Parkinson’s disease, or paralysis agitans,is a progressing neurologic movement disorder that eventually leads to disability. It occurs after the age of 50 and increases in incidence with age. The disease affects more men than women and it’s the fourth most common neurodegenerative disease, with 50,000 new cases reported each year in the United States.
Parkinson’s disease is associated with decreased levels of dopamine resulting from destruction of pigmented neuronal cells in the substantia nigra in the basal ganglia region of the brain. Neuronal pathways project from the substantia nigra to the corpus striatum, where neurotransmitters are key to the control of complex body movements. The loss of dopamine stores in areas of the brain results in more excitatory neurotransmitters than inhibitory neurotransmitters, leading to an imbalance that affects voluntary movement.
Nursing Care Plans
The nursing goals for patients with Parkinson’s Disease include improving functional mobility, maintaining independence in performing ADLs, achieving optimal bowel elimination, attaining and maintaining acceptable nutritional status, achieving effective communication, and developing positive coping mechanisms.
- Ineffective Airway Clearance
- Disturbed Thought Process
- Impaired Verbal Communication
- Impaired Physical Mobility
- Imbalanced Nutrition: Less Than Body Requirements
- Impaired Swallowing
- Risk for Injury
- Ineffective Coping
- Deficient Knowledge
- Other Nursing Care Plans
Impaired Verbal Communication
- Impaired Verbal Communication
May be related to
- physical barrier from hypertonicity from parkinsonism
- rigidity of facial muscles
- depression medications
- psychological barriers
- psychological barriers
- decreased circulation to the brain
- age-related factors
- lack of stimuli
Possibly evidenced by
- confusion, anxiety, restlessness
- flight of ideas
- inability to speak
- impaired articulation
- difficulty with phonation
- inability to name words
- inability to identify objects
- difficulty comprehending communication
- inappropriate verbalizations
- slow monotonous speech
- high-pitched rapid speech, repetitive speech
- facial muscle rigidity
- Patient will be able to have effective speech and understanding of communication, or will be able to use another method of communication and make needs known.
- Patient will be able to use assistive devices and techniques to improve the ability to communicate.
- Patient will be able to speak in an understandable way possible when necessary.
- Patient will be able to understand communication.
- Patient will be able to exhibit minimal frustration and anxiety with speech attempts.
- Patient will be able to make needs known utilizing nonverbal methods if required.
- Family will be compliant and supportive of the patient’s attempt at communication.
|Assess the patient’s ability to speak, language deficit, cognitive or sensory impairment, presence of aphasia, dysarthria, aphonia, dyslalia, or apraxia. Presence of psychosis, and/or other neurologic disorders affecting speech.||Speech disorders are present in most patients with Parkinson’s disease, this helps identify problem areas and speech patterns to help establish a plan of care.|
|Instruct patient to make a conscious effort to speak slowly, with deliberate attention to what they’re speaking. Remind the patient to face the listener, exaggerate the pronunciation of words, speak in short sentences, and take a few breaths before speaking.||This helps establish a clear method of communication and speaking to the patient.|
|Monitor the patient for nonverbal communication, such as facial grimacing, smiling, pointing, crying, and so forth; encourage the use of speech when possible.||Indicates that feelings or needs are being expressed when speech is impaired. Excessive mumbling, striking out, or non-verbalization clues may b e the only method left for the patient to express discomfort.|
|Attempt to anticipate the patient’s needs.||Helps to prevent frustration and anxiety.|
|When communicating with the patient, face patient and maintain eye contact, speaking slowly and enunciating clearly in a moderate or low-pitched tone.||Clarity, brevity, and time provided for responses promote the opportunity for a successful speech by allowing the patient time to receive and process the information.|
|Remove competing stimuli, and provide a calm, unhurried atmosphere for communication.||Reduces unnecessary noise and distraction and allows the patient time to decrease frustration.|
|Use simple, direct questions requiring one-word answers. Repeat and reword questions if a misunderstanding occurs.||Promotes self-confidence of the patient who is able to achieve some degree of speech or communication.|
|Provide a small electronic amplifier if necessary.||Helpful if the patient has difficulty being heard.|
|Encourage patient to control the length and rate of phrases, over-articulate words, and separate syllables, emphasizing consonants.||Helps to promote speech in the presence of dysarthria.|
|Avoid rushing the patient when struggling to express feelings and thoughts.||Impaired verbal communication results in a patient’s feeling of isolation, despair, depression, and frustration. Compassion helps to foster a therapeutic relationship and sense of trust and is important for continuing communication.|
|Instruct patient and/or SO regarding the need to use glasses, hearing aids, dentures.||Helps promote communication with sensory or other deficits.|
|Instruct patient and/or SO in the performance of facial muscle exercises, such as smiling, frowning, sticking tongue out, moving tongue from side to side and up and down.||Promotes facial expressions used to communicate by increasing muscle coordination and tone.|
Recommended nursing diagnosis and nursing care plan books and resources.
- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use.
- Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively.
- NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales.
- Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates.
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing.
- Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans.
- Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you.
- Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023.
- All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other nursing care plans related to neurological disorders:
- Alzheimer’s Disease | 15 Care Plans
- Brain Tumor | 3 Care Plans
- Cerebral Palsy | 7 Care Plans
- Cerebrovascular Accident | 12 Care Plans
- Guillain-Barre Syndrome | 6 Care Plans
- Meningitis | 7 Care Plans
- Multiple Sclerosis | 9 Care Plans
- Parkinson’s Disease | 9 Care Plans
- Seizure Disorder | 4 Care Plans
- Spinal Cord Injury | 12 Care Plans