- A progressive neurological disorder causing destruction and degeneration of nerve cells in the basal ganglia; results in damage to the extra pyramidal system, causing difficulty in control and regulation movement.
- Dopamine , a neurotransmitter, is responsible for normal functioning of the extra pyramidal system
- The condition is correlated with depletion of, or imbalance in dopamine and an increased activity of acetylcholine
Clinical Manifestations
- General onset is after age 60
- Tremor: affects the arms and hands bilaterally – often the first sign; tremors usually occur at rest, voluntary movement may decreased tremor; tremors during voluntary movement not as common
- Described as “pill-rolling” tremor
- Aggravated by emotional stress and increased concentration
- Muscle rigidity: increased resistance to passive movement; movement may be describe as “cog-wheel rigidity” due to jerky movement of extremities
- Bradykinesia – slow activity
- Decreased blinking of the eyelids; loss of ability to swallow saliva; facial expression is blank or “mask-like”; loss of normal arm swing while walking; difficulty initiating movement
- Stooped posture, shuffling propulsive gait
- May exhibit mental deterioration similar to Alzheimer ’s disease
- Onset usually gradual
Treatment
- Medication to enhance dopamine secretion; anticholinergic medications to decrease effects of acetylcholine
Goals of Nursing Care
- To maintain homeostasis: encourage independence in activities of daily living utilizing self- help devices; maintain nutrition; maintain muscle function
- To promote a positive self-image: encourage diversional activities, assist client to set realistic goals, explore reasons for depression, encourage client to discuss changes occurring in lifestyle, assist client in gaining control of activities of daily living and environment; assist client to identify and avoid activities that increase frustration levels and encourage good personal hygiene
No comments:
Post a Comment