Mnutt_Parkinson'sdiseaseproject_030919.docx - Running head PARKINSON\u2019S DISEASE 1 Parkinson\u2019s Disease Michelle Nutt Rasmussen College Author Note

Mnutt_Parkinson'sdiseaseproject_030919.docx - Running head...

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Running head: PARKINSON’S DISEASE1Parkinson’s DiseaseMichelle NuttRasmussen CollegeAuthor NoteThis paper is being submitted on March 10, 2019, for Professor Shijuan McKinney’sNUR3205 Applied Pathophysiology class.
PARKINSON’S DISEASE2Parkinson’s DiseaseI chose Parkinson’s disease to research for my course project. Until recently, I have worked as a hospice nurse and have had a couple of patients with Parkinson’s disease. I never fully understood this disease except, the fact it seemed to affect my patient’s differently. Some progressed quicker, needing total care and some were able to function independently. I think a better understanding of this disease will help me to provide better nursing care to my patients. Knowing what to look for in terms of decline and disease progression will help me to provide appropriate symptom management and advanced care for my patients.Neurological disorders are now the leading source of disability globally, and the fastest growing neurological disorder in the world is Parkinson’s disease (Dorsey, Sherer, Okun, & Bloem, 2018). Parkinson’s disease was first described by Dr. James Parkinson in 1817 as a “shaking palsy” (DeMaagd & Philip, 2015). Parkinson’s disease is a complex, chronic, and progressive neurodegenerative disease. It is characterized by both motor and nonmotor features affecting sensory, emotional, cognitive, and autonomic functions (Homayoun, 2018). This disease has significant clinical impact on patient’s, families, and caregivers through its progressive degenerative effects on mobility and muscle control. Common related disease includes: Parkinsonism, Dementia, and Alzheimer’s disease.Pathogenesis of Parkinson’s DiseaseParkinson’s disease is a disorder of the extrapyramidal system, which includes motor structures of the basal ganglia, and is characterized by the loss of dopaminergic function and consequent diminished motor function, leading to clinical features of the disease (DeMaagd & Philip, 2015). The hallmark pathologic features of Parkinson’s disease are loss of dopaminergic pigmented neurons in the substantia nigra pars compacta with dopaminergic deficiency in the
PARKINSON’S DISEASE3putamen portion of the striatum (McCance & Huether, 2014). Dopamine loss in other brain areasincluding the brain stem, thalamus, and cortex also occurs. Typically, patients experience the motor features of Parkinson’s disease only after 50% to 80% of the dopaminergic neurons have been lost, suggesting the involvement of a compensatory mechanism in the early stages of the disease (DeMaagd & Philip, 2015).Degeneration of the dopaminergic nigrostriatal pathway to the basal ganglia results in underactivity of the direct motor pathway (normally facilitates movement) and overactivity of the indirect motor loop (normally inhibits movement). This results inhibition of the motor cortex manifested with bradykinesia and rigidity (McCance & Huether, 2014). The subthalamic nucleusoveractivity also influences the limbic system, accounting for emotional signs and symptoms.

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