Parkinson's Disease Nursing Interventions

Jul 15, 2024

Parkinson's Disease Nursing Interventions

General Information

  • Parkinson's Disease (PD) is a progressive neurological disorder affecting movement.
  • Major symptoms include bradykinesia (slowed movement), tremors, dysphasia (difficulty in swallowing), and cognitive changes.
  • Nursing care focuses on managing symptoms, ensuring patient safety, and improving quality of life.

Key Nursing Interventions

Nutrition and Swallowing

  • Offer High Calorie Soft-Textured Foods
    • Goal: Ensure adequate nutrition and reduce the risk of aspiration.
    • Rationale: Dysphasia can lead to malnutrition and aspiration pneumonia.
  • Maintain Upright Position During Meals
    • Goal: Prevent aspiration.
    • Rationale: Helps food travel down the esophagus properly.
  • Recommend Chewing Sugar-Free Gum or Sucking on Ice Chips
    • Goal: Manage dry mouth, a common side effect of anticholinergic medications.
    • Rationale: Stimulates saliva production.
  • Encourage Fluid and High-Fiber Intake
    • Goal: Alleviate constipation, a common issue due to autonomic nervous system impairment.
    • Rationale: Prevents constipation and ensures regular bowel movements.

Mobility and Safety

  • Use Assistive Devices (e.g., Walker)
    • Goal: Provide stability and prevent falls.
    • Rationale: Parkinson's disease often leads to a shuffling gait and bradykinesia, increasing fall risk.
  • Administer Anti-Parkinson Medication Promptly on Schedule
    • Goal: Manage bradykinesia and improve movement.
    • Rationale: Timely medication helps control symptoms effectively.
  • Encourage Gradual Increased Activity
    • Goal: Enhance mobility without causing fatigue.
    • Rationale: Gradual activity avoids overwhelming the patient.
  • Suggest Tai Chi and Yoga
    • Goal: Focus on balance, flexibility, and strength.
    • Rationale: Reduces the risk of falls and improves overall mobility.
  • Marching in Place During Freezing Episodes
    • Goal: Overcome freezing phenomenon.
    • Rationale: Provides rhythm and triggers movement.

Cognitive and Emotional Support

  • Recommend Participation in Support Groups
    • Goal: Reduce feelings of isolation and improve coping strategies.
    • Rationale: Support groups provide emotional support and communal understanding.
  • Encourage Expression of Feelings in a Safe Setting
    • Goal: Help patients cope with emotional changes.
    • Rationale: Provides a supportive environment for dealing with emotional regulation issues.
  • Comprehensive Disease Education
    • Goal: Reduce anxiety by providing knowledge about disease progression and management.
    • Rationale: Empowers patients and alleviates the fear of the unknown.

Managing Specific Symptoms

  • Administer Levodopa-Carbidopa Therapy
    • Goal: Improve voluntary movements.
    • Rationale: Increases dopamine levels in the brain.
  • Monitor for Hallucinations
    • Goal: Recognize side effects of long-term dopaminergic therapy.
    • Rationale: Helps manage medication side effects and adjust treatment as necessary.
  • Encourage Regular Moderate Exercise
    • Goal: Improve both physical and mental health.
    • Rationale: Exercise reduces symptoms of depression and improves well-being.
  • Provide Comprehensive Care Plan
    • Goal: Address all aspects of daily life affected by PD.
    • Rationale: Enhances patient's overall quality of life and independence.

Safety and Home Environment

  • Modify Home Environment to Prevent Falls
    • Goal: Ensure safety at home.
    • Rationale: Patients with PD are at high risk for falls due to mobility issues.
  • Promote Regular Sleep Schedule and Calming Bedtime Routine
    • Goal: Manage sleep disturbances.
    • Rationale: Improve sleep quality.
  • Provide Adaptive Devices
    • Goal: Support independence in daily activities.
    • Rationale: Facilitate dressing, eating, and grooming.

Medication Management

  • Review Medication Regimen with Healthcare Provider
    • Goal: Address off periods and optimize medication effectiveness.
    • Rationale: Ensures medications are working effectively and safely.
  • Do Not Alter Medication Without Consultation
    • Goal: Prevent adverse effects and ensure safe usage.
    • Rationale: Medication adjustments should always be supervised.

Emergency Response

  • Monitor for Orthostatic Hypotension
    • Goal: Manage blood pressure changes safely.
    • Rationale: Prevent dizziness and falls due to blood pressure drops.
  • Provide Strategies for Managing Dyskinesias
    • Goal: Recognize and treat involuntary movements.
    • Rationale: Adjustments to treatment may be necessary to manage these symptoms.

Conclusion

  • Effective nursing care for Parkinson's disease patients involves a multifaceted approach addressing nutrition, mobility, cognitive and emotional support, medication management, and home safety.
  • Regular consultation with healthcare providers and personalized care plans are essential for optimal patient outcomes.