10. Stool softener and prune juice for constipation.
MS Nursing Interventions
High fiber and adequate fluids
High protein & vitamin supplements
Obese, dietitian for low calorie diet
Exercise not to fatigue (spasticity & coordination)
Daily rest periods
Stablize gate- lean towards less involved side
Avoid hot baths - increases weakness
Refer pt & fam. to support group.
A syndrom that consists of bradykinesia, rigidity, tremor, and impaired postural reflexex
Damage or lose of dopamine-producing cells in the midbrain leads to depletion of dopamine that influences the initiation, modulationn and clompletion of movement and regulates unconscious autonomic movements.
Drug induced parkinsonism- dopamine receptors in the brain are blocked.
Causes of PD
Type A encephalitis
Intoxication of carbon Monoxide
Intocation of Manganese
Drugs: Haldol, Thorazine Methyldopa
Reduced estorgen levels
Exposure to industrial metals and chemicals
PD commonly occures after the age of
PD is more common in men or women
A neurotransmitter that is essential for functioning of the extramidal motor system including control of posture, support and voluntary motion.
More prominent at rest but disappears whe the pt moves
Initially minimal becomes more pronounced in later stages.
Increased resistence to passive motion when limbs are moved through their range of motion.
Is a jerky quality when the joint is moved (cogwheel rigidity)
Evident in the loss of automatic movements and lack of spntaneous activity ( Autonomic movements include blinking, swing the arms while walking, swallowing saliva, facial expressions, and minor posturl adjustments)
Features include: stooped posture, masked face, drooling and shuffling gait
Dx tests for PD
No firm Dx test
2 signs of the classic triad: tremor, rigidity & bradykinesia.
Confimation: positive response to low-dose of antiparkinson med. (Carbidopa-levodopa, Sinemet)
CT scan- cerebral atrophy
EEG- minimal slowingof brain electircal activity
UGI- decreased motility
abnormal involuntary movement
When all drugs are withdrawn for a time because their effectiveness has decreased or have side effects from prolonged use.
Medical Management for PD
- carbidopa-levodopa (Sinemet)
- levodopa (Dopar)
with prolonged treatment side effects such as dyskinesia may occure and decreased medication effectiveness. Hospitalization my be helpful during a drug holiday. Meds are then restarted offen at smaller doses.
Aspiration can occur when meds are restarted
Surgury for PD
Ablation therepy: Destroys portion of the brain
Deep Brain Stimulation: electrods are placed in the brain and connected it to a generator placed in the upper chest.
Nursing Interventions for PD
Lay on firm bed without pillow- prevent spine from bending forward
Hold hands behind the back when walking
Use a chair that propels them to an upright position
Nutrition for PD Patients
avoid malnutrition and constipation
Appetizing foods that can be easily chewed & swallowed
Ample time for eating, avoid frustration, encourage independence