Question

A 40 year old complains of slow gait and a hand tremor of a few months duration.

HPI. His wife also describes postural instability, drooling of saliva and generalized rigidity.

PE. "Mask-like facies; mild involuntary pill-rolling tremor at rest; gait-short stepped and shuffling. Deep tendon reflex is normal. Plantar responses bilaterally flexed. On gross pathology, there is absence pigment in the substantia nigra. Micro pathology shows presence of Lewy bodies with decreased neurons in the substantia nigra.

What would be four nursing differential diagnoses for this patient case?

Answer 1

Lewy bodies are abnormal aggregates of protein that develops inside nerve cells in Parkinson disease.

Parkinson is a chronic ,progressive neurodegenerative disorder. It is a clinical syndrome characterised by tremor , bradykinesia , rigidity, postural instability.

This 40 year old man is a case of Parkinsonism .

This man is experiencing most of the complaints like slow gait, short step, shuffling,pill rolling tremor at rest, postural instability ,hand tremor,drooling of saliva, generalized rigidity.

The four differential nursing diagnosis for this casesare as following

Risk for fall related to postural instability as evidenced by gait -short step and shuffling

Risk for injury related to fall

Body image disturbance as evidenced by mask like facies

Risk for Nutrional imbalance related to tremor in hand secondary to involuntary movements or motor sense abnormality