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.