presented by Muhammad Raees afridi

1. ADULT HEALTH NURSING
GBSN,SEM-IV
FACULTY: MR.RAFIQUE SYIAL
PRASENTED BY: MUHAMMAD RAEES
Parkinson’s disease

2. Objectives
 At the end of this presentation the students
will be able to learn about:
 Definition of Parkinson's disease.
 Signs and sym of Parkinson's disease.
 Causes of Parkinson's disease.
 Pathophysiology of Parkinson's disease.
 Diadnose of Parkinson's disease.
 Treatment of Parkinson's disease.
 Nursing management of Parkinson's disease.

3. Definition
 Parkinson's disease is a progressive disorder
of the nervous system that affects
movement. It develops gradually, sometimes
starting with a barely noticeable tremor in
just one hand. But while a tremor may be the
most well-known sign of Parkinson's disease,
the disorder also commonly causes stiffness
or slowing of movement.

5. Signs and symptoms
 Tremor.
 Slowed movement (bradykinesia)
 Rigid muscles.
 Impaired posture and balance.
 Loss of automatic movements.
 Speech changes.
 Writing changes.

7. Causes
 The cause of Parkinson's disease is unknown,
but several factors appear to play a role,
including:
 Your genes. Researchers have identified
specific genetic mutations that can cause
Parkinson's disease, but these are uncommon
except in rare cases with many family
members affected by Parkinson's disease.

8. Causes
 Environmental triggers. Exposure to certain
toxins or environmental factors may increase the
risk of later Parkinson's disease, but the risk is
relatively small.
 The presence of Lewy bodies. Clumps of
specific substances within brain cells are
microscopic markers of Parkinson's disease.
These are called Lewy bodies, and researchers
believe these Lewy bodies hold an important
clue to the cause of Parkinson's disease.

9. Risk factors
 Age. People usually develop the disease
around age 60 or older.
 Heredity. Having a close relative with
Parkinson's disease increases the chances
that you'll develop the disease.
 Sex. Men are more likely to develop
Parkinson's disease than are women
 Exposure to toxins.

10. Additional problems
 Thinking difficulties.
 Depression and emotional changes.
 Swallowing problems.
 Sleep problems and sleep disorders.
 Blood pressure changes.
 Smell dysfunction
 Fatigue.

11. Pathophysiology
 Parkinson’s disease is primarily associated with the
gradual loss of cells in the substantia nigra of the
brain.This area is responsible for the production of
dopamine. Dopamine is a chemical messenger that
transmits signals between two regions of the brain
to coordinate activity. For example, it connects the
substantia nigra and the corpus striatum to regulate
muscle activity. If there is deficiency of dopamine in
the striatum the nerve cells in this region “fire” out of
control.This leaves the individual unable to direct or
control movements.

12. Pathophysiology
 .This leads to the initial symptoms of
Parkinson’s disease. As the nervous system
degenerate as well causing a more profound
movement disorder

14. Diagnosis
 No tests can conclusively show that you
have Parkinson's disease.Your doctor will
base a diagnosis on your symptoms,
medical history and a detailed physical
examination.

15. Diagnosis
 The finding of Lewy bodies in the midbrain
on autopsy is usually considered final proof
that the person had PD.
 People may be given levodopa, with any
resulting improvement in motor impairment
helping to confirm the PD diagnosis

16. Treatment
 Parkinson's disease can't be cured, but
medications can help control your symptoms,
often dramatically. In some later cases,
surgery may be advised
 Medications
 Medications may help you manage problems
with walking, movement and tremor.These
medications increase or substitute for
dopamine, a specific signaling chemical
(neurotransmitter) in your brain.

17. Treatment
 Carbidopa-levodopa.
 Carbidopa-levodopa infusion.
 Dopamine agonists.
 MAO-B inhibitors.These medications include
selegiline (Eldepryl, Zelapar) and rasagiline
(Azilect).They help prevent the breakdown of
brain dopamine by inhibiting the brain enzyme
monoamine oxidase B (MAO-B).This enzyme
metabolizes brain dopamine.
 Anticholinergics.

18. Surgical procedures
 Deep brain stimulation. In deep brain
stimulation (DBS), surgeons implant
electrodes into a specific part of your brain.
The electrodes are connected to a generator
implanted in your chest near your collarbone
that sends electrical pulses to your brain and
may reduce your Parkinson's disease
symptoms.

20. Nursing Interventions
 Assess neurological status.
 Assess ability to swallow and chew.
 Provide high-calorie, high-protien, high-fiber
soft diet with small, frequent feedings.
 Increase fluid intake to 2000 mL/day.
 Monitor for constipation.
 Promote independence along with safety
measures

21. Nursing Interventions
 Administer antiparkinsonian medications to
increase the level of dopamine in the CNS.
 Instruct the client to avoid foods high in
vitamin B6 because they block the effects of
antiparkinsonian medications.

22. References
 Suchowersky O, et al. (2006). Practice
parameter: Neuroprotective strategies and
alternative therapies for Parkinson disease (an
evidence-based review).
 http://www.neurology.org/content/66/7/968.f
ull.