parkinson's hesi case study

3 min read 10-03-2025

Introduction:

Parkinson's disease is a progressive neurodegenerative disorder affecting millions worldwide. This article analyzes a hypothetical HESI case study focusing on a patient with Parkinson's, exploring the disease's symptoms, complications, and nursing management. Understanding Parkinson's is crucial for healthcare professionals to provide optimal patient care. This case study will highlight key assessment findings, nursing diagnoses, and interventions.

Case Presentation: A 72-Year-Old Male with Parkinson's Disease

Patient History:

A 72-year-old male presents with a history of Parkinson's disease diagnosed three years prior. He reports increasing difficulty with ambulation, tremors in his right hand, and rigidity. His speech has become softer and less clear. He lives at home with his wife, who is his primary caregiver. He has a history of hypertension, well-controlled with medication.

Assessment Findings:

Neurological: Bradykinesia (slow movement), resting tremor in the right hand, rigidity in the upper extremities, masked facies (expressionless face), postural instability.
Musculoskeletal: Muscle stiffness, limited range of motion in the joints, decreased gait speed and balance.
Gastrointestinal: Constipation reported due to decreased mobility and medication side effects.
Psychosocial: Expresses frustration and anxiety about his declining abilities. Wife reports increasing caregiver burden.

Subjective Data:

Patient states, "I'm just so tired all the time. Even simple tasks take so much effort."
Wife reports, "He's fallen a few times recently. I'm worried about him."

Nursing Diagnoses: Prioritizing Patient Needs

Based on the assessment, several nursing diagnoses are formulated:

Impaired Physical Mobility related to muscle rigidity, bradykinesia, and postural instability. This is a high-priority diagnosis due to the risk of falls and injury.
Risk for Falls related to impaired balance and gait. Falls are a major concern in Parkinson's disease, leading to fractures and other complications.
Constipation related to decreased mobility and medication side effects. This impacts overall health and well-being.
Ineffective Coping related to the chronic and progressive nature of the disease. The patient's emotional state is important to address.
Caregiver Role Strain related to the increasing demands of caring for a spouse with Parkinson's disease. Supporting the caregiver is vital.

Nursing Interventions: A Multifaceted Approach

Effective nursing interventions address the identified nursing diagnoses:

Improving Mobility and Preventing Falls:

Implement fall prevention measures: Assistive devices (cane, walker), environmental modifications (removing tripping hazards), supervision during ambulation.
Encourage regular exercise: Physical therapy to improve strength, balance, and coordination. Specific exercises targeting Parkinson's symptoms are crucial. This includes techniques like Tai Chi.
Medication management: Administer prescribed medications (e.g., levodopa, dopamine agonists) as ordered, monitoring for side effects.
Promote safe transfers: Teach the patient and caregiver proper transfer techniques to minimize risk of falls.

Addressing Constipation:

Increase fluid intake: Encourage adequate hydration throughout the day.
Dietary modifications: Increase fiber intake through fruits, vegetables, and whole grains.
Promote regular bowel movements: Establish a regular toileting schedule. Consider stool softeners as prescribed.

Supporting Emotional Well-being:

Provide emotional support: Encourage the patient to express his feelings and concerns.
Refer to support groups: Connect the patient and caregiver with resources to help cope with the challenges of Parkinson's.
Cognitive Behavioral Therapy (CBT): May help with coping mechanisms for anxiety and depression.

Caregiver Support:

Educate the caregiver: Provide information about Parkinson's disease, symptom management, and available resources.
Respite care: Suggest respite care options to allow the caregiver some time off.
Support groups for caregivers: Connect the caregiver with other caregivers facing similar challenges.

Evaluating Outcomes: Measuring Success

The effectiveness of nursing interventions is evaluated through:

Improved mobility and reduced risk of falls: Observed through gait analysis, balance assessments, and fall incidence.
Regular bowel movements: Monitoring bowel patterns.
Improved coping mechanisms: Assessed through patient self-reports, mood scales, and observation of behavior.
Reduced caregiver burden: Evaluated through caregiver self-reports and observation of caregiver stress levels.

Conclusion: A Holistic Approach to Care

Managing Parkinson's disease requires a comprehensive and holistic approach. This case study demonstrates the importance of thorough assessment, accurate nursing diagnoses, and individualized interventions to improve the patient's quality of life and support the caregiver. Ongoing monitoring and evaluation are crucial for adapting the care plan as the disease progresses. Collaboration between healthcare professionals, the patient, and the caregiver is essential for optimal outcomes. Further research and ongoing advancements in Parkinson's treatment continue to offer hope for improved management and future therapies.