Parkinson disease (PD), also referred to as Parkinson’s disease and paralysis agitans, is a progressive neurodegenerative disease that is the third most common neurologic disorder of older adults. It is a debilitating disease affecting motor ability and is characterized by four cardinal symptoms: tremor rigidity, bradykinesia or kinesis (slow movement/no movement), and postural instability. Most people have primary, or idiopathic, disease. A few patients have secondary parkinsonian symptoms from conditions such as brain tumors and certain anti-psychotic drugs.
The path physiology of Parkinson’s disease is the pathogenesis if Parkinson disease is unknown. Epidemiologic data suggest genetic, viral, and environmental toxins as possible causes. Nigral and basal loss of neurons with depletion of dopamine, an inhibitory neurotransmitter, is the principal biochemical alteration in Parkinson disease. Symptoms in basal ganglia disorders result from an imbalance of dopaminergic (inhibitory) and cholinergic (excitatory) activity in the caudate and putamen of the basal ganglia.
Parkinson disease begins after the age of 40 years, with peak age of onset between 58 and 62 years. It is slightly more prevalent in males. This disease is one of the most prevalent of the primary CNS disorders and a leading cause of neurologic disability in individuals older than 60 years. The prevalence rate is 107 to 187 per 100,000 persons, with 40,000 new cases in the United States each year.
PD is separated into stages according to the symptoms and degree of disability Stage 1 is mild disease with unilateral limb involvement. Whereas the patient with stage 5 disease is completely dependent in all ADLs. Other classification refer simply to mild, moderate, and severe disease. The classic manifestation of Parkinson disease are tremor at rest (resting tremor), rigidity ( muscle stiffness), bradykinesia/kinesis (poverty of movement), postural disturbance, dysarthria, and dysphasia. They may develop alone or in combination, but as the disease progresses, all are usually present. There is no true paralysis. The symptoms are always bilateral but usually involve one side early in the illness. Because the onset is insidious, the beginning of symptoms is difficult to document. Early in the disease, reflex status, sensory status, and mental status usually are normal. Postural abnormalities (flexed, forward leaning), difficulty walking, and weakness develop. Speech may be slurred. Autonomic-neuroendocrine symptoms include inappropriate diaphoresis, orthostatic hypotension, drooling, gastric retention, constipation, and urinary retention. Depression is also prevalent.
Client is a person who requires medical care. The client’s family is whoever the client say who his or her family is. Client’s rights, which a client is entitled to receive service from his/her regular physician unless he/she has been advised that the client/doctor relationship has been terminated, that is assuming that the...