Parkinson's concept map

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Secondary

Emotional Changes

Insecurity

Embarrassment

Paranoia

Irritability

Pessimism

Rapid Mood swings

Fear

Depression

Autonomic Nervous System Changes

Skin Changes

Flushing, seborrhea, oily skin, changes in texture

Bowel and Bladder Dysfunction

Urinary incontinence or retention, due to ANS regulating smooth muscle activity, and constipation due to slow motility of GI tract and/or poor nutrition and fluid intake.

Erectile Dysfunction

Excessive Perspiration

Orthostatic Hypotension

Loss of sympathetic innervation in the heart and blood vessel response

Motor Changes

Stage 1

Stage 2

Stage 3

Stage 4

Stage 5

DEATH

Complete ADL Dependence

Rigidity

Akinesia

Increased Gait Disturbances

Short, hesitant, or propulsive gait with inability to stop quickly. Sensation of being frozen or glued to floor.

Postural Instability

Stooped

Slow, Shuffling, Gait

Masklike Facies

With wide, fixed, staring eyes

Facial Rigidity

Changes in Speech Patterns

Dysarthria, echololia, hypophonia

Uncontrollable Drooling

Chewing/Swallowing Impairment

Aspiration

Pneumonia

Choking

Inadequate Nutrition

Bilateral Limb Involvement

Bradykinesia

Hand and Arm Trembling

Tremors at rest

Minimal Weakness

Fatigue, difficulty getting out of bed

Unilateral Limb Involvement

Clinical Manifestations

Normal Pressure Hydrocephalus

Antipsychotic Meds

Brain Tumor

Head Trauma

Mini Stokes

Environmental Exposure

Metals

Drinking Well Water

Industrial Chemicals

Herbacides

Pesticides

Genetic Factors

50% more males than females

Familial Tendency

parkin 1 gene on chromosome 4

Reduced Estrogen Levels

Older than 40 years

Risk Factors

References

Ignatavicius, D. D., & Workman, M. L. (2010). Medical-surgical nursing: Patient-centered collaborative care (7th ed.). 941-946. St. Louis, MO: Saunders/Elsevier.

Risk for Injury

Parkinson's Disease

Ideopathic (Primary)

Diagnostics

Analysis of CSF may show decrease in dopamine levels

No specific Diagnostic Tests

Clinical Findings based on symptoms after ruling out other neurological diseases

Degeneration of Substantia Nigra

Substantia Nigra produces dopamine and trasmits it to the basal ganglia.

Decrease in Dopamine Production

Dopamine/Acetylcholine Imbalance

ACh is produced by the basal ganglia and is responsible for transmitting excitatory neurons. Dopamine inhibits these, making voluntary motor refinement possible.

Inability to Refine Voluntary Movement

Cognitive Changes

Memory Deficits

Delayed Reaction Time

Dementia