The nurse is interviewing a client with a tentative diagnosis of Parkinson disease

. 1998 May;245 Suppl 1:S19-22.

doi: 10.1007/pl00007732.

Affiliations

  • PMID: 9617718
  • DOI: 10.1007/pl00007732

Practical approach to quality of life in Parkinson's disease: the nurse's role

D G MacMahon et al. J Neurol. 1998 May.

Abstract

In recent years it has become apparent that nurses have several key roles in the treatment of Parkinson's disease. These include the practice of skilled clinical care, the provision of advice and education, communicating with patients and carers, and also between health and social care agencies. Their goals are to facilitate good clinical care, to reduce morbidity (both physical and psychological) and to achieve better informed patients by the reduction of misinformation, fear and distress caused by the diagnosis and consequences of this disease. The overall goal is to improve the prognosis and to reduce the impact of this disease on patients and their care givers. To achieve these goals the specialist nurse needs skills in assessment, reassessment and counselling in addition to knowledge of the disease and its management. The training needs have been established for the nursing profession to address these issues, and courses have been established and approved. A scale comprising four clinical management stages has been proposed: initially around the time of diagnosis; stable maintenance therapy; a more complex management stage, and palliative care. Nursing interventions and priorities differ in these arbitrary stages. Several models of nursing provision have been piloted in the United Kingdom, and results of evaluations are keenly awaited. Meanwhile, specialist nurses are proving to be popular with patients and carers, medical specialists, and the Parkinson's Disease Society which aims to see their provision in each Health District throughout the United Kingdom. In summary, the nursing role is complementary to those of the other members of the multi-disciplinary health team that aims to improve the quality of life of PD patients and their carers.

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Which clinical manifestation would the nurse expect to find when assessing a client with Parkinson disease?

Rigidity or stiffness. Lead-pipe rigidity and cogwheel stiffness are common symptoms of Parkinson's disease. Lead-pipe rigidity is a constant, unchanging stiffness when moving a body part. Cogwheel stiffness happens when you combine tremor and lead-pipe rigidity.

Which term would the nurse use to document observing the characteristic gait associated with Parkinson disease?

Another case that we would commonly identify is the gait of Parkinson's disease. It's a posture that's characterized by universal flexion. Every joint is flexed and the patient typically will take very small steps. This is called a festination gait.

How would the nurse describe the characteristic gait associated with Parkinson's?

The parkinsonian gait is characterized by shuffling of the feet, decreased arm swing on one or both sides of the body, and stooping of posture. Patients are typically unable to turn in a single step and instead break their turns into multiple small increments.

Which muscle strength rating would the nurse record for a client who can complete range of motion?

Grade 4 (Good) : This grade means the patient is able to complete the full range of motion (movement) against gravity while the practitioner applies moderate resistance.