Question

Neurology Case Study

George is a 74-year-old male with a diagnosis of Parkinson’s disease for more than 10 years. His primary caregiver is his wife of 52 years, who is in good health except for rheumatoid arthritis. The couple’s grown sons live in another state but visit the family once a year during the Christmas holiday. Recently Mr. R. has experienced a greater degree of twitching in his arms. He slurs his speech and is difficult to understand at times. He and his wife had enjoyed a wide range of activities such as bowling, going to the movies, and trying new restaurants. However, since his condition has deteriorated they rarely leave the house. Mr. R. has also experienced difficulty walking and getting up from the bed or chair. His wife must assist him in all activities of daily living.

What abnormalities would you expect to find on his neurological evaluation?

Formulate health promotion topics, risks, and nursing diagnoses for George and his wife.

Answer 1

Upon neurological examination the abnormalities found in the patient are

• Slurred speech
• Initial memory loss
• Twitching of the muscles

This is because of the severe stage 5 were patients have difficulty in getting out of bed or chair .They are severely progressed needing assistance in daily activities due to degeneration of the brain cells.

The health promotion topic needed for this patient are

• Range of motion exercises ( active and passive exercise to improve muscle function)
• Speech therapy to enable him to talk
• Cognitive therapy to enhance the memory function
• Physical therapy to delay progression of motor abnormalities
• Medication and Diet

Risks

• Risk of impaired motility
• Injury can occur
• Pressure ulcer

Nursing diagnosis

• Impaired mobility related to degenerative disease as evidenced by reduced motility
• Impaired communication related to disease condition as evidenced by slurred speech
• Impaired cognittion related to degeneration as evidenced by loss of memory