Question

In: Nursing

You are seeing a new patient for the first time who is presenting with symptoms that...

You are seeing a new patient for the first time who is presenting with symptoms that correlate to Parkinson’s. Answer the following questions.

What does the patient look like, and what physical and (if any) psychological symptoms does the patient have?
What diagnostic test/s would you perform?
What medical management would you prescribe for this patient and why?

Expert Solution

Parkinsonism or Parkinson's disease is the common neurodegenerative disorder, which leads to progressive deterioration of motor function .both genetic and environmental factors are involved in his disease.

physical symptoms are

tremors(trembling of the limbs and head while at rest and worsen when an individual get excited tired or stressed)
rigidity(stiffness of the limbs and trunk.also muscle pain)
bradykinesia(slowness of voluntary actions, together with stiffness affect the facial muscles results in expressionless, 'mask-like' appearance.
postural instability(impaired balance)
parkinsonian gait( shuffling walk with a stooped position and a diminished arm swing.it is difficult to start walking and to turn.

psychological symptoms

anxiety
confusion
memory loss
depression

diagnosis at the beginning of the disease is important to developing good treatment strategies.there are several diagnostic guidelines.in that I would choose the unified Parkinson's disease rating scale.would do a thorough neurological examination to differentiate the disease from similar conditions.

if the patient has any three major symptoms of parkinsonism, the onset of symptoms starts from one side of body and symptoms usually improved with levodopa.

Parkinson's disease is not a curable disease.there are treatments to delay the symptoms which increase the dopamine amount in the brain or mimicking dopamine or prolonging its effect.

medical management

levodopa

the most effective therapy, which converts to dopamine in the brain.

carbidopa

prescribe along with levodopa which prevents the breakdown of levodopa before reaching the brain.

surgical management

deep brain stimulation implants electrodes to stimulate areas of the brain involved in the movement.

lifestyle changes

rest and exercise
physical therapy
occupational therapy
speech therapy

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