Care for a Parkinson’s Disease Patient

CLINICAL CASE REPORT 1
Care for a Parkinson’s Disease Patient
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CLINICAL CASE REPORT 2
Care of a Parkinson’s Disease Patient
Introduction
My report involves Jessica, a 79-year-old woman who lives in South Australia’s rural
area. She lives with her husband, Frank who is 60 years old. She has been admitted to my ward
at the Crystal Brook for respite care and was diagnosed with Parkinson’s disease 15 years ago.
Her mother had the same ailment and died of pneumonia aged 80 years. She takes Sinemet CR
tablets every four hours and a daily dose of Pramipexole 1.5 mg to control her PD symptoms.
Her husband is the primary caregiver. The purpose of this report is to act as the tool to plan and
evaluate care to the patient (Cereda et al. 2011, p. 2620). The record will act as the means to
communicate in detail to other parties who may be involved in rendering care to the patient. The
report includes the primary admission diagnosis where the client’s pathophysiology is described
in detail. The report also has the nursing problems sections where the manifestations and
pathophysiology presented in the admission section are applied to identify the nursing problems
that arise. The final section is the nursing management where the above nursing problems are
addressed. The nursing assessment, interventions and the role of the registered nurse involved in
this medication are also stated.
The Primary Admission Diagnosis
Mrs. Jessica George has a tremor in her upper limbs. It was also noted that her face
looked mask-like and she spoke in a hoarse voice which was also monotonous rather than the
normal inflections. The patient also has a drag in her left foot. This is because the muscles are
rigid and happen to limit her motion range. The patient also displays slowed movement also
known as bradykinesia. This makes even the tasks which were simple seem difficult and

CLINICAL CASE REPORT 3
consume a lot of time. For example, the walking steps are shorter and it may be difficult to get
out from a sitting position. She also has impaired posture and body balance. Even though she
could walk without any aid, her balance appears unstable. She had recently fallen while at home
and sustained a bruise and a skin tear in her lateral lower leg. She complains of a lack of appetite
and constipation. She also starts coughing whenever she takes a drink of water. She is very
anxious. This shows that she has emotional complications which may result in even depressions.
She is also very particular in timely medications and she believes that the effectiveness of
levodopa therapy starts to diminish after a period of four hours. She states that she has a little
good time due to her immobility and her need for assistance in all the activities of daily living.
This shows that she is sad and lacks motivation and thinks of her life like the one that purely
relies on the medication that she gets (Hirsch and Hunot 2009, p. 397). She also displays a state
of excessive and uncontrolled movements in the times that the medication is in effect. Her limb
Nursing Problems
The nursing problems that I noticed include impaired physical mobility. From the
diagnosis, it was clear that Jessica had difficulties in movements, which in most cases was very
slow. There was also some weakness in the lower limbs which are attributable to the recent
accidental fall while she was at home. Her unstable balance made her unable to bear much
weight. She was also mostly immobile where she only stays in one place as even rising up from
her seat is difficult. It is also clear that she has balance and muscle coordination deficits that
further hinder movement. She clearly states of her desire to move from one place to another and
do her daily activities all on her own. She says that she has a little good time due to her
immobility and uncontrolled movement at the time the medication is in effect. This muscle
rigidity also affects her capability to do such small tasks. This is because movement in a human

CLINICAL CASE REPORT 4
is solely attributed to the flexibility of the joints and muscles (Tomlinson et al., 2010, p. 2600).
The PD also affects her body balance. This brings an injury risk due to the accidental falls. The
tremors and loss of body postural adjustment cause these accidents. It can also be related to poor
judgment where the strides are poorly estimated in line with the coordination capability of the
limbs. The patient is therefore forced to remain at a sitting position most of the time (Soldner et
al. 2009, p. 970).
The other problem that I noted is the disturbed thought process. Mrs. Jessica experiences
a disruption in the cognitive operations. The patient has had some lifestyle since the disease
struck. She is reported to be very anxious of late. She entirely believes in effectivity of the
medical attention that she receives. She is also unable to conduct the normal daily activities on
her own to the point that she has to rely on her caregiver (Deuschl et al 2009, p. 899). She is at
times sorrowful and in some cases. She laments that of late her good times are reduced due to her
inability to move. She is reported to be very alert in some cases.
Nursing Management
As the registered nurse in charge of Jessica, my role is to intervene while looking out for
any possible depressive behaviors. After discharge, there are regular visits to the hospital where
she meets the nurse. Considering the possibility of thought complications my role patient to the
reality. The patient ought to be made aware of her own self as well as the surroundings because
the ailment greatly drains their memory and level of judgment (Rayner et al 2011, p. 25). The
nurse is also expected not to have a judgmental attitude towards the patient and also pay attention
to her feelings. I’m supposed to establish a trustworthy relationship with the patient. She can
discuss topics that will help the patient deal with her concerns in most appropriate ways. Most of
the time the PD patients feel embarrassed, lonely and bored. This is brought about by their