[Expert Solution]: Wally and Parkinson’s disease

Wally and Parkinson’s disease. Consider the person. Wally , aged 78, was diagnosed with Parkinson’s Disease at age 64. His wife died 5 years ago, and he has no other family living. Mr Avneil worked for more than 40 years as a mechanic in a large factory. He now lives in a residential aged care facility. He recently visited the clinic for review of medications and discussions with the nurse regarding the impact of the disease on his life, and how changes in care might help. Collect cues. Skin assessment: oily and damp Musculoskeletal: Tremors in both hands and lips; gait slow and shuffling with forward leaning posture; face expressionless; speech slow and slurred Gastrointestinal: patient reports constipation, poor oral intake, difficulty chewing and swallowing Renal: patient reports occasional incontinence Vital signs: orthostatic hypotension noted when vital signs assessed; patient reported dizziness on standing. Medications: Sinemet (levodopa + carbidopa) since diagnosis, with gradually increasing doses – now taking Sinemet 250/25. Process information: interpret, relate and infer, and predict based on existing and new knowledge. 1.Depletion of a neurotransmitter in a specific region of the brain causes Parkinson’s disease. Work with your group to determine the following: Name the neurotransmitter: Name the area of the brain: 2.Depletion of this neurotransmitter impairs function of the upper motor neurons. Work with your group to describe the functions of the upper motor neuron. 3.Three somatic motor symptoms of Parkinson’s disease are resting tremor, bradykinesia, and hypertonia. a)Work with your group to describe, in a sentence what each of these symptoms is. Resting tremor is Bradykinesia is Hypertonia is b)Link the functions of the upper motor neuron to each of these symptoms. 4.Explain why Wally is experiencing orthostatic hypotension. Actions – rationale for interventions and therapy 5.Wally takes Sinemet, a combination of the synthetic neurotransmitter, L-DOPA and another drug, Carbidopa. Use the following links to answer the questions. Mechanism of action for each drug: Aim of therapy Evaluate the therapy by describing the evidence in Wally s assessment data which would indicate effectiveness. Why might Wally be a candidate for levodopa intestinal gel?.