Rodney Eberhart is a 63 year old man who has a PhD in government. He taught at a local university where he was a tenured professor. He was forced to retire last year because of Parkinson's disease

Click Here to see pictures and read the story of this real patient with Parkinson's Disease

Subjective Data

  • Has difficulty writing because of a tremor of his right hand when it's in a relaxed position (resting tremor). It gets worse when he is frustrated.
  • When he doesn't take his medication (Sinemet) on time, he becomes so rigid or stiff that his wife has to put the pill in the back of his mouth so he can swallow it.
  • Slowness of movement (called bradykinesia) and a delay in initiating movements,
  • Poor balance. Usually occurs when making a sudden change in the body's position.
  • Walking problems. These include short, shuffling steps, and an inability to take the next step (gait "freezing").
  • Other symptoms include slurred speech, slowness of thought, small cramped handwriting and a slight foot drag. This is especially difficult for a man who has made his living teaching and sharing his knowledge with others.

Objective Data

Physical Examination:

  • appears thin, undernourished
  • short suffling gait; forward tilt to posture
  • slow monotonous slurred speech
  • flat affect
  • responds slowly but appropriately to conversation
  • abdomen firm, slightly distended; hypoactive bowel sounds
  • regular sinus rhythm

Diagnostic study:

  • CBC WNL
  • Electrolytes WNL
  • Chest x-ray WNL
  • Cholesterol < 200
  • T3 WNL

Critical Thinking Questions

  1. Your are a home health nurse visiting Mr. Eberhart and his wife. Consider these nursing diagnoses, select three priority diagnoses, and write interventions for Mr. Eberhart.
  2. Give your rationale for the three priorities.
  • Impaired physical mobility
  • Self-care deficit
  • Risk for impaired skin integrity
  • Sensory-perceptual alterations
  • Altered urinary elimination; incontinence or retention
  • Constipation
  • Sexual dysfunction
  • Self-esteem
  • Caregiver role strain
  • Altered family processes
  • Impaired verbal communication

Post your responses to the discussion board.