1.  Define Parkinson’s disease.

Chronic, slow, progressive neurodegenerative disorder caused by loss of dopaminergic neurons in the substantia nigra of the basal ganglia characterized by tremors at rest, rigidity, bradykinesia, and postural instability.

2.  Describe the pathophysiology of Parkinson’s disease.

Role of DA producing neurons in the substantia nigra.

Imbalance of two neurotransmitters dopamine (DA) and acetylcholine (ACh).

3.  Identify the etiology of Parkinson’s disease.

Possible causative factors of PD.

Other medical conditions with Parkinson-like symptoms.

4.  State the incidence of Parkinson’s disease.

Age group most affected

Gender

5. Describe the clinical manifestations (motor and non-motor features) of Parkinson’s disease.

Primary:

Tremors

Rigidity

Akinesia/bradykinesia

Postural instability

Secondary:

Fine motor function problems

DysarthriaHypophonia

Masklike face

Fatigue and weakness

Autonomic manifestations

Cognitive impairments

Emotional lability

Sleep disturbance

6. Describe the stages of Parkinson’s disease.

Stages I-V

7.  Understand the diagnosis of Parkinson’s disease.

History and clinical findings

Rule out other disorders

Conventional diagnosis

8.  Identify health problems in patients with Parkinson’s disease.

Worsening of motor and nonmotor symptoms as the disease process progresses.

9. Describe nursing interventions used to promote adaptation in patients with Parkinson’s disease.

General principles and specific interventions

Team approach

Referrals

Education

Discharge planning

Community care and involvement

Nurse’s role

10. Understand nonpharmacological strategies to manage the signs and symptoms associated with Parkinson’s disease.

Exercise therapy

Speech therapy

Relaxation techniques

Self-care management

Balance nutrition

Strategies to prevent constipation, anxiety, pain, sleep disorders, and activities to improve cognition

Use of complementary therapies

11. Identify surgical procedures that may be implemented to alleviate the symptoms of Parkinson’s disease.

Thalamotomy

Pallidotomy

Deep brain stimulation (DBS)

Fetal-adrenal transplants

Stem cell transplants