5. Diagnosis
The doctor may diagnose a person with PD if signs are present. The person may not show all signs but an experienced doctor may diagnose if a person has PD if they show at least 2 signs. These are:
- Shaking or tremors
- The slowness of movement( bradykinesia)
- Stiffness or rigidity of trunk legs and arms
- Having trouble with their balance may result to fall (postural instability)
6. Treatment
Medications
- Prescription medications
- Levodopa
- Dopamine Agonists
- Amantadine
- Adenosine A2a antagonists
- COMT inhibitors
- Anticholinergic drugs
- MAO-B inhibitors
There are medicines that may react to other medications once taken. It is advised to inform the person’s doctor about the medications that they take such as levodopa.
Surgical therapy
- Deep brain stimulation (DBS): used to treat PD tremors and other advanced PD symptoms. This is a treatment option for patients with PD for four years that can’t be controlled with medications. Doctors that perform surgery may insert electrodes.
- Duopa: this is a drug therapy that requires surgery on the stomach. The surgeon will make a hole in the stomach so that Duopa can be administered. Duopa is a combination of carbidopa and levodopa. This is in a gel form otherwise called enteral suspension.
Other Surgical Options
- Focused ultrasound: non-invasive since the doctor doesn’t need to cut the person open. All that is needed is the MRI or magnetic resonance imaging. The energy that it releases forms heat. This then destroys a specific area in the brain causing tremors.
- Thalamotomy: this is a brain surgery where part of the thalamus is removed. This is performed to lessen the tremors but can cause some problems in speech and cognition in the future.
- Pallidotomy: a small part of the globus pallidus in the brain is taken. This part controls movement. But doctors rarely perform this surgery.
Other Treatment Options
- Physical therapy
- Occupational therapy
- Lifestyle modification
- Rest and exercise
7. Nursing Intervention
- Assess the patient’s energy and endurance. Take note of the respiratory status such as the depth, ease of breathing, and respiratory rate.
- Check for unusual lung sounds that show difficulty of breathing. Lung sounds such as crackles, wheezing and rhonchi are signs of breathing problems.
- Give oxygen to the patient as advised. Check oxygen levels through a pulse oximeter.
- Turn patient every 2 hours as ordered.
- Inform the patient how beneficial exercise and rest are.
- Ensure patient’s safety while performing postural drainage.
- Assess the patient if there are signs of depression.
- Encourage patients to verbalize their own feelings and pain.
- Check the patient’s medication schedule. Some medicines taken may affect mood such as levodopa.
Pages: Page 1 Page 2
