hesi case study parkinson's disease

3 min read 11-03-2025

Meta Description: Dive into a comprehensive analysis of a HESI case study focusing on Parkinson's Disease. This guide covers symptoms, diagnosis, treatment, nursing interventions, and potential complications, equipping you with the knowledge to excel in your studies. Learn about medication management, patient safety, and effective communication strategies for optimal patient care. Prepare for your HESI exam with confidence!

Understanding Parkinson's Disease

Parkinson's disease is a progressive neurological disorder affecting movement. It's characterized by the degeneration of dopamine-producing neurons in the brain. This dopamine deficiency leads to the hallmark motor symptoms. Early diagnosis and management are crucial for improving quality of life.

Key Symptoms of Parkinson's Disease

The classic triad of Parkinson's includes:

Tremor: Often begins in one hand, a resting tremor that worsens with stress but improves with movement.
Rigidity: Stiffness and resistance to passive movement in the limbs and trunk.
Bradykinesia: Slowness of movement, impacting activities of daily living (ADLs).

Other common symptoms can include:

Postural instability: Difficulty maintaining balance and coordination, increasing fall risk.
Gait disturbances: Shuffling gait, festination (short, rapid steps).
Masked facies: A blank, expressionless face.
Dysphagia: Difficulty swallowing.
Drooling: Due to impaired swallowing reflexes.
Cognitive changes: Dementia can develop in later stages.
Depression and anxiety: Commonly associated with the disease's impact on life.

HESI Case Study: A Sample Scenario

Let's consider a hypothetical HESI case study featuring a patient, Mr. Jones, diagnosed with Parkinson's disease. He presents with significant bradykinesia, rigidity, and a noticeable tremor in his right hand. He's experiencing difficulty with dressing and eating. He's also exhibiting signs of depression and reports fatigue.

Nursing Assessment and Diagnosis

A thorough nursing assessment is crucial. This includes:

Physical assessment: Evaluating motor skills, gait, balance, and overall physical status. Note any contractures or muscle weakness.
Cognitive assessment: Assessing mental status, memory, and cognitive function.
Medication review: Identifying current medications and potential drug interactions.
Nutritional assessment: Evaluating dietary intake and swallowing abilities.
Psychosocial assessment: Assessing mood, coping mechanisms, and support systems.

Based on the assessment, key nursing diagnoses might include:

Impaired physical mobility related to bradykinesia and rigidity.
Risk for falls related to postural instability and gait disturbances.
Imbalanced nutrition: less than body requirements related to dysphagia and decreased appetite.
Ineffective coping related to chronic illness and its impact on daily life.
Risk for injury related to falls and impaired coordination.

Treatment and Management of Parkinson's Disease

Treatment focuses on managing symptoms and slowing disease progression. This typically involves:

Medication: Levodopa is a cornerstone medication, often combined with carbidopa to reduce side effects. Other medications may target specific symptoms like tremor or rigidity.
Physical therapy: Improves mobility, strength, and balance, reducing fall risk.
Occupational therapy: Helps adapt ADLs to compensate for physical limitations.
Speech therapy: Addresses swallowing difficulties and communication challenges.
Deep brain stimulation (DBS): A surgical option for advanced cases, involving implanted electrodes to stimulate specific brain regions.

Medication Management: A Crucial Aspect

Understanding the medications prescribed for Parkinson's is vital. This includes:

Knowing the mechanism of action: How each medication works to alleviate symptoms.
Monitoring for side effects: Levodopa can cause dyskinesia (involuntary movements). Other side effects include nausea, vomiting, orthostatic hypotension.
Educating the patient and family: On medication administration, potential side effects, and the importance of adherence.

Nursing Interventions in Parkinson's Disease

Nursing interventions should focus on:

Promoting mobility and safety: Assisting with ambulation, using assistive devices as needed. Creating a safe environment to prevent falls.
Improving nutrition: Modifying diet to improve swallowing, providing thickened liquids if necessary. Monitoring weight and nutritional status.
Enhancing communication: Using clear and concise communication, providing ample time for responses.
Supporting emotional well-being: Providing emotional support, encouraging participation in social activities.
Patient and family education: Educating about the disease, its progression, and management strategies.

Addressing Specific Challenges: Dysphagia

Dysphagia, or difficulty swallowing, requires special attention. Interventions include:

Dietary modifications: Thickened liquids, pureed foods.
Positioning: Upright posture during meals.
Swallowing techniques: Specific exercises and strategies to improve swallowing function.
Collaboration with speech therapist: For comprehensive evaluation and management.

Potential Complications of Parkinson's Disease

Several complications can arise, including:

Falls: Leading to injuries and fractures.
Pneumonia: Due to aspiration and impaired cough reflex.
Urinary tract infections: Due to immobility and changes in bladder function.
Depression and anxiety: Significantly impacting quality of life.
Dementia: Cognitive decline in later stages.

Conclusion: Preparing for the HESI Exam

Mastering the HESI case study on Parkinson's disease requires a thorough understanding of the disease's pathophysiology, symptoms, treatment, and nursing implications. By applying the principles discussed above, you'll be well-equipped to analyze case studies, identify key issues, and formulate appropriate nursing interventions. Remember to prioritize patient safety, effective communication, and a holistic approach to care. Good luck with your HESI exam!