The document discusses degenerative conditions such as Parkinson's disease and Alzheimer's disease. It provides information on the pathophysiology, clinical manifestations, diagnostic and treatment options for these conditions. It outlines nursing diagnoses and interventions for patients with these diseases. The document aims to help students apply knowledge of degenerative diseases and understand how social factors can impact a patient's health.

1. Degenerative conditions:
Parkinsons & Alzheimers
BY C SETTLEY

2. Student Outcomes
After completion of this unit, the student will be able to:
• Apply knowledge regarding: Patho-physiology, disease process, clinical
manifestations, specific diagnostic and therapeutic interventions
(diagnostic tests and examinations) of degenerative conditions.
• Assess, relate and apply the scientific process of nursing, provision and
facilitation of nursing care.
• Evaluate, analyse and solve problems in familiar and unfamiliar context
in the Comprehensive Health Care system.
• Understand the relationship between social, cultural and economic
factors that may impact significantly on the health status of clients /
patients and groups.
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3. Parkinson's disease – pg. 890
• A disorder of the central nervous system that affects
movement, often including tremors.
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4. Causes of Parkinsons disease
• Parkinson's disease is primarily caused by low and falling dopamine
levels. A person with Parkinson's has abnormally low dopamine
levels. What is Dopamine?
• A hormone which plays a big role in starting movement.
• Dopamine is produced in areas in the brain.
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5. Pathophysiology of Parkinson's disease
• Depletion of dopamine due to loss of neurons in the
substantia nigra and other pigmented areas of the
brainstem and basal ganglia
• VIDEO * Parkinson's disease
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6. Assessment and common findings
• Hypokinesia
• Characterized by a partial or complete loss of muscle movement due to a disruption in
the basal ganglia.
• Bradykinesia
• Slowness of movement.
• Ataxia
• Lack of voluntary coordination of muscle movements
• Tremors
• Involuntary quivering movement.
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7. Assessment and common findings
• Poor postural control
• Fatigue and muscular aches
• Backward or forward leaning
• Rigidity
• Increased resistance during passive mobilization of an extremity
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8. Management
• Directed at controlling the motor symptoms to enable the patient to be
mobile and independent.
• Treatment is pharmacological:
• Dopaminergic agents such as levodopa
• These agents replenishes dopamine stores and alleviates symptoms of Parkinson’s
disease.
• Decarboxylase inhibitors such as carbidopa
• Retards the breakdown of dopamine in the CNS, thereby increasing the levels of
dopamine in the brain.
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9. Management
• Selegilin
• Inhibits the breakdown of levodopa in the brain and allows
the use of smaller dose of levodopa to be given.
• Amantadine
• Increases the levels of dopamine in the basal ganglia but
is toxic and should only be used if levodopa is
contraindicated or the patient finds it intolerable.
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10. Management
• Dopamine antagonist
• Eg bromocriptine have a dopamine like action.
• Antecholinergics
• Inhibits the action of acetylcholine, enhancing the effect
of existing dopamine levels.
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11. Side effects of medication may include:
• mild nausea, dry mouth, loss of appetite, heartburn, diarrhoea,
constipation;
• headache, dizziness, drowsiness, blurred vision;
• sneezing, stuffy nose, cough, or other cold symptoms;
• sleep problems (insomnia), strange dreams;
• muscle pain, numbness or tingly feeling
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12. Nursing Diagnosis- Brunner- pg. 2065
• Impaired physical mobility
• Self care deficits
• Constipation related to medication
• Imbalanced nutrition: less than body requirements related to tremor, slowness in eating, difficulty in
chewing and swallowing
• Impaired verbal communication related to decreased speech, inability to move facial muscles
• Ineffective coping related to depression and dysfunction
• Sleeping pattern disturbances
• Risk for injury
• Activity intolerance
• Compromised family coping
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13. Nursing interventions- Brunner- pg. 2065
• Improving mobility
• Enhancing self care activities
• Improving bowel elimination
• Improving nutrition
• Enhancing swallowing
• Encouraging the use of assistive devices
• Improving communication
• Supporting coping abilities
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14. Essential health information
• Take the drugs with or just after a meal
• Consult the doctor before taking other medications, as drug
interactions are common
• OTC meds
• Comply
• Decrease high protein foods in diet as it reduces the absorption of
levodopa
• Information to family, educate
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15. Alzheimers – pg 892
• A progressive disease that destroys memory and other important
mental functions.
• Brain cell connections and the cells themselves degenerate and
die, eventually destroying memory and other important mental
functions.
• Memory loss and confusion are the main symptoms.
• No cure exists, but medication and management strategies may
temporarily improve symptoms.
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16. Alzheimer's disease
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17. 10 Early Signs and Symptoms of Alzheimer's
• MEMORY LOSS THAT DISRUPTS DAILY LIFE
• CHALLENGES IN PLANNING OR SOLVING PROBLEMS
• DIFFICULTY COMPLETING FAMILIAR TASKS AT HOME, AT WORK OR AT
LEISURE
• CONFUSION WITH TIME OR PLACE
• TROUBLE UNDERSTANDING VISUAL IMAGES AND SPATIAL
RELATIONSHIPS
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18. 10 Early Signs and Symptoms of Alzheimer's
• New problems with words in speaking or writing
• Misplacing things and losing the ability to retrace steps
• Decreased or poor judgment
• Withdrawal from work or social activities
• Changes in mood and personality
• Memory loss
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19. Reference list
• https://www.alz.org/10-signs-symptoms-alzheimers-dementia.asp
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