informationfornurses

Studious nurses – oh we don’t seem to have a problem in diagnosing a patient with shuffling gait or a festination. Do we??

I hope every Nurse’s answer must be “NO”.

Parkinsonism is degenerative disorder of CNS, was a movement disorder, happens because of lack of the dopamine which was produced in the dopaminergic neurons of brain.Genetic, environmental toxins, head trauma, cerebral anoxia are the reasons for the development of the Parkinsonism. The dopaminergic pathway of brain was in right in the case of Parkinsonism (left in normal).There was ostensible loss of dopamine secreting cells from the substantia nigra. While doing the positron emission topography will give a clear picture of lack of dopamine activity in the substantia nigra.

Possible signs and symptoms:-

1. tremor
2. rigidity
3. bradykinesia/ akinesia
4. postural instability
5. shuffling gait
6. decreased arm swing
7. stooped forward flexed posture
8. festination(stooped posture, imbalance, short steps)
9. hypophonia
10. drooling
11. dysphagia
12. mask like face (hypomimia)
13. akathesia(inability to sit)
14. micrographia (small cramped writing)
15. depression
16. dementia

Rx- using combination of levodopa and carbidopa (sinemet or duodopa)

-         Using the deep brain stimulation and pallidotomy.

-         Number of drugs is limited in use for its side effects.

Nursing care-

-         we should take care of the safety of the patient

-         always get one relative with patient while walking as there is more chance to fall

-         give health education about the exercise to be done for the right rehabilitation

-         psychological support

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