Parkinson's Disease: HESI Case Study - Practice Makes Perfect

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Post on Mar 13, 2025

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Parkinson's Disease: HESI Case Study - Practice Makes Perfect

Mastering the HESI exam requires diligent preparation, and understanding neurological conditions like Parkinson's Disease is crucial. This in-depth guide will walk you through a sample Parkinson's Disease case study, highlighting key assessment findings, nursing interventions, and potential complications. We'll focus on practical application, mirroring the HESI exam's style and emphasis on critical thinking. Practice truly does make perfect!

Understanding Parkinson's Disease: A Quick Review

Parkinson's Disease is a progressive neurological disorder affecting movement. It's characterized by the degeneration of dopamine-producing neurons in the substantia nigra of the brain. This dopamine deficiency leads to the classic motor symptoms:

• Tremor: Often a resting tremor, typically starting in one hand.
• Rigidity: Stiffness and resistance to passive movement.
• Bradykinesia: Slowness of movement.
• Postural Instability: Impaired balance and coordination.

Beyond motor symptoms, patients may experience:

• Cognitive impairment: Including dementia in later stages.
• Depression and anxiety: Significant emotional and psychological impacts.
• Sleep disturbances: Insomnia, vivid dreams, and sleepwalking.
• Constipation: Due to decreased gut motility.
• Dysphagia: Difficulty swallowing.

HESI Case Study Example: Mr. Jones

Scenario: Mr. Jones, a 72-year-old male, is admitted to the hospital with a diagnosis of Parkinson's Disease. He presents with a noticeable tremor in his right hand, rigidity in his limbs, and shuffling gait. He reports increasing difficulty with activities of daily living (ADLs), including dressing and eating. He also complains of constipation and fatigue.

Assessment Findings:

• Neurological: Tremor (right hand), rigidity (all extremities), bradykinesia, postural instability, decreased facial expression (masked facies).
• Gastrointestinal: Constipation reported, decreased bowel sounds.
• Psychosocial: Expresses frustration and difficulty with self-care. Reports feeling isolated.
• Respiratory: Clear lung sounds.
• Cardiovascular: Regular rhythm, normal blood pressure.

Questions for Consideration (Similar to HESI Format):

1. Prioritize the nursing diagnoses based on the assessment findings. (Consider factors like airway, breathing, circulation, safety, and psychological well-being.)

2. Develop a plan of care, including specific nursing interventions to address the identified nursing diagnoses. (Consider medication administration, mobility assistance, safety precautions, and psychosocial support.)

3. What are the potential complications of Parkinson's Disease that the nurse should monitor for? (Think about falls, aspiration pneumonia, malnutrition, skin breakdown, and depression.)

4. Describe the teaching points that are crucial for patient and family education about managing Parkinson's Disease. (Include medication adherence, exercise strategies, dietary recommendations, safety measures, and support resources.)

Answering the HESI Style Questions: A Sample Approach

1. Prioritized Nursing Diagnoses:

• Risk for falls: Due to postural instability and gait impairment. This is a high priority!
• Impaired physical mobility: Related to rigidity, bradykinesia, and tremor.
• Constipation: Related to decreased bowel motility and medication side effects.
• Impaired self-care: Due to physical limitations.
• Risk for social isolation: Related to decreased mobility and frustration.

2. Plan of Care & Interventions:

• Fall Prevention: Side rails (if needed), bed alarm, non-skid footwear, clear pathways, assistive devices (walker, cane).
• Mobility Assistance: Encourage regular, individualized exercise programs (physical therapy). Assist with ambulation and ADLs.
• Constipation Management: High-fiber diet, increased fluid intake, stool softeners (as prescribed).
• Self-Care Support: Adaptive equipment (e.g., button hooks, long-handled utensils), assistance with bathing and dressing.
• Social Support: Referral to support groups, counseling, family involvement.

3. Potential Complications:

• Falls: Leading to fractures or head injuries.
• Aspiration Pneumonia: Due to dysphagia.
• Malnutrition: From difficulty eating.
• Pressure Ulcers: From immobility.
• Depression: Exacerbated by the disease's progression.

4. Patient & Family Education:

• Medication adherence: Emphasize the importance of taking medications as prescribed.
• Exercise program: Highlight the benefits of regular physical activity.
• Dietary recommendations: Discuss the importance of a balanced diet, including fiber-rich foods.
• Safety measures: Review fall prevention strategies.
• Support resources: Provide information about support groups and organizations dedicated to Parkinson's Disease.

Conclusion: Practice Makes Perfect!

By working through sample case studies like this one, you can effectively prepare for the HESI exam's challenges related to Parkinson's Disease. Remember to focus on the critical thinking skills required to assess, plan, and intervene effectively. Consistent practice and a thorough understanding of the disease process will greatly enhance your performance. Good luck!