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
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
- 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 Interventions | Rationale |
|---|---|
| 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. |
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.