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This terminology allows development of terminological subsets of diagnoses, outcomes, and interventions targeted to specific areas of clinical nursing practice.
The role of nurses in Parkinson's disease Research has shown increasing specialization among nurses who care for patients with PD [ 11 — 13 ]; thus, knowledge of the pathophysiology of this disease is arguably an important starting point for vocational training [ 14 ]. Classification of the main motor and nonmotor symptoms in Parkinson's disease. The symptoms of PD are divided into motor and nonmotor; each of these classifications contains various other signs and symptoms related to both the neurodegenerative disease process itself as well as multifactorial causes.
Thus, hierarchical organization of symptoms is not an easy task, and various descriptions have been proposed to facilitate understanding of the pathophysiology of the disease [ 15 — 18 ]; however, none of them have structured the symptoms into an organizational chart.
Our research on nursing diagnoses, outcomes, and interventions was based on this chart. From these documents, empirical evidence regarding nursing diagnoses, outcomes, and interventions was extracted.
Greater variability was observed in nursing diagnoses, outcomes, and interventions related to nonmotor symptoms of Parkinson's disease; in general, it appears that nurses work in a comprehensive and communicative manner with other professionals on multidisciplinary teams. These symptoms were described in in a monograph by James Parkinson and are currently considered the cardinal signs for clinical diagnosis of the disease [ 20 ]. It is characterized by involuntary tremors of the hands, lips, and jaw 4—6 Hz in intensity.
They occur at rest but may worsen in stressful situations or while walking and stopping when actions are performed by the affected limb [ 21 ]. This is a broad term that can be considered a syndrome that encompasses several specific terms corresponding to this diagnosis.
Muscle rigidity is characterized by disharmony of the flexor and extensor muscles, compromising joint mobility by making them rigid. Its prevalence in this population ranges from 10 to Bradykinesia is defined as difficulty and slowness in initiating movement.
Decreased arm balance occurs asymmetrically in the early stages of PD [ 3 ]. Hypomimia is defined as the reduction of voluntary orofacial movements that result in reduced facial expression in patients with PD.
These symptoms may be related to bradykinesia [ 3 ], as well as other cognitive disorders that impair emotional recognition of facial expression [ 23 ]. It is characterized by deficits in vocalization related to the variation in the height and intensity during speech [ 24 — 26 ]. Risk for fall Postural instability is related to the loss of postural reflexes, which occurs in the later stages of PD.
Instability is measured by retropulsion or propulsion tests. Postural instability is defined as more than two steps backward or forward, or when there is an absence of postural response. This symptom is the most common cause of falls and contributes significantly to the risk of fractures [ 17 ]. The role of the family, both to encourage maximum independence in the patient's activities of daily living and to provide compensatory care for the deficits, is not an easy task.
Thus, identification of these diagnoses is considered the starting point of the rehabilitation program. Nursing diagnoses and outcomes related to nonmotor symptoms The hierarchical organization of nonmotor symptoms includes disautonomic urogenital, gastrointestinal, cardiovascular, and thermoregulation , sleep, neurobehavioral mood, cognition, and psychiatric , sensory, and other subdivisions.
Impotence Sexual dysfunctions are the result of neurodegeneration and include difficulty with erection, loss of libido, and lack of orgasm. However, patients may also experience the opposite symptoms, mainly related to dopamine agonist therapy, which are characterized by obsessions or compulsions related to sex [ 15 , 16 ]. In PD, degenerative impairment of the vagus nerve, which is responsible for nervous control of the esophagus, stomach, and intestine via the parasympathetic and spinal cord system, causes dysfunction of the motility of the entire gastrointestinal tract, resulting in the following symptoms: oropharyngeal dysphagia impaired swallowing , gastric stasis, constipation or slow motility constipation , and sphincter dyssynergism and drooling abnormal salivation related to the decrease or absence of the swallowing reflex, which leads to the accumulation of saliva in the mouth [ 29 , 30 ].
A review study also revealed that drooling may be related to both increased saliva production and slowed orofacial movements [ 31 ].In his time he had to go to war well that what he told me. A psychosis with delusions and associated delirium is a recognized complication of anti-Parkinson drug treatment and may also be caused by urinary tract infections as frequently occurs in the fragile elderly , but drugs and infection are not the only factors, and underlying brain pathology or changes in neurotransmitters or their receptors e. Arch Biochem Biophys ; — The health departments of respective counties will be contacted; meetings will be arranged in seeking their advice to plan a community screening operation of Parkinson disease patients. Progressive Supranuclear Palsy. Lycopersicon esculentum L.
Arch Neurol. The protective effect is exerted by its antioxidant reducing and antiapoptotic abilities
London: Pitman Medical; This symptom may be subtle in early PD and does not necessarily worsen with disease progression [ 15 , 16 ]. EGb protects against nigrostriatal dopaminergic neurotoxicity in 1-methylphenyl-1,2,3,6-tetrahydropyridine-induced Parkinsonism in mice: role of oxidative stress.
For this reason, strict adherence to the medication plan is warranted to control the symptoms from getting worse.
Scientific basis for the therapeutic use of Withania somnifera ashwagandha : a review. Moreover, oligosaccharide derivatives of PRE act against clinical depression by binding to norepinephrine transporter proteins