Hi, welcome to our neurological series.
In this video, we're going to take a look
at Parkinson's disease,
and what the health care team does
to work together collaboratively
to help them have the best,
most effective and safe care.
is a progressive nervous system disorder.
Don't miss that word "progressive."
Sadly, these symptoms develop,
the patient gets treatment.
But, eventually, this disease progresses
with these nervous system problems,
so it affects the patient's ability
to control movement.
It also affects a lot of other areas.
But as a first step,
let's just have that laid down.
Parkinson's affects a person's ability
to control movement.
It can also impact how a person feels,
how they think,
how they sleep,
and how they speak or talk.
So, Parkinson's disease is progressive.
It does affect a person's ability
to control movement
that involves walking,
all the activities of daily living,
but it also affects
their emotional feelings,
thinking, sleeping, and talking,
because Parkinson's is an imbalance.
We've got a picture for you there
of the brain.
We've got a scale.
It's helping you see that
there is an imbalance in movement,
it comes from an imbalance
in dopamine and acetylcholine.
So because we have
this imbalance in the brain
that ends up being an imbalance
in the patient's ability
to control their movement.
So, we've got not enough dopamine
and too much acetylcholine.
That's the state of the imbalance
in a patient's brain
with Parkinson's disease.
Now, sadly, there's no cure.
We just have medications
that treat the symptoms.
And one of the most difficult things
is eventually the effectiveness
of these medications wears off.
So, initially, it will have
a really good response,
but sometimes as short
as three to five years,
the patient has returned
to the level before medication.
So, what's our goal?
Let's talk about some good news.
What are the things
we can do for our patient?
Well, number one, we want
to maintain functional mobility
and activities of daily living
as long as possible.
Everyone wants to be
as independent as possible.
And that's our goal
as a health care team,
help them remain functional
in their daily life.
We want to improve
the quality of their life
by helping them maintain
their functional mobility.
And so we're going to look
to some medications.
Now, these medications work
in one of two ways.
They can help us either increase
the dopamine that's available
or we can decrease the action
of the acetylcholine.
So, that's how we're gonna look
to rebalance those scales,
are we gonna make
more dopamine available,
or we're going to block the action
of acetylcholine in the brain.
Now, if you're thinking about,
"Hey, what are some possible
Now, stay with us.
I know sometimes it's really difficult
to deal with nursing diagnoses
because you start thinking
about care plans and grading.
But let's think of this
from the patient's perspective.
What are the things
they're going to be most on their mind?
So, how can we help them
solve these problems?
Well, we know that Parkinson's
gives the patients
difficulty with mobility.
That's because they become really rigid.
They tend to walk
really slow movements.
Bradykinesia, slow movement.
Akinesia, they can't make themselves move.
They also have postural instability.
Okay, so we know they're not going to be
as safe and as effective
at moving as they used to be.
They're stiff, they're slow,
and they're not really stable
on their feet.
So, we are going to watch them.
They're definitely at a risk for falls.
They might also have
because in the neuromuscular impairment.
So, they might even have a decreased
or absent gag reflex.
Well, that gag reflex
is what protects my airway
from getting yucky
that are not supposed to be in my lungs,
in my lungs.
So, you're always on the lookout.
Patient with Parkinson's disease
might struggle with that gag reflex,
might be decreased,
not as effective,
or completely absent in severe cases.
So, swallowing is something
that you consistently have to evaluate
with a Parkinson's patient.
Now, they can also have difficulty
with verbal communications
because the have a hard time
controlling the muscles of speech.
If you think about it,
it's pretty complicated.
You use your tongue
to formulate sounds into words
much more than we realize.
Until you go to the dentist
and they numb your tongue,
then you have a pretty good idea
of how important your tongue is.
So, other problems
related to communication
include tremors and bradykinesia.
So, Parkinson's is a cruel disease.
It attacks every aspect
of a patient's life.
So, they can't control their movements.
We want to make sure
you're familiar with that term.
D-Y-S means difficult,
kinesias means movement.
And there's also non-motor symptoms.
So, when I'm thinking
of a Parkinson's patient,
I know it's imbalance of two things:
acetylcholine and dopamine
with not enough dopamine,
and the patient is going to have
difficulty controlling movements,
and there's also non-motor symptoms.
So, there's two categories
of the imbalance:
acetylcholine and dopamine.
And there's also two categories
and there's non-motor symptoms.