Lesson 35. Parkinson's Disease
2-35. PARKINSON'S DISEASE a. Definition. Parkinson's disease is a progressive neurological disorder affecting the brain centers that are responsible for control of movement.
- (1) Primary degenerative changes of the basal ganglia and their connections prevent motor transmission of automatic movements (blinking, facial expressions, muscle tone).
- (2) The exact cause of Parkinson's is unknown. Suspected causes include genetic factors, viruses, chemical toxicity, encephalitis, and cerebrovascular disease.
b. Signs and Symptoms.
- (1) Bradykinesia, which usually becomes the most disabling symptom.
- (2) Tremor which tends to decrease or disappear on purposeful movements.
- (3) Rigidity, particularly of large joints.
- (4) Classic shuffling gait.
- (5) Muscle weakness which affects eating, chewing, swallowing, speaking, writing.
- (6) Mask-like facial expression with unblinking eyes.
- (7) Depression.
- (8) Dementia.
c. Medical and Nursing Management.
(1) Treatment is based on a combination of the following:
- (a) Drug therapy.
- (b) Physical therapy.
- (c) Rehabilitation techniques.
- (d) Patient and family education.
(2) Encourage patient to participate in physical therapy and an exercise program to improve coordination and dexterity.
- (a) Emphasize importance of a daily exercise program.
- (b) Instruct patient in postural exercises and walking techniques to offset shuffling gait and tendency to lean forward.
- (c) Encourage warm baths and showers to help relax muscles and relieve spasms.
- (3) Instruct patient to establish a regular bowel routine with a high fiber diet and plenty of fluids. Constipation is a problem due to muscle weakness, lack of exercise, and drug effects.
- (4) Eat a well-balanced diet. Nutritional problems develop from difficulty chewing and swallowing and dry mouth from medications.
- (5) Encourage patient to be an active participant in his/her therapy and in social and recreational events, as Parkinsonism tends to lead to withdrawal and depression.
- (6) Inform patient about American Parkinson's Disease Foundation for patient education and group support.