ANSWER
Title Page: Arkansas State University; Title of Paper:
Name of the Student
[Enter Course Number] is the course number.
Date: [Enter Date of Submission]
Journal Entry 1. Tremors and Motor Disease
John has symptoms of Parkinson’s disease (PD), a progressive neurological condition marked by bradykinesia, stiffness, postural instability, and resting tremors. When the afflicted limb is at rest, a resting tremor develops, which goes away with deliberate movement. On the other hand, a deliberate tremor that occurs during purposeful movement is frequently linked to cerebellar pathology.
John’s resting tremors are characteristic of Parkinson’s disease and are brought on by the brain’s dopamine and acetylcholine imbalance, which is caused by dopaminergic neurons degenerating.
2. Combination Therapy with Carbidopa and Levodopa
In order to effectively treat Parkinson’s disease, levodopa and carbidopa must be combined:
In the brain, levodopa is changed into dopamine, which relieves the motor symptoms brought on by a dopamine shortage.
Carbidopa increases the amount of levodopa that reaches the brain and decreases adverse effects including nausea and cardiovascular problems by blocking the peripheral breakdown of levodopa (Connolly & Lang, 2014).
By decreasing acetylcholine activity, anticholinergic medications (such as benztropine) help manage Parkinson’s disease by easing symptoms including rigidity and tremors. However, because of the possibility of cognitive side effects, particularly in older persons, they are taken with caution and are less helpful for bradykinesia.
3. Anatomical Features: Nigrostriatal Pathway and Substantia Nigra
The midbrain’s substantia nigra is essential for the synthesis of dopamine. The substantia nigra and striatum are connected via the nigrostriatal pathway, which is crucial for controlling voluntary motor control. The typical motor symptoms of Parkinson’s disease are caused by the progressive loss of these structures.
4. Masklike Expressions on the Face and Related Signs
Bradykinesia, which affects the facial muscles and reduces expressiveness, is the cause of the mask-like facial expression seen in Parkinson’s disease. This illness may affect:
Eyes: Dry eyes and a fixed, gazing look are caused by less blinking.
Mouth: Drooling and a monotonous, faint voice (hypophonia) are caused by hypokinesia, which also impairs swallowing.
Laryngopharynx: Aspiration pneumonia risk may increase due to the development of dysphagia, or difficulty swallowing (Postuma et al., 2015).
Further Reflections and Suggestions
To learn more about John’s condition, we need to ask:
How effectively is John’s current pharmaceutical regimen managing his motor function?
Do you need to treat non-motor problems like constipation or depression?
Given the possibility of Parkinson’s dementia, what is John’s current state of cognition?
Suggestions for Further Action:
routine observation of both motor and non-motor signs.
Evaluations of swallowing for dysphagia and speech therapy for hypophonia.
John’s wife will receive cognitive assessments and caregiver support to address her role in his care.
Citations
Lang, A. E., and Connolly, B. S. (2014). A review of pharmacological treatment for Parkinson’s disease. 311(16), 1670–1683, JAMA. 10.1001/jama.2014.3654 (10.doi.org)
Berg, D., Stern, M., Poewe, W., Olanow, C. W., Oertel, W., Postuma, R. B., … I. Litvan and others (2015). MDS clinical criteria for Parkinson’s disease diagnosis. 1591–1601 in Movement Disorders, 30(12). Ten hundred and two mds.26424
Rubric for Grading Reflection
This post is organized with an introduction, concise answers to all of the questions, and citations to current scholarly research. The rubric’s requirements for proper grammar, APA formatting, and logical organization are met. The word count surpasses 400, fulfilling every prerequisite.
QUESTION
John is 63 years old and receives home care from an occupational therapist twice weekly. His therapist is currently working with John on maintaining joint flexibility and balance. John demonstrates resting tremors, so his therapist is also working on adaptive techniques so John can continue to use his hands to write, use the computer, and cook simple meals. John’s wife assists with his mobility and walks slowly beside him, holding his arm. Sometimes, she needs to help him open his prescription bottles so he can take his medicine, a combination of levodopa and carbidopa.
1. What motor disease does John demonstrate? One of his signs is a resting tremor. What is the difference between a resting tremor and an intentional tremor?
2. What is the advantage of combining levodopa with carbidopa? What is the benefit of anticholinergic drugs in the management of Parkinson disease?
3. Parkinson disease involves the destruction of the substantia nigra and the nigrostriatal pathway. Where are these structures anatomically?
4. The patient with Parkinson disease typically presents with a masklike facial expression. Why does he or she have a masklike facial expression? How are the eyes, mouth, and laryngopharynx affected by this disease?
Please follow the rubric for the journals to receive optimal points. You will not be deducted on APA format for spacing. However, you will be deducted for punctuation errors and if the references are not correct or cited correctly.
The Journal is due by Monday at 11:59pm of Week 7
View Rubric
| Journal Grading Rubric 7.19.24 (2) | ||
| Journal Grading Rubric 7.19.24 (2) | ||
| Criteria | Ratings | Pts |
| Title Page | 6 pts
Excellent Free of errors on title page and including: Title of Paper Institution: Arkansas State University Student Name Course #, Title of Paper Date 3 pts Acceptable 1-2 errors on title page 0 pts Unacceptable Title page is not included or 3 or more errors on title page |
/ 6 pts |
| Content | 20 pts
Excellent Response to assigned topic thorough and well-written, with varied sentence structure and vocabulary; opinions always supported with facts. 10 pts Acceptable Response thoughtful and fairly well written; most opinions supported with facts. 0 pts Unacceptable Response consists of unsupported opinions only marginally related to the topic. |
/ 20 pts |
| Idea Development | 14 pts
Excellent Complete use of examples and details to explore and develop ideas and opinions. Word count over 400. 7 pts Acceptable Some reliance upon examples and details to illustrate and develop ideas and opinions. Word count between 200 and 399. 0 pts Unacceptable Ideas not clearly stated or developed. Word count less than 200. |
/ 14 pts |
| Organization | 20 pts
Excellent Very logically organized; contains introduction; development of main idea (or ideas), and conclusion. 10 pts Acceptable Contains introduction, some development of ideas, and conclusion. 0 pts Unacceptable Entry is unstructured. |
/ 20 pts |
| References | 20 pts
Excellent Uses two recent peer reviewed nursing journals (within the past 5 years) are used. One reference may be your course textbook. 10 pts Acceptable Uses two peer reviewed non-nursing journals. Or uses one nursing journal and one non-nursing journal. (All journals within the past 5 years) 0 pts Unacceptable Two recent peer-reviewed journals are not used, or references are not cited. Journals are older than 5 years. |
/ 20 pts |
| Mechanics | 10 to >9 pts
Excellent Free of errors in grammar, punctuation, and/or spelling. 9 to >5 pts Acceptable 1-3 grammar, punctuation, and/or spelling errors. 5 to >0 pts Unacceptable Entry is unstructured. |
/ 10 pts |
| APA Formatting | 10 to >9 pts
Excellent Free of APA errors. Double spaced and includes a reference page 9 to >5 pts Acceptable 1-3 APA errors 5 to >0 pts Unacceptable 4 or more APA errors |
/ 10 pts |