Parkinson's Disease Nursing Care Plan - Diagnosis Interventions

Parkinson's disease is a progressive neurodegenerative disorder that affects movement control, impacting millions of people worldwide. This article explores the key aspects of Parkinson's disease, including its causes, symptoms, and current management strategies.

Causes of Parkinson's Disease:

1. Neurodegeneration: Parkinson's disease is characterized by the gradual loss of dopamine-producing neurons in the substantia nigra, a region of the brain involved in movement control.
2. Genetic Factors: While most cases of Parkinson's are sporadic, some have a genetic component. Mutations in specific genes, such as LRRK2 and SNCA, are associated with an increased risk of developing the condition.
3. Environmental Factors: Exposure to certain environmental toxins, such as pesticides and herbicides, has been linked to an elevated risk of Parkinson's disease.

Symptoms of Parkinson's Disease:

1. Tremors: Involuntary shaking or trembling, typically starting in the hands, is a hallmark symptom of Parkinson's.
2. Bradykinesia: Slowed movement and a gradual reduction in the ability to initiate and complete physical activities.
3. Muscle Rigidity: Stiffness and resistance to movement in the muscles, leading to reduced flexibility.
4. Postural Instability: Difficulty maintaining balance and an increased risk of falls.
5. Changes in Handwriting: Micrographia, or the shrinking of handwriting, is a common early sign.

Parkinson's Disease Nursing Care Plan

1. Nursing Diagnosis Impaired physical mobility related to the stiffness and muscle weakness.

Goal: The client is able to perform physical activity according to ability.

Expected results: the client can participate in training programs, joint contractures did not occur, increased muscle strength and the client indicates an act to increase the mobility

Nursing Interventions for Parkinson's Disease :

1. examine existing mobility and observation of an increase in damage
2. do an exercise program increases muscle strength.
3. encourage hangan bath and massage the muscle
4. help clients perform ROM exercises, self-care according to tolerance
5. collaboration physiotherapists for physical exercise

2. Nursing Diagnosis Self care deficit related to neuromuscular weakness, decline in strength, loss of muscle control / coordination.

Goal: self-care clients are met

Expected results: the client can indicate a change of life for the needs of taking care of themselves, clients are able to do self-care activities in accordance with the level of ability, and identify personal / community that can help.

Nursing Interventions for Parkinson's Disease :

1. assess the ability and the rate of decline and the scale of 0-4 to perform ADL
2. avoid what not to do the client and help if needed.
3. collaborative provision of laxatives and consult a doctor of occupational therapy
4. teach and support the client during the client's activities
5. environmental modifications

3. Nursing Diagnosis Impaired Verbal Communication related to the decline in speech and facial muscle stiffness

characterized by:

• Subjective Data: client / family says the difficulty in talking
• Objective data: the words are difficult to understand, face rigid.

Goal: maximize the ability to communicate.

Nursing Interventions for Parkinson's Disease:

1. Keep the complications of treatment.
2. Refer to speech therapy.
3. Teach clients to use facial exercises and breathing methods to correct the words, volume, and intonation.
4. Breath deeply before speaking to increase the volume and number of words in sentences of each breath.
5. Practice speaking in short sentences, reading aloud in front of the glass or into a voice recorder (tape recorder) to monitor progress.

 

Bibliography:

1. Olanow, C. W., Stern, M. B., & Sethi, K. (2009). The scientific and clinical basis for the treatment of Parkinson disease (2009). Neurology, 72(21 Suppl 4), S1–S136. doi: 10.1212/WNL.0b013e318198db1d
2. Dorsey, E. R., Bloem, B. R., & Okun, M. S. (2020). The past, present, and future of Parkinson's disease: A special essay on the 200th Anniversary of the Shaking Palsy. Movement Disorders, 35(6), 795–801. doi: 10.1002/mds.27986
3. Schapira, A. H., Chaudhuri, K. R., & Jenner, P. (2017). Non-motor features of Parkinson disease. Nature Reviews Neuroscience, 18(7), 435–450. doi: 10.1038/nrn.2017.62

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Nursing Assessment - Physical Examination for Appendicitis

Physical Examination for Appendicitis

Interview

• Get a thorough medical history, especially regarding:
• The main complaint: the client will get a pain around the epigastrium radiating to the lower right abdomen. Complaints arising under the right abdominal pain may be a few hours later after the pain in the center or in the epigastrium felt in some time ago. Pain is felt continuously, may be lost or attributable to, pain in a long time. Complaints which usually accompanies a client complaining of nausea and vomiting, the body heat.
• Past medical history of health problems usually associated with a client right now.
• Diet, eating foods low in fiber.
• Elimination habits.

Physical examination

• Physical examination of the general state of ill clients seem mild / moderate / severe.
• Circulation: tachycardia.
• Respiratory: Tachypnea, shallow breathing.
• Activity / rest: Malaise.
• Elimination: Constipation in early onset, sometimes diarrhea.
• Abdominal distension, tenderness / pain off, stiffness, decreased or absent bowel sounds.
• Pain / comfort, epigastric and abdominal pain around the umbilicus, the increased severe and localized to the point Mc. Burney, an increase of walking, sneezing, coughing or breathing deeply. Pain in the lower right quadrant because the position of the right leg extension / seated upright position.
• Fever over 38 ° c.
• Psychological data, appear restless.
• There are changes in pulse rate and breathing.
• On rectal toucher palpable lump and the patient will feel pain in the pro-lithotomy.
• Weight as an indicator to determine the drug.

Examination Support

• Signs of peritonitis, lower right quadrant. Line drawings of air fluid level in the cecum or ileum.
• Erythrocyte sedimentation rate (ESR) is increased in the state of appendicitis infiltrates.
• Routine urinalysis is important to see what there is infection in the kidney.
• The increase of leukocytes, Neutrophilia, without eosinophils.
• Appendix on barium enema is not filled.
• Ultrasound: fekalit non-calcified, non-perforated appendix, appendix abscess.

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Risk for Deficient Fluid Volume - Nursing Interventions for Appendicitis

Appendicitis

The main complaint in patients with appendicitis is pain around the epigastrium radiating to the lower right abdomen. Complaints arising under the right abdominal pain may be a few hours later after the pain in the center or in the epigastrium felt in some time ago. Nature of the complaints of persistent pain is felt, may be lost or there is pain in a long time. Complaints which usually accompanies a client complaining of nausea and vomiting, loss of heat.



Risk for Deficient Fluid Volume

Definition: The decrease intravascular fluid, interstitial, and / or intrasellular. This leads to dehydration, loss of fluids with sodium expenditure.

Characteristics :

• Weakness
• Thirst
• Decreased skin turgor / tongue
• Mucous membrane / dry skin
• Increased pulse rate, decreased blood pressure, decrease in volume / pulse pressure
• Completion of decreased venous
• Changes in the mental position
• The concentration of urine increased
• Increased body temperature
• Elevated hematocrit
• Weight loss immediately (except on third spacing)

Nursing Diagnosis Interventions for Appendicitis

Risk for deficient Fluid Volume related to a sense of nausea and vomiting,
characterized by:

• Sometimes diarrhea.
• Abdominal distension.
• Tense abdomen.
• Decreased appetite.
• There is a sense of nausea and vomiting.

Purpose: Maintaining the balance of fluid volume

Results Criteria:

• The client is not diarrhea.
• A good appetite.
• The client no nausea and vomiting.

Nursing Intervention for Appendicitis :

1) Monitor vital signs.
Rational: This is an early indicator of hypovolemia.

2) Monitor intake and urine output and concentration.
Rational: Decreased urine output and concentration will improve the sensitivity / sediment as one the impression of dehydration and require increased fluids.

3) Give fluid little by little but often.
Rationale: To minimize the loss of fluids.

Pediatric Nursing Care Plan – Fluid Volume Deficit related to Diarrhea

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Nursing Care Plan for Acute Respiratory Infections (ARI)

Acute respiratory infections are respiratory tract infection that lasts up to 14 days. Respiratory tract includes the organs from the nose to the lungs, along with the surrounding organs such as the sinuses, middle ear space and the pleura.

Acute Respiratory infection is a disease that often occurs in children, because the immune system of children is still low.

Terms of ARI include three elements namely : infections, respiratory tract, and acute, where the notion as follows:

1. Infection

Is the entry of germs or microorganisms into the human body and multiply, causing symptoms of the disease.

2. Respiratory tract

Is the organ, from the nose to the alveoli, along with the sinuses, middle ear cavity and the pleura.

3. Acute infections

Acute infection is a direct infection of up to 14 days. limit of 14 days is taken to indicate an acute process although for some diseases that can be classified in a process may take more than 14 days.

Assessment - Nursing Care Plan for Acute Respiratory Infections (ARI) for Acute Respiratory Infection

Things that need to be assessed in patients with Upper Respiratory Infection:

1. History: fever, cough, runny nose, anorexia, weakness / listlessness, respiratory disease history, treatment done at home and accompanying diseases.
2. Physical signs: fever, dyspnea, tachypnea, use of additional respiratory muscles, enlarged tonsils, painful swallowing.
3. Growth factor: General, level of development, daily habits, coping mechanisms, ability to understand the action taken.
4. Knowledge of the patient / family: the experience of respiratory diseases, respiratory diseases and knowledge about the action taken.

Nursing Diagnosis for Acute Respiratory Infection

1. Hyperthermia related to the invasion of microorganisms

2. Risk for Imbalanced Nutrition: Less Than Body Requirements related to painful swallowing, decreased appetite secondary to acute respiratory tract infections.

3. Knowledge deficient: on the management of Acute Respiratory Infections related to lack of information

4. Ineffective breathing pattern related to decreased lung expansion

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