4. Parkinson’s Types
• Primary or idiopathic – caused by a reduction in
dopamine producing cell
• Secondary – caused by head trauma, intracranial
infections, tumors & drug exposure
• Motor symptoms start insidiously
• Usually begin on one side of the body
• Eventually have postural & gait alterations
• Non-motor – depression, anxiety, apathy, chronic
fatigue
5. Drug Therapy
• Minimizing the symptoms
• Non-pharmacologic therapy – support
services, exercise, nutrition
• Pharmacology to relieve the symptoms &
restore dopaminergic activity
6. Nursing Process: Assessment
• Unified Parkinson’s Disease Rating Scale
• History
• Obtain data to classify Stages I-V
• Motor function
• Facial Appearance
• Nutrition
• Salivation
• Psychological
• Stress
• Safety & Self-care
• Family Resources
7. Unified Parkinson’s Disease Rating Scale
• UPDRS
• Baseline symptoms
• Monitor changes in symptoms
• Evaluates
• Mentation, behavior, mood
• ADL’s
• Motor examination
• Complication of therapy
• Modified Hoehn and Yahr staging
• Schwab and England ADL scale
8. UPDRS
• Stage I –one limbs, slight tremor or change in
speech, facial expression, posture change or
movement, mild disease
• Stage II –two limbs, early postural changes, social
withdrawal, depression
• Stage III –significant gait disturbances & moderate
generalized disability
• Stage IV –akinesia, rigidity & severe diability; still able
to walk or stand unassisted
• Stage V –unable to stand or walk, perform all
ADL’s, wheelchair-bound or bedridden unless aided
9. Motor function
• Tremors
• Dyskinesia
• Bradykinesia
• Rigidity
• Postural instability
10. Nursing Process: Diagnoses
• Risk for Constipation
• Deficient knowledge
• Risk for injury
• Ineffective Self-Health Management
• Bathing Self-Care Deficit
• Dressing Self-Care Deficit
• Feeding Self-Care Deficit
• Toileting Self-Care Deficit
• Imbalanced Nutrition: Less Than Body
Requirements
11. Nursing Process: Planning
• History-abilities, mental status schedule a
meeting to plan baseline before initiating
therapy
• Safety-obtain anti-slip pad, perform safety
check
• Care needs-other departments, periodic
evaluations, family, provide information &
resources
• Medication-vital signs routinely especially BP
12. Nursing Process: Implementation
• Monitor & record vitals signs – BP**
• Degree of therapeutic response & adverse effects
• Monitor bowel function & prevent constipation
• Support effort to remain mobile –removing clutter & throw
rugs, correct equipment & supportive devices
• Minimize deformities- erect posturing, joint mobility (ROM)
• Reinforce principles for gait training
• Nutritional needs
• Encourage self maintenance & social involvement
• Provide restful environment & reduce stressors
• Monitor mood and affect- depression1
• Ambulating safely
