH PARKINSON’S
DISEASE

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BY: KRIS NIELSEN P. AMANTILLO

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ASSESSMENT

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Assessment focuses on how the disease has affected the patient’s ADLs and functional abilities. The
patient is observed for degree of disability and functional changes that occur throughout the day,
such as responses to medication. Almost every patient with a movement disorder has some
functional alteration and may have some type of behavioral dysfunction. The following questions
may be useful to assess alterations:

o Do you have leg or arm stiffness?
o Have you experienced any irregular
jerking of your arms or legs?
o Have you ever been “frozen” or rooted
to the spot and unable to move?
o Does your mouth water excessively?
Have you noticed yourself grimacing
or making faces or chewing
movements?
o What specific activities do you have
difficulty doing?
o Have you had any recent falls?
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DIAGNOSIS

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MAJOR NURSING DIAGNOSES MAY INCLUDE THE FOLLOWING:
 Impaired Physical Mobility Related To Muscle Rigidity And Postural Impairment
 Self-care Deficits (Feeding, Dressing, Bathing, And Toileting) Related To Tremor And Muscle Rigidity
 Constipation Related To Medication And Reduced Activity
 Imbalanced Nutrition: Less Than Body Requirements Related To Tremor, Slowness In Eating, Difficulty In
Chewing And Swallowing
 Impaired Verbal Communication Related To Decreased Speech Volume, Slowness Of Speech, Inability To
Move Facial Muscles
 Ineffective Coping Related To Depression And Dysfunction Due To Disease Progression

Other nursing diagnosis may include sleep pattern disturbances, deficient

knowledge, risk for injury, risk for activity intolerance, disturbed thought
processes, and compromised family coping 002
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PLANNING AND GOALS

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 The goals for the patient may include improving functional
mobility, maintaining independence in ADLs, achieving adequate
bowel elimination, attaining and maintaining acceptable
nutritional status, achieving effective communication, and
developing positive coping mechanism.

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NURSING
INTERVENTIONS
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 Improving mobility
 Enhancing
 Improving bowel elimination
 Improving nutrition
 Enhancing swallowing
 Encouraging the use of assistive devices
 Improving communication
 Supporting coping abilities
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EVALUATIONS

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Expected patient outcomes may include
1. Strives toward improved mobility
 Participates in exercise program daily
 Walks with wide base of support: exaggerated arm swinging when walking
 Takes medication as prescribed

2. Progresses toward self-care

 Allows time for self-care activities
 Uses self-help devices
 3. Maintains bowel function
 Consumes adequate fluid
 Increases dietary intake of fiber
 Reports regular pattern of bowel function

4. Attains improved nutritional status

 Swallows without aspiration
 Takes time while eating
 5. Achieves a method of communication
 Communicates needs
 Practices speech exercises

6. Copes with effects of PD

 Sets realistic goals
 Demonstrates persistence is meaningful activities
 Verbalizes feelings to appropriate person
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THANK
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