9 Parkinson’s Disease Nursing Care Plans

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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:

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  1. Ineffective Airway Clearance
  2. Disturbed Thought Process
  3. Impaired Verbal Communication
  4. Impaired Physical Mobility
  5. Imbalanced Nutrition: Less Than Body Requirements
  6. Impaired Swallowing
  7. Risk for Injury
  8. Ineffective Coping
  9. Deficient Knowledge
  10. Other Nursing Care Plans
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Deficient Knowledge

Nursing Diagnosis

May be related to

  • lack of knowledge about Parkinson’s disease
  • stigma of disease
  • difficulty understanding the disease process
  • lack of coping skills
  • cognitive impairment

Possibly evidenced by

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  • verbalization of questions
  • verbalization of incorrect information
  • noncompliant
  • presence of preventable complications
  • inability to follow instructions
  • inappropriate behavior
  • agitation
  • depression
  • withdrawal
  • apathy
  • restlessness

Desired Outcomes

  • Patient and/or family will be able to exhibit an understanding of disease process, medication regimen, and treatment plan of care.
  • Patient will be able to accurately verbalize understanding of parkinsonism and its treatment regimen.
  • Patient will be able to comply with medication regimen and notify the physician if patient experiences untoward side effects.
  • Patient and/or family will be able to identify and demonstrate safety precautions to prevent injury.
  • Patient and/or family will be able to identify need for long-term goals and potential for end-of-life decisions to be made.
Nursing InterventionsRationale
Assess patient’s understanding of the disease process. Consider the older patient’s life experiences.Provides a baseline of understanding from which to establish a plan of care. New information can be used the patient’s existing knowledge base and life experience.
Educate patient and/or SO about Parkinson’s disease, signs, and symptoms, treatments and prevention of complications. Limit the length of teaching sessions and provide a quiet and productive environment for each session.Elderly patients may not be aware of old information and the stigma that was attached to PD and dementia, and will require re-education regarding current treatments. Reduction of extraneous stimuli assists with learning and the ability to process new information without distraction. Short sessions allow the patient to learn at own speed and prevent information overload.
Prepare patient for surgery as indicated.Surgical options may be required to replenish dopamine, improve dyskinesias and rigidity, or to treat disabling drug-resistant tremors.
Advise the patient to take the anti-parkinsonism drugs on schedule.The patient can adjust the schedule to produce peak effect of the drug when mobility is mostly needed.
Instruct patient and/or SO regarding medications and need for compliance with dosage, scheduling, and physician follow-up.Provides knowledge and facilitates compliance with the treatment regimen. Provides for timely identification of serious adverse effect from medication regimen to allow the physician to be notified postdischarge from the hospital.
Instruct family regarding side effects of medications and when to notify the physician.Anticholinergic drugs (diphenhydramine, trihexyphenidyl, procyclidine) can cause sedation, confusion, and urinary retention.Dopaminergic drugs (carbidopa-levodopa) can cause nausea, anorexia, confusion, psychotic disturbances, dyskinesia, and nightmares.

 

Dopamine agonists (bromocriptine) can cause nausea, vomiting, confusion, hallucination, dyskinesia, and hypotension.

MAOIs (selegiline) can cause nausea, insomnia, and confusion.

Amantadine can cause urinary retention, increased intraocular pressure, and confusion.

Provide time for questions and concerns to be voiced, and answer questions honestly. Give patient and/or family written materials to refer to later.Provide for correction of misinformation and written materials allow for documentation to assist with care once the patient is discharged.
Instruct patient and/or family regarding need for long-term planning and potential for end-of-life care decisions.Disease is chronic and the patient will eventually become severely impaired. Issues that may occur in the future (tube feedings, DNR, etc) should be discussed to enable patient and family to make informed choices while the patient is capable of understanding the severity of the condition.
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Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

Other nursing care plans related to neurological disorders:

Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.
  • 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

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