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.
Here are nine (9) nursing care plans (NCP) and nursing diagnosis for Parkinson’s Disease:
- 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 Swallowing
Nursing Diagnosis
May be related to
- Parkinson’s disease
- neuromuscular impairment
- dysphagia
Possibly evidenced by
- inability to swallow effectively
- choking
- aspiration
- food remaining in the oral cavity
- slow eating
- difficulty swallowing
- chewing
- stiff
- masklike face
- choking, drooling
- weight loss
- facial rigidity
- muscle rigidity
- tremors
- aspiration
Desired Outcomes
- Patient will be able to swallow effectively with no incidence of aspiration.
- Patient will be able to eat and swallow normally.
- Patient will be able to ingest an adequate amount of nutrients without the dangers of aspiration.
- Patient will be able to follow instructions and strengthen muscles used for eating and swallowing.
| Nursing Interventions | Rationale |
|---|---|
| Evaluate the patient’s ability to swallow, extent of paralysis, and ability to maintain airway. | Swallowing difficulties and choking are common in PD, evaluation provides baseline information from which to plan interventions for care. |
| Maintain head position and support, with head of bed elevated at least 30 degrees or more during immediately after feeding. | Helps to prevent aspiration; facilitates ability to swallow. |
| Instruct patient to chew sugarless chewing gum or suck on hard candy. | To keep his mouth moist and easy dryness of the mouth, a side effect of medications for PD. |
| Place food in the unaffected side of patient’s mouth. | Allows for sensory stimulation and taste, and may assist to trigger swallowing reflexes. |
| Provide foods that are soft and require little chewing; provide thickened liquids if possible. Avoid thin liquids. | These types of foods are easier to control and decrease potential for choking or aspiration. |
| Administer tube feedings or enteral alimentation as warranted/ordered. | May be required if oral intake is not sufficient. |
| Instruct patient and/or family to use straw for drinking liquids. | Helps strengthen facial oral muscles to decrease the potential for choking. |
| Teach patient to place food in tongue, close the lips and teeth, lift the tongue up and then back, and swallow. Encourage the patient to chew first on one side of the mouth and then on the other. | Proper technique to prevent aspiration. |
| Instruct patient to make conscious effort to swallow. | To control the buildup of saliva. |
| Massage the facial and neck muscles before meals. | Can help during meal time. |
Recommended Resources
Recommended nursing diagnosis and nursing care plan books and resources.
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- 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, 2021-2023Â (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.
See also
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 | 15Â 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
Awesome stuff.
Feel like I have found a gold mine !! Very helpful.
Very nice and helpful
This website has helped me so much with nursing interventions and now is helping me come up with interventions and understanding why because of the rationale
Would be Important to add references. Apart from that is very good.