Parkinson Disease and the Nurse Practitioner: Diagnostic and Management Challenges

Vernon, Gwyn M.

doi:10.1016/j.nurpra.2008.12.007

Cited by 6 publications

(7 citation statements)

References 66 publications

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“…Motor symptoms including tremor, bradykinesia, rigidity, and postural instability have been the focus of numerous medical studies. NMSs including sleep disturbance, pain, fatigue, behavioral and mood changes, and autonomic symptoms are less well studied (Vernon, 2009). As a result, the focus of this article is on the NMS of fatigue.…”

mentioning

confidence: 99%

Fatigue in Parkinson Disease

Bruno

Sethares

2015

Journal of Neuroscience Nursing

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Fatigue, one of the most prevalent and underassessed nonmotor symptoms in patients with Parkinson disease (PD), is reported to be a major cause of disability and reduced quality of life. The purpose of this review was to systematically examine the scientific literature and report how fatigue is defined and measured and what interventions are used to treat it. A synthesis of the current literature will expose the current state of the science of fatigue in PD, propose areas for future research, and offer practice implications. An integrative review of the literature was conducted. The electronic databases CINAHL, Psychinfo, and PUBMED were searched using the keywords "Parkinson's disease," "fatigue," "definition," "mental fatigue," "physical fatigue," "measurement," "interventions," "treatment," and "methylphenidate." One hundred fourteen articles were found. Nineteen studies met review criteria. No universal definition of fatigue in PD was found, making it difficult to measure. However, central, physical, mental, and peripheral fatigues were described. Six scales were found that measure fatigue in PD; only one specific to PD, the Parkinson Fatigue Scale, measured physical fatigue. Seven studies reported interventions to treat fatigue and were categorized as medication, exercise, and alternative interventions. None of these interventions had a significant effect on fatigue. Findings showed that (a) there is a lack of a universally accepted definition of fatigue because of its subjective nature, (b) existing fatigue measurement tools do not measure all types of fatigue in PD, and (c) no intervention had a significant effect on fatigue. There is a need to define and explore fatigue further using qualitative methods. Further development of instruments to measure fatigue in women, younger onset, and older adults with PD is needed. A focus on person-centered interventions to reduce fatigue in patients with PD is a research priority.

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confidence: 99%

Fatigue in Parkinson Disease

Bruno

Sethares

2015

Journal of Neuroscience Nursing

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“…Chorea symptoms range from fidgeting movements to uncontrolled movement of the arms and legs. Dystonic symptoms include sustained painful muscle contractions affecting the neck, trunk and limbs (Vernon, 2009). Dyskinesias can occur when levodopa and dopamine reach maximum dose concentrations in the brain, termed peak-dose dyskinesias.…”

Section: Levodopa Treatmentmentioning

confidence: 99%

“…This is important because dopamine cannot cross the blood-brain barrier. By allowing more levedopa to reach the brain COMT inhibitors can reduce 'OFF' periods (Vernon, 2009). They have wide ranging side effects that require careful monitoring by nurses (Box 2) (JFC, 2014).…”

Section: Pharmacodynamic Aspects Of Levodopamentioning

confidence: 99%

Management of levodopa for residents with Parkinson’s disease

Mages

2016

Nursing Older People

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SummaryThis article discusses the medication management of levodopa in older people who have Parkinson's and live in a nursing home setting. It provides a detailed description of the diagnostic criteria, motor and non-motor clinical features of Parkinson's disease. Against this clinical picture the benefits and challenges of levodopa medication management are considered. A person-centered approach is championed as it supports collaborative clinical assessment and decision making between nurses and residents. To fully appreciate why a person-centered approach is important to safe and effective medication practice the pharmacological basis of levodopa management is explained. An empowerment approach to medication management is advocated that facilitates self-medication by residents. To this end the importance of continuous professional development for nursing home staff is discussed.

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“…It is a multisystem and neurodegenerative disease with genetic The symptoms of PD are divided into motor and nonmotor; each of these classifications contains various other signs and symptoms related to both the neurodegenerative disease process itself as well as multifactorial causes. Thus, hierarchical organization of symptoms is not an easy task, and various descriptions have been proposed to facilitate understanding of the pathophysiology of the disease [15][16][17][18]; however, none of them have structured the symptoms into an organizational chart.…”

Section: Introductionmentioning

confidence: 99%

The Role of Nurses in Parkinson's Disease

Tosin¹,

Oliveira²

2016

Challenges in Parkinson's Disease

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Background: The complexity of motor and nonmotor symptoms in patients with Parkinson's disease (PD) requires multidisciplinary health actions. Objective: To describe the role of nurses as members of multidisciplinary teams tasked with treatment of motor and nonmotor symptoms and provide nursing protocols for the care of patients with Parkinson's disease. Methods: Analysis of the main diagnoses, outcomes, and ICNP ® interventions identified by cross-mapping empirical evidence described in 2123 nursing documents and data from medical records of patients with Parkinson's disease in the specialized rehabilitation program at the Sarah Network of Rehabilitation Hospitals in Brazil. The protocols were based on scientific evidence and international recommendations. Results: Clinical nursing protocols were developed based on a standardized nursing language of diagnoses, outcomes, and interventions focused on motor and nonmotor symptoms and principles of rehabilitation. Conclusion: These protocols are expected to guide the clinical reasoning of nurses for comprehensive care of patients with Parkinson's disease and their families.

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Parkinson Disease and the Nurse Practitioner: Diagnostic and Management Challenges

Cited by 6 publications

References 66 publications

Fatigue in Parkinson Disease

Fatigue in Parkinson Disease

Management of levodopa for residents with Parkinson’s disease

The Role of Nurses in Parkinson's Disease

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