Neurology (Medical Surgical)

• Patients with Parkinson's is at risk for falls due to postural instabilility, and Aspiration pneumonia due to dysphagia.
• Parkinson's causes lack of movement (akinesia), slow movement (bradykinesia). They have mask-like expression, drooling, and difficulty swallowing (dysphagia).
• Parkinson's disease

  A progressive neurodegenerative disease that causes muscle rigidity, akinesia, and involuntary tremor
• Parkinson's disease


  • Degeneration of dopamine-producing neurons in the substantia nigra
  • Decreased dopamine and increased acetylcholine
• Cause of Parkinson's disease is not known, but believed to be caused by genetic and environmental factors
• Symptoms of Parkinson's disease


  • Muscle rigidity
  • Tremor
  • Slow shuffling gait
  • Postural instability
  • Akinesia (lack of movement)
  • Bradykinesia (slow movement)
  • Mask-like expression
  • Drooling
  • Dysphagia (difficulty swallowing)
• TRAP


  Mnemonic for symptoms of Parkinson's disease: Tremor, Rigidity, Akinesia, Postural instability
• Cognitive changes in Parkinson's disease usually occur later with disease progression
• Treatment for Parkinson's disease


  1. Levodopa/carbidopa to increase dopamine

  2. Benztropine (anticholinergic) to decrease acetylcholine
• Nursing care for Parkinson's disease

  • Monitor swallowing and food intake
  • Thicken liquids
  • Sit patient upright
  • Tuck chin when swallowing
  • Have suction equipment nearby
  • Encourage range of motion exercises
  • Assist with ADLs
  • Implement fall precautions
• Alzheimer's disease

  A gradual, irreversible form of dementia that causes memory problems, judgment issues, and changes in personality
• Pathophysiology of Alzheimer's disease

  • Formation of beta-amyloid deposits and neurofibrillary tangles in the brain
  • Impaired communication between neurons
  • Neuron atrophy and death
• Risk factors for Alzheimer's disease

  • Older age
  • Family history
  • Cardiovascular disease
• Stages of Alzheimer's disease

  • Stage 1 (mild): Forgetfulness, short-term memory loss, mild cognitive impairment
  • Stage 2 (moderate): Disorientation, agitation, wandering, incontinence, need for assistance with ADLs
  • Stage 3 (severe): Bedridden, loss of ability to talk, move, or swallow
• Definitive diagnosis of Alzheimer's disease is not possible until after death and examination of brain tissue
• Treatment for Alzheimer's disease


  1. Pharmacological agents like donepezil to improve cognition

  2. Medications to manage symptoms like antipsychotics, antidepressants, and antianxiety drugs
• Nursing care for Alzheimer's disease


  • Maintain structured environment
  • Provide short directions and frequent reorientation
  • Avoid overstimulation
  • Use single-day calendar
  • Maintain routine toileting schedule
  • Implement home safety measures like removing scatter rugs, installing door locks, providing good lighting, marking step edges, and removing clutter
• Huntington's disease


  A progressive brain disorder that causes uncontrolled movement, emotional problems, and dementia
• Huntington's disease


  • Autosomal dominant genetic disorder
  • Causes chorea (abnormal or excessive involuntary movements)
  • Causes cognitive issues like dementia, memory loss, and poor impulse control
  • Causes psychiatric issues like depression, mania, and personality changes
• Diagnosis of Huntington's disease

  Genetic testing
• Treatment for Huntington's disease


  1. Use psychotropic agents to manage psychiatric issues

  2. Use tetrabenazine to help decrease chorea symptoms
• There is no cure for Huntington's disease or Alzheimer's disease