CASE STUDY PARKINSON’S DISEASE

Miss Rose is a 74-year-old female, who is a retired widow and lives with her son for the past five years. Both enjoy planting seedlings and own a community agriculture store. She does not suffer with hypertension or diabetes and has an active lifestyle. She is also not known to have any psychiatric illnesses. Over the past six months Miss Rose’s son and herself noticed physical changes and decided to visit her General Practitioner. At her visit she mentioned to the doctor that she was having difficulty rising from a sitting position after grooming her plants or turning from one table to another when she has customers. Documentation on her clinic file noted that she previously complained of difficulty walking and falling when coming out of bed. She was sent for an X-ray but there were no clinical findings. The physician asked her to describe what happened when she fell. Miss Rose verbalized that when she got up from bed and starting walking, she started moving forward and backward then stooped forward with small fast steps and then she fell. Her son mentioned to the doctor that he has noticed that when she is pruning her plants, she has abnormal rhythmic movement of the upper and lower limbs. She occasionally has a slight limp, and her handwriting has become smaller over the past months. This has stopped her from doing her daily yoga exercises and she has been very disturbed about it. Miss Rose then further explained that the movement started on the distal part of both upper limbs at the same time. She also expressed that during rest she noticed the movement in her limbs and as she started her tasks the movements became more aggravated. Urinary incontinence is also a problem for Miss Rose, and she is having difficulty in her swift movements to her bathroom. The patient was later diagnosed with Parkinson’s disease.

After the assessment and interview of Miss Rose the Physician documented the following: Physical Assessment Vital Signs: BP- 130/74 mmHg Temperature - 36.7 C, Pulse- 78 bpm regular and bounding Respiration- 20 bpm Height- 5ft 7 in Weight- 70 kg Facial expression- Masklike Gait- Shuffling gait with tendency to fall forward and backward CNS Examination Alert and oriented to time, person and place Level of consciousness GCS- 15/15 Sleeping patterns- normal Swallowing gag reflex- normal Cogwheel rigidity present Tremor present Bradykinesia present Dysphonia present

INSTRUCTION:

1. Prepare the nursing management for this patient using a care plan, include assessments three actual problems, patient desired goals, nursing interventions, and evaluations?

2. Prepare the nursing management for this patient using a care plan, include assessments, two potential problems, patient desired goals, nursing interventions, and evaluations?

Research and describe 2 (two) workplace procedures for hazard identification in a healthcare setting (in 50-70 words).

This unit’s assigned reading focuses on chemical-induced mutagens. For this assignment, compare and contrast a carcinogen that is a mutagen to a carcinogen that is not a mutagen. Find at least four peer-reviewed journal articles published within the last 7 years that discuss the carcinogens and the cancer that each causes.

Compare the means of exposure of each chemical and the type of cancer each causes. Be sure to integrate the perspective and information gathered from each article into a discussion in your own words.

The Business Source Ultimate database is a good source of journals for safety-related articles from the CSU Online Library.

Your literature review must include the following components:

• an introduction of your topic of choice (include some background information on the origins of exposure and cancer),
• the methods used to search for the articles,
• the results of the articles,
• a discussion and conclusion with your own opinion, and
• APA references and in-text citations for the article.

The literature review must be three to four pages in length, not including the title or reference page, and follow APA formatting.

What are several solutions to prevent or mitigate COVID-19 cases now or in the future? Please list examples, Thanks

“Why are ethics important to health communication?”

Which of the following sampling techniques poses the BIGGEST threat to the external validity of a study?

Group of answer choices

simple random sampling

convenience sampling

stratified random sampling

proportional quota sampling

J. G. is a 34-year old P1 G1 woman who underwent an emergency cesarean delivery after a prolonged labor, during which she exhibited a sudden change in neurologic functioning and started seizing. Since that time, she has experienced 3 tonic-clonic (grand mal) seizures, diagnosed as having a basal ganglion hematoma with infarct, and was started on phenytoin. Postdelivery, J. G. demonstrated dyskinesia, resulting in frequent falls with ambulation. When the seizure disorder appeared to be under control, she was transferred to a rehabilitation facility for evaluation, and 2 weeks of intensive physical therapy. She is now home, where she is doing quite well but still has occasional falls and is receiving physical therapy 3 times a week in her home. She remains on phenytoin and has had no seizures since her release from the rehabilitation facility. As case manager for J. G.’s HMO, you visit her and her family at home for evaluation of long-term, follow-up care.

1. A seizure is not a disease in itself but a symptom of a disease. What is the term for chronically recurring seizures?
2. Does J. G. have epilepsy?
3. The 3 main phases of a seizure are the preictal, ictal, and postictal. Differentiiate between the 3 phases, and list clinical symptoms you may observe when a patient is having a seizure.
4. What is the pathophysiology of a seizure?
5. J. G. had grand mal, or tonic-clonic, seizures. Describe this type of seizure. List 5 other types of seizures.
6. Some patients know they are about to have a seizure. What is this preseizure warning called, and what form does it take?
7. Besides the brain injury, what are some other possible conditions that could be contributing to J. G.’s lowered seizure threshold?
8. List 5 classifications of antizeisure medications.
9. J. G’s husband comes to visit and asks you what he should do if she has a seizure at home. What would you tell him?
10. Her husband states that he is afraid for J. G. to take care of the baby. What would you say to him?
11. J. G.’s husband tells you that his wife is not good at remembering to take medication. What are some strategies that you should review with J. G. and her husband to increase the likelihood of compliance?
12. J. G. asks, “If I get my blood level under control will it stay at the same level as long as I take my medicine?” How would you answer her question?
13. J. G.’s husband asks if the drugs could harm his wife in any way. What general information would you give them about anticonvulsants?
14. J. G.’s husband says, “I was watching ‘Emergency’ last night and they showed this guy who just kept on having a seizure. That doctor had to give him lost of medicine before he came out of it. What is that called?” How would you explain status epilepticus, and why is it a medical emergency?

J. G. is a 34-year old P1 G1 woman who underwent an emergency cesarean delivery after a prolonged labor, during which she exhibited a sudden change in neurologic functioning and started seizing. Since that time, she has experienced 3 tonic-clonic (grand mal) seizures, diagnosed as having a basal ganglion hematoma with infarct, and was started on phenytoin. Postdelivery, J. G. demonstrated dyskinesia, resulting in frequent falls with ambulation. When the seizure disorder appeared to be under control, she was transferred to a rehabilitation facility for evaluation, and 2 weeks of intensive physical therapy. She is now home, where she is doing quite well but still has occasional falls and is receiving physical therapy 3 times a week in her home. She remains on phenytoin and has had no seizures since her release from the rehabilitation facility. As case manager for J. G.’s HMO, you visit her and her family at home for evaluation of long-term, follow-up care.

1. A seizure is not a disease in itself but a symptom of a disease. What is the term for chronically recurring seizures?
2. Does J. G. have epilepsy?
3. The 3 main phases of a seizure are the preictal, ictal, and postictal. Differentiiate between the 3 phases, and list clinical symptoms you may observe when a patient is having a seizure.
4. What is the pathophysiology of a seizure?
5. J. G. had grand mal, or tonic-clonic, seizures. Describe this type of seizure. List 5 other types of seizures.
6. Some patients know they are about to have a seizure. What is this preseizure warning called, and what form does it take?
7. Besides the brain injury, what are some other possible conditions that could be contributing to J. G.’s lowered seizure threshold?
8. List 5 classifications of antizeisure medications.
9. J. G’s husband comes to visit and asks you what he should do if she has a seizure at home. What would you tell him?
10. Her husband states that he is afraid for J. G. to take care of the baby. What would you say to him?
11. J. G.’s husband tells you that his wife is not good at remembering to take medication. What are some strategies that you should review with J. G. and her husband to increase the likelihood of compliance?
12. J. G. asks, “If I get my blood level under control will it stay at the same level as long as I take my medicine?” How would you answer her question?
13. J. G.’s husband asks if the drugs could harm his wife in any way. What general information would you give them about anticonvulsants?
14. J. G.’s husband says, “I was watching ‘Emergency’ last night and they showed this guy who just kept on having a seizure. That doctor had to give him lost of medicine before he came out of it. What is that called?” How would you explain status epilepticus, and why is it a medical emergency?