Friday, June 22, 2012

Nursing Diagnosis for Parkinson's Disease - Diagnosa Keperawatan Parkinson

Nursing Diagnosis for Parkinson's Disease


Parkinson's disease is a common disorder that arises due to some imperfection that amends the normal functioning of the central nervous system. The disease results in the loss of the neurons or nerve cells that contain dopamine in the substantia niera, the part of the brain that controls movement.

Parkinson's disease (Paralysis agitans) as described by James Parkinson in 1817 is characterized by degeneration of central nervous tissues, affecting the motor skills of a person, thereby impairing his (rarely her) movements and speech.

The causes of the disease have not been proven, the following factors increase the risk of Parkinson's;
  • Age
  • Male
  • Genetic link to a sufferer
  • Stress
  • Head trauma
  • Environmental exposure to pesticides
  • Rural living
  • High fat diet
There are also three factors that have been associated with a decreased risk of Parkinson's, these are cigarette smoking, anti-oxidants being present in diet and having measles early in life.




Parkinson's Disease Nursing Care Plan - Diagnosis Interventions
1. Nursing Diagnosis for Parkinson's disease - Self-care deficit related to neuromuscular weakness, decline in strength, loss of muscle control / coordination.

Goal: self-care clients are met

Expected results: the client can indicate a change of life for the needs of taking care of themselves, clients are able to do self-care activities in accordance with the level of ability, and identify personal / community that can help.

Nursing Interventions for Parkinson's Disease :
  • assess the ability and the rate of decline and the scale of 0-4 to perform ADL
  • avoid what not to do the client and help if needed.
  • collaborative provision of laxatives and consult a doctor of occupational therapy
  • teach and support the client during the client's activities
  • environmental modifications
Source : http://nanda-nursing-care-plan.blogspot.com/2012/06/self-care-deficit-of-parkinsons-disease.html

2. Nursing Diagnosis for Parkinson's Disease : Impaired physical mobility related to bradykinesia, muscle rigidity and tremors

characterized by:
Subjective data: the client said it was difficult to do activities
Objective data: tremors while on the move

Outcome: improve the mobility

Nursing Interventions for Parkinson's Disease :

Help clients make daily exercise such as walking, cycling, swimming, or gardening.
Encourage clients to stretch and exercise as directed postural therapist.
Bathe with warm water and the clients do sorting to help muscle relaxation.
Instruct the client to rest on a regular basis in order to avoid weakness and frustration.
Teach for postural exercise and walking techniques to reduce the stiffness when walking and the possibility of learning continues.
Instruct the client to walk with your legs open.
Create a client's hand with awareness raising, lifting the feet when walking, use the shoes for walking, and walking with step length.
Tell the client to walk to the rhythm of music to help improve the sensory.

Source : http://nanda-nursing-care-plan.blogspot.com/2012/06/impaired-physical-mobility-of.html


Diagnosis dan Intervensi Keperawatan Parkinson

1. Hambatan mobilitas fisik berhubungan dengan kekakuan dan kelemahan otot.
Tujuan : dalam waktu 2 x 24 jam klien mampu melakukan aktivitas fisik sesuai dengan kemampuannya.
Kriteria : klien dapat ikut srta dalam program latihan, tidak terjadi kontraktur sendi,bertambahnya kekuatan otot dan klien menunjukkan tidakan untuk meninktkan mobilitas
Intervensi
1. kaji mobilitas yang ada dan observasi terhadap peningkatan kerusakan
2. lakukan program latihan meningkatkan kekuatan otot.
3. anjurkan mandi hangan dan masase otot
4. bantu klien melakukan latihan ROM,perawatan diri sesuai toleransi
5. kolaborasi ahli fisioterapi untuk latihan fisik

2. Defisit parawatan diri berhubungan dengan kelemahan neuromuskular,menurunya kekuatan,kehilangan kontrol otot/koordinasi.
Tujuan : dalam waktu 2 x 24 jam keperawatan diri klien terpenuhi
Kriteria : klien dapat menunjukkan perubahan hidup untuk kebutuhan merawat diri, klien mampu melakukan aktivitas perawatan diri sesuai dengan tingkat kemampuan ,dan mengidentifikasi personal/masyarakat yang dapat membantu.
Intervensi
1. kaji kemampuan dan tingkat penurunan dan skala 0 – 4 untuk melakukan ADL
2. hindari apa yang tidak dapat dilakukan klien dan bantu bila perlu.
3. kolaborasi pemberian pencahar dan konsul ke dokter terapi okepasi
4. ajarkan dan dukung klien selama klien aktifitas
5. modifikasi lingkungan
6. harga didri yang negatif.



3. Gangguan komunikasi verbal yang berhubungan dengan penurunan kemampuan bicara dan kekakuan otot wajah ditandai dengan : DS: klien/keluarga mengatakan adanya kesulitan dalam berbicara DO: kata-kata sulit dipahami, pelo, wajah kaku.
Intervensi:
Tujuan: memaksimalkan kemampuan berkomunikasi.
• Jaga komplikasi pengobatan.
• Rujuk ke terapi wicara.
• Ajarkan klien latihan wajah dan menggunakan metoda bernafas untuk memperbaiki kata-kata, volume, dan intonasi.
•Nafas dalam sebelum berbicara untuk meningkatkan volume suara dan jumlah kata dalam kalimat setiap bernafas.
•Latih berbicara dalam kalimat pendek, membaca keras di depan kaca atau ke dalam perekam suara (tape recorder) untuk memonitor kemajuan.