NR 507 Week 7 – Recorded Disease Process Presentation Peer Review

Introduction

Thank you for your exploration of Parkinson’s disease (PD), an important neurologic disorder, especially of the elderly (Palma, 2018). Definitive diagnosis is histological, with its etiology visible as either loss of pigmented dopaminergic neurons of the substantia nigra pars compacta or the occurrence of Lewy bodies in neurons (Palma, 2018).

Risk factors and etiology

Genetic predisposition is likely since about 10% of patients have a family history of Parkinson’s disease. The genetic disease usually has an earlier onset with a usually more benign course compared to later-onset disease.

Health care provider implications for prevention of the disease.

Secondary and tertiary prevention of illness is more feasible due to the lack of modifiable risk factors. That is important to the healthcare provider as they counsel the patient and relatives as well as health education as part of population health.

Progression from the initial injury to the defect in the tissue, organ, and system functioning

The defect is usually genetic, primarily a mutation in leucine-rich repeat kinase 2 (LRRK2; also known as PARK8), affecting the mandarin protein responsible for the neuron defects on histology and clinical presentation.

Link changes in the tissue, organ, and system functioning to the initial presenting signs and symptoms seen in primary care of the disease

A gradual accumulation of defective protein in neurons in the illness causes an insidious onset of the disease. The degeneration that results in the dorsal aspect of the putamen on the basal ganglia is a critical cause of the characteristic motor manifestations.

Diagnosis

It is primarily clinical, as alluded to. Palma (2018) note that it presents as tremor, reduced dexterity, reduced arm swing on the first-involved side, softening of voice, reduced facial expression, sleep disturbances, decreased olfaction, autonomic dysfunction, weakness, malaise or lassitude, depression or anhedonia, slow thinking, imaging, and lab tests are usually unremarkable therapy in the disease.

NR 507 Week 7 – Recorded Disease Process Presentation Peer Review

Pharmacological and nonpharmacological interventions

This is primarily to control the manifestation of the disorder (Palma, 2018). Hence, pharmacotherapy entails symptomatic drug therapy to control motor signs. Levodopa/carbidopa forms the mainstay of symptomatic treatment. Other drugs include Monoamine oxidase (MAO)– B inhibitors and dopamine agonists. Other treatments target nonmotor symptoms. Nonpharmacological therapy includes deep brain stimulation, which is minimally invasive (Suarez-García et al., 2020).

Summary and relevance to APN

The APN must understand that Parkinson’s disease is a synucleinopathy that is diagnosed primarily clinically; hence, the need to know the presentation. One must also distinguish it from other disorders to proceed to symptomatic treatment. APNs must apply their knowledge not only to correctly manage the distressing disorder but also competently counsel the patient and their relatives for optimal holistic outcomes.

References

Palma, J. A. (2018). Autonomic dysfunction in Parkinson’s disease and other synucleinopathies: introduction to the series. Movement disorders: Official Journal of the Movement Disorder Society, 33(3), 347.

Suarez-García, D., Grisales-Cárdenas, J. S., Zimerman, M., & Cardona, J. F. (2020). Transcranial Direct Current Stimulation to Enhance Cognitive Impairment in Parkinson’s Disease: A Systematic Review and Meta-Analysis. Frontiers in Neurology, 11, 1615.

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NR 507 Week 7 – Recorded Disease Process Presentation Peer Review

Introduce the disease with a brief definition and description.
Discuss the risk factors and the connection to the etiology of the initial injury to the
cell/tissue/organ.
Discuss health care provider implications for the prevention of the disease.
Show the progression from the initial injury to the defect in the tissue, organ, and system
functioning.
Link changes in the tissue, organ, and system functioning to the initial presenting signs and
symptoms seen in primary care of the disease.
Provide a brief description of how the disease is diagnosed.
Provide a brief description of the pharmacological and non-pharmacological interventions used
to treat and manage the disease.

Summarizes the disease on the final slide with concluding remarks; includes implications for nurse
practitioner practice.
Utilizes at least two current (within 5 years) peer-reviewed scholarly sources to support
presentation content.
Reference slides and in-text citations depict references correctly cited according to APA.