N213: Health Differences Across the Life Span 3

N213: Health Differences Across the Lifespan 3 Study Guide Nursing assessment for Parkinson’s disease: • Head to toe general assessment with musculoskeletal and neurological focus • Check ability to move extremities, ability to hold posture, position self, and gait • Note any tremors precipitated by stress or any at rest • Check motor function and facial expression • Check swallowing and chewing ability and evidence of drooling and salivation • Inquire about signs of dementia, cognition, and emotional status • Take food history and ability to chew, swallow, and maintain adequate nutrition • Review diagnostic testing results: o MRI/CT scans: Checks for subtle changes in brain tissues o EEG: Can find other neurological causes of symptoms o EMG: Tests the nerve conduction to the muscles Nursing diagnosis for Parkinson’s disease: • Risk for injury related to unsteady gait and issues with balance • Impaired communication related to tremors, cognition, and dysarthria • Impaired mobility related to tremors, poor positioning, Bradykinesia, and rigid muscles • Self-care deficits related to tremors and motor dysfunction • Knowledge deficit related to disease, medications, and adaptation to disease process Nursing interventions for Parkinson’s disease: • Monitor changes in motor skills, cognition, and balance • Assist patient in making adjustments to ADL routine to adapt: brushing teeth, shaving, and eating • Give medications per MD order: o Sinemet (carbidopa-levodopa): Most commonly used medication for tremors and rigidity. Adding carbidopa has helped absorption and function of levodopa. o Larodopa (levodopa): Not as commonly used. One of the first drugs for Parkinson’s and has side effects such as cough and hoarse voice, hypotension, vomiting, anorexia and GI Bleeding. Have patient take on an empty stomach. o Cogentin (benztropine): Helps to lower the body’s sensitivity to acetylcholine and decrease tremors and rigidity. Side effects include dizziness, urinary retention, glaucoma, dry mouth, and blurry vision. • Assist with preparation for surgery if necessary; stereotaxic thalamotomy is a procedure to remove the part of the thalamus that increases contractions of themuscles • Monitor eating to prevent aspiration and choking episodes; order appropriate diet, have patient sit up for meals, and allow plenty of time for eating ©2017 Achieve Test Prep Page 95 of 204