Clinical Manifestation
Parkinson’s Disease (PD) is a common neurodegenerative disorder that affects the motor skills of a person including their speech. There are only a few known causes of Parkinson’s disease which has led to PD being classified as idiopathic, which means “of unknown cause”. There are a number of key clinical manifestations of PD which include the following. There are increased tremors which worsen with stress, rigidity of muscles which makes it increasingly difficult to move, a stooped posture and a distinctive walking style characterized with short fast steps to keep the patient from falling, and slowness in executing voluntary movements by the patient.
Signs and Symptoms
Jankovic (2008) notes that there is no definitive test for the diagnosis of Parkinson’s Disease and as a result of this, diagnosis can only be done on the basis of clinical criteria. Parkinson’s Disease is primarily characterized by rhythmic tremor of the limbs and hence the first terming of the disease as the “shaking palsy”. Communication is also greatly impaired by the masklike facial expression that arises as a result of PD. The motor-related symptoms of PD have been discovered to be as a result of the degeneration of nerve cells in a part of the mid brain. Ronken and Scharrenburg (2002) illustrate that apart from this key motor-related symptoms, the disease also has depression as a major secondary symptom. A study by the author indicates that 50% of the population that suffers from PD is also exposed to depression therefore leading to an even more reduction in the quality of life that they experience.
Diagnosis
PD shows prevalence for the 50 to 60 age group; a patient’s age and clinical history is therefore used in the diagnosis process. Diagnosis of PD is based on the presence of its core symptoms of motor skills inhabitation. Even so, the presence of these symptoms is not always an indication of PD. Neuroimaging is also used to look for markers of disease progression in PD.
Nursing Management of Parkinson’s disease
A major goal of nursing care is to control the tremors and rigidity that characterize PD. As of today, there is no known cure for PD and all the current therapy aims to reduce the symptoms of the disease therefore improving the quality of life for the patient. One of the most widely used treatments is dopa treatment which aims at activating dopamine in the brain of the patient. A common side effect of PD treatment is Dyskinesias which is the medical term for “excessive movements” (Ronken & Scharrenburg, 2002). This makes it necessary for a patient to be under the close supervision of medical care personnel while they are on medication.
Promoting the independence of the patient is also part of the nursing care plan. A patient should be encouraged to participate optimally in self-care activities at all times. Adaptive devices can be used if the patient is unable to support himself/herself. Physical and occupational therapy are crucial in the program since they help to reduce flexion contractures and assist the patient to carry out everyday activities. These therapies assist in the exercising of muscles that would become passive without activity.
A study by Roken and Scharrenburg (2002) indicates that 50% of the population that suffers from PD is also exposed to depression. Depressed people often have a low self image and are emotional frail. The nursing plan should therefore help reinforce a positive self-image in the patient. This can be done by emphasizing on the patient’s abilities and commending success. The caregiver should also provide a lot of emotional support to the patient.
References
Jankovic, J. (2008). “Parkinson’s Disease: Clinical Features and Diagnosis”. J Neural Neurosurg Psychiatry, 79:368-376.
Ronken, E., & Scharrenburg, J. (2002). Parkinson’s disease. IOS Press.