NURS 6501 Module 5: Case Study Analysis of Parkinson's Disease

This assignment provides a detailed case study analysis of a 67-year-old male patient diagnosed with Parkinson's disease. It explores the neurological and musculoskeletal pathophysiologic processes underlying the patient's symptoms, including impaired movement, balance issues, rigidity, tremors, and autonomic nervous system dysfunction. The analysis explains how these processes interact to affect the patient's daily life, such as communication, mobility, and activities of daily living. Furthermore, it discusses the potential impact of racial and ethnic variables on the prevalence and manifestation of Parkinson's disease, referencing epidemiological studies and environmental risk factors. The assignment uses the provided case study to illustrate key concepts in disease pathophysiology and patient care.

1
NURS 6501
Student’s name:
Institutional:

2
Explain both the neurological and musculoskeletal pathophysiologic processes of why the
patient presents these symptoms.
Parkinson’s disease (PD) generally affects the neurons in the nervous system (Caviness, 2014).
This damage and neural deaths in various parts of the body leads to the development of various
related symptoms. The 67-year-old male patient is experiencing such symptom as impaired
movement and balanced. This is as a result of the loss of dopamine-producing neurons found in
the substantia nigra pars compacta (Gröger, Kolb, Schäfer, & Klose, 2014). The patient required
help to rise from bed, had uneven gait and even shuffles when he walks with the head/neck, hips,
and knees flexed forward. The patient portrayed a cogwheeling or jerky movement. The cells
that control movement would not send proper messages to the muscles due to lack of dopamine;
hence the patient demonstrates tremors in the hands at rest and fingers exhibit "pill-rolling"
movement.
Moreover, he experienced episodes of sweating and flushing not associated with an activity. This
is as a result of damage by of the autonomic nervous system which controls such functions. The
musculoskeletal processes are also affected by the PD since it causes rigidity. Rigidity in PD
alters the flexor and extensor muscles can interfere with movement (Takakusaki, 2017). This
explains the stiffness experienced by the patient and also the immobile mask-like face.
Explain how the highlighted processes interact to affect the patient.
These processes, therefore, interact to affect the patient in various ways. For example, the
rigidity can alter communication since the masked face appearance will make others unsure of
the emotional reaction that the patient exhibit during communication (Bantjes, 2017). The patient
will therefore find hard communicating even with the spouse. This may cause unstable

3
relationship and affect the patient more. Together with neurological damage, rigidity also affects
movement. This affects the patient’s life since walking and turning would be difficult and unsafe.
For example, in the case scenario the patient remains stiff, and also has unbalanced movements.
Moreover, eating and rising from a chair as exhibited by the patient in the case study would be
hard for the patient. Overall, the patient would find a rough time while performing the activities
of daily living which include communication, eating and drinking, bathing and toileting, and
walking.
Explain any racial/ethnic variables that may impact physiological functioning.
According to the largest epidemiological study of Parkinson’s disease in the United States, the
disease is more prevalent in the Northsea and the Midwest and strikes the whites and Hispanics
twice as compared to blacks and Asians (Elbaz, Carcaillon, Kab, & Moisan, 2016). The most
likely reason for the effect in the two regions is environmental risk factors since they are
involved in agriculture and metal processing and the chemicals used in the process. It is also
thought that the African or Asian ancestry exhibit genes that protect them from the
environmental risk factors or that they may be experiencing fewer exposure to the risk factors.
This is because the environment is not polluted by the chemicals as much as it will be for the
regions involved in the agriculture and metal processing. They may get exposed directly or
indirectly through the air they breath and the products that they consume, hence impacting on the
physiological functions.

4
References
Elbaz, A., Carcaillon, L., Kab, S., & Moisan, F. (2016). Epidemiology of Parkinson's
disease. Revue neurologique, 172(1), 14-26.
Bantjes, C. (2017). The experience of people living with Parkinson's disease (Doctoral
dissertation, University of Pretoria).
Caviness, J. N. (2014). Pathophysiology of Parkinson's disease behavior–a view from the
network. Parkinsonism & related disorders, 20, S39-S43.
Gröger, A., Kolb, R., Schäfer, R., & Klose, U. (2014). Dopamine reduction in the substantia
nigra of Parkinson's disease patients confirmed by in vivo magnetic resonance
spectroscopic imaging. PloS one, 9(1).
Takakusaki, K. (2017). Functional neuroanatomy for posture and gait control. Journal of
movement disorders, 10(1), 1.