Question

F.P. is a 66-year-old man hospitalized for surgical management of an enlarged prostate. His chart indicates that he has had Parkinson disease for 5 years prior to admission, and has been managed with a dopamine precursor (levodopa/carbidopa). He also has a seizure history, having experienced a seizure about 20 years ago as a complication of a motor vehicle accident. He took an anticonvulsant medication for many years but stopped taking it about 3 years ago because he was “tired of taking it” and hadn’t had a seizure since the accident.

Discussion Questions

1. What types of motor difficulties would F.P. be expected to exhibit related to his Parkinson disease?

2. What is the rationale for managing Parkinson disease with a dopamine precursor? 3. What safety and activities-of-daily-living problems might F.P. have encountered while hospitalized?

4. If F.P. experiences seizure activity while in the hospital, what should be assessed during the seizure episode? How would his seizure be managed?

Answer 1

1. Motor difficulties:

Flapping tremor

Bradykinesia

Urinary problems

Constipation

Sleeping distances

Rigidity

Gait disturbances

2. Rational:

In Parkinson disease the dopamine level is reduced.

The levodopa drug helps to increase the dopamine level in the brain, it improves the control of movements.

3. Safety:

Stairs in good shape.

Have side rails.

Stable chair with adequate have rest.

Remove clutter.

Well ventilated rooms.

Rock front and back before starting any activities, it helps improve co ordination.

4. Management of seizure:

Give safe environment.

Provide sidelying positions

Clear the airway.

Oxygen administration.

Loosen the clothes.

Do not restrict seizure activities.

Psychological support.

Proper rest.

Administer anti convulsant as per doctors order.

Contionus monitor of patients.