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Parkinson’s Disease Interventions (Picmonic)
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Hey guys, in this care plan, we will explore Parkinson's disease. In this Parkinson's disease care plan, we will cover the desired outcome, the subjective and objective data along with the nursing interventions and rationales.
Parkinson's disease is a degenerative neurological disorder that's characterized by the loss of controlled movement. This is caused by the depletion of circulating dopamine levels in the brain. Dopamine is a neurotransmitter that's responsible for controlled muscle movements. A genetic component is suspected, but the true cause is unknown. Depletion of the dopamine happens because of the atrophy of a substantia nigra, which is the structure in the midbrain that's responsible for the situation of dopamine. The desired outcome is to optimize independence in the ability for the patient to care for themselves for as long as possible. We want to improve the dopamine levels in the brain to minimize symptoms. Unfortunately, there is no cure for this disease.
Let's take a look at the care plan for Parkinson's disease. Let's start with the subjective data. So, the patient is going to be experiencing some weakness, fatigue, difficulty swallowing, they might feel heavy or really stiff and this is all due to the lack of controlled movement because of the lack of dopamine in the brain.
Now, let's discuss the objective data. You might notice a pill rolling motion. It's called a pill rolling tremor in the hands that looks like they're really rolling pills between their thumb and their fingers. The patient with Parkinson's, they look pretty stiff okay? They're really stiff and when you get them up to walk, they kind of just shuffle. They don't move their feet very much, so it's really difficult for them, and it takes a long time to get them from point A to point B. They have really slowed movements or Brady Kenesha. They might have some lip-smacking, some drooling, a blank face, like a flat affect almost. These symptoms are all due to the loss of muscle control and they worsen as the disease progresses.
You will assess the patient's ability to swallow before you give them anything by mouth to avoid aspiration, because remember, their muscles are weak and it causes a difficult time swallowing. Involve speech therapy as appropriate for interventions and assessments pertaining to the patient's abilities or inabilities regarding swallowing different foods and drinks. Encourage your patient to work with the PTO team and use assistive devices for ambulation multiple times a day. You want to keep them moving. You want to help them improve their range of motion by working with them. You want to encourage them to maintain independence for as long as possible. If they don't participate in these activities, muscle atrophy is going to occur, and this is not fun. I mean, then they can't really do as much in the end, so you want to guide these patients to do as much as they can and you want to encourage independence. Educate your patient on activity and energy conservation options because these patients are going to fatigue easily. Teach them how to cluster care and allow for periods of rest. It's super helpful to teach your patients to try to use that rocking motion. If they're sitting in a chair and you want to get them up, just have them rock back and forth a few times. Getting that momentum is going to help assist with getting up when weakness is present.
You want to encourage small, frequent, nutrient dense meals. This is because you want to make sure they get the proper caloric intake. It's harder for them to eat. They have weak muscles. It's hard to chew and hard to swallow, so try to encourage high fluid intake. Encourage protein-rich foods and high fiber. They should avoid foods that are high in B6 because these can interfere with anti-Parkinsonian drugs. Administer medications as ordered by the doctor to help increase the levels of dopamine in the brain. Carbidopa levodopa is a super commonly used drug. Anticholinergics can also be used to decrease drooling and secretions.
You want to provide resources for the patient and family for community support. This is a tough time that they're going to be going through right? Progressive degenerative diseases can really take a toll on the patients and their family. Having community support is very helpful for them.
We love you guys. Now, go out and be your best self today and as always, happy nursing!
Parkinson's disease is a degenerative neurological disorder that's characterized by the loss of controlled movement. This is caused by the depletion of circulating dopamine levels in the brain. Dopamine is a neurotransmitter that's responsible for controlled muscle movements. A genetic component is suspected, but the true cause is unknown. Depletion of the dopamine happens because of the atrophy of a substantia nigra, which is the structure in the midbrain that's responsible for the situation of dopamine. The desired outcome is to optimize independence in the ability for the patient to care for themselves for as long as possible. We want to improve the dopamine levels in the brain to minimize symptoms. Unfortunately, there is no cure for this disease.
Let's take a look at the care plan for Parkinson's disease. Let's start with the subjective data. So, the patient is going to be experiencing some weakness, fatigue, difficulty swallowing, they might feel heavy or really stiff and this is all due to the lack of controlled movement because of the lack of dopamine in the brain.
Now, let's discuss the objective data. You might notice a pill rolling motion. It's called a pill rolling tremor in the hands that looks like they're really rolling pills between their thumb and their fingers. The patient with Parkinson's, they look pretty stiff okay? They're really stiff and when you get them up to walk, they kind of just shuffle. They don't move their feet very much, so it's really difficult for them, and it takes a long time to get them from point A to point B. They have really slowed movements or Brady Kenesha. They might have some lip-smacking, some drooling, a blank face, like a flat affect almost. These symptoms are all due to the loss of muscle control and they worsen as the disease progresses.
You will assess the patient's ability to swallow before you give them anything by mouth to avoid aspiration, because remember, their muscles are weak and it causes a difficult time swallowing. Involve speech therapy as appropriate for interventions and assessments pertaining to the patient's abilities or inabilities regarding swallowing different foods and drinks. Encourage your patient to work with the PTO team and use assistive devices for ambulation multiple times a day. You want to keep them moving. You want to help them improve their range of motion by working with them. You want to encourage them to maintain independence for as long as possible. If they don't participate in these activities, muscle atrophy is going to occur, and this is not fun. I mean, then they can't really do as much in the end, so you want to guide these patients to do as much as they can and you want to encourage independence. Educate your patient on activity and energy conservation options because these patients are going to fatigue easily. Teach them how to cluster care and allow for periods of rest. It's super helpful to teach your patients to try to use that rocking motion. If they're sitting in a chair and you want to get them up, just have them rock back and forth a few times. Getting that momentum is going to help assist with getting up when weakness is present.
You want to encourage small, frequent, nutrient dense meals. This is because you want to make sure they get the proper caloric intake. It's harder for them to eat. They have weak muscles. It's hard to chew and hard to swallow, so try to encourage high fluid intake. Encourage protein-rich foods and high fiber. They should avoid foods that are high in B6 because these can interfere with anti-Parkinsonian drugs. Administer medications as ordered by the doctor to help increase the levels of dopamine in the brain. Carbidopa levodopa is a super commonly used drug. Anticholinergics can also be used to decrease drooling and secretions.
You want to provide resources for the patient and family for community support. This is a tough time that they're going to be going through right? Progressive degenerative diseases can really take a toll on the patients and their family. Having community support is very helpful for them.
We love you guys. Now, go out and be your best self today and as always, happy nursing!
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