Question

Mrs. Downs is 55 years old when she was diagnosed with PD (Parkinson’s disease). Her initial symptoms were depression, stooped posture, loss of energy, dragging leg, difficulty walking, tremors, and a loss in her arm swing. Her physician started her on Sinemet^® (levodopa-carbidopa combination). While discussing her medication history with her, you find out that she takes a B-complex multivitamin that contains B₆. She also tells you that her wife has told her to take some of her phenothiazine (an antipsychotic) since she thinks it may “lift her out of her depressed mood”.

A year has passed, and when you see Mrs. Downs again her symptoms have worsened. She is feeling muscle rigidity, fixed facial expressions, slowed movement, arm numbness, and cognitive difficulty. Her physician has changed her Sinemet^® to Stalevo^® (levodopa-carbidop-entacopone); he has also added a dopamine agonist (such as pramipexole) and an antidepressant for her mood disorders.

question :

1/ Mrs. Downs wife states, “I read somewhere that using stem cells may help to improve the condition of a person with Parkinson’s disease. Is it true?” How will you respond to Mrs. Downs wife? Explain your answer

2/ Identify one nursing problem based on the case study and create a comprehensive Teaching Plan. Your final teaching plan should only consist of one relevant objective and the objective should have an appropriate outline of teaching content, teaching methods, resources and method of evaluation.

Answer 1

1.Parkinson's disease is a progressive disease but can be well managed and controlled with the medication. The stem cell therapy use in Parkinson's disease is still in research an efficient treatment method is still not found using this.Rather stem cell therapy can be helpful to reduce the symptoms and the need for dopamine drugs in future.So far the levodopq is the drug of choice to effectively control and manage the symptoms

2.The main problem here is muscle rigidity ,this can reduce the mobility and the movement of the muscular structure resulting in rigid or fixed muscles.The main problem here is the the decrease in motor function and the objective is based on it.The patient shpujd be given the following education

• Encourage to take the medication regularly and without skipping
• Not to take over the counter medication which can interact the action of the drug
• Teach simple range of motion exercises (passive and active) to regain the muscle and motor function

The best teaching method is to explain and demonstrate the care

The patient can be evaluated on the basis of improvement of symptoms during subsequent visits.