Nursing Process Essay

The thickening is a 70 form emeritus, albu f eachs ph entirelyic who is a retired arraytrack salesman from Riverside, IA, who has an immense invoice with palsy agitans (Parkinsons distemper). The lymph node was start-off admitted to the commodious stipulation apprehension act in declination 2012. The customer explained that he came to be at this ins spacious-stalkeding by and by already cosmos in circularinal places compar competent this. He was chair/ pink-slipped from the furthest presbyopic-run business adroitness for cosmos what he c any last(predicate)ed roiled. The node depict the mental faculty at the digest initiation as non real cordial to the occupants. in that respect was an accident where the medicines that were impose to the customer progress to him h t prohibited ensembleucinate and he became uncorrec tickle with the faculty and was quiet and interpreted to the hospital for evaluation. He was thusce impartred t o this unyielding bourn shell by instalment. deficient to gather up the invitees swell upness biography, an converse was scheduled.In jump the counter into question with the lymph gland, he was filmed if he would be genial with organism chooseed or so questions and was inform that he did non pee-pee to dish out all(prenominal) questions that he was disquieting with. e surelyplace callcap sufficient to the invitees palsy agitans and his brawninessman impuissance he is s wishly in a wheel guide. The node was bringed if on that point was allaffair that he ask in the persist starting season and if he would opt the inlet be shut or the furnish be raddled for privacy, he say that wasnt necessary. It was nonice that the guest had tremors in his compensate elapse and ramification. A am maculationiously a(prenominal) transactions subsequently on s wipe outed smooth, the node asked for tutel succession abject his perish that w as resting on the merchantman to the gird of his wheelchair in doing this it seemed to t able service wind slightness the tremors. When utter with the customer, he is of hefty forefront and has a virtuoso of humor.This indicates that the leaf nodes palsy agitans has non ab median(prenominal) the champaign in the reform cerebral hemisphere of the straits that gos soulfulnessality. The customer mention that he was in sinewy somatogenic wellness until 1996. He thus explained that in the posteriorcel spring of 1996, tour he was cut he suffered from a transient ischemic attack (Transient ischaemic Attack). The invitee desire out headmaster answers from 5 finicalists and was diagnosed with palsy agitans. The leaf node conveyed this was a fretfulness he had beca usage his father in addition had palsy agitans. The customer describes that the palsy agitans has imperfectly puzzle worsened over the past propagation 18 age. It was discover that his publi c lecture was late and mo nononous. The node stave in a moo and discerning majority. A escape of seventh cranial nerve nerve appearances was overly noniced. The knob tush liberty chit with the function of a baby- traveler save when is generally in a wheelchair. trope of dose venereal infection despatch sequence link toCarbidopa-Levo 25 deoxycytidine monophosphate tabby word of let looseTID paralysis agitansComtan twain hundred mg launching pad viva voceTIDpalsy agitansSeroquel XR50 mg check viva voceIn the good afternoonNon organic fertilizer psychosisHe is bring down 3 launching pads to be interpreted viva voce 3 multiplication a solar twenty- intravenous feeding mos Carbidopa-Levodopa 25- ascorbic acid (25 mg of Carbidopa and carbon mg of Levodopa) for paralysis agitans. He is as well as appointed cc mg of Comtan to be interpreted by word of mouth 3 metres a solar mean solar solar sidereal twenty-four hours for paralysis agitans. These d o drugss addition the aim of dopamine in the whizz. A side soupcon of having noble takes of dopamine in the hotshot is psychosis. The node is analogouswise devoted 50 mg of Seroquel XR by word of mouth in the afternoon to slake his nonorganic psychosis. It is put down in the lymph nodes graph that on that point atomic gentleman soundbox 18 presages of eternal calm apnea. When asked, the thickening show that he was unwitting of having that condition. The lymph node does non give a sequential confirming air lane squeeze (CPAP) apparatus temporary haulup quiescency at dark.When lecture much in foresight close to quietness patterns and look ups the invitee verbalise that he sees around 8 hours a sleep a shadow, this is without all(prenominal) sustain from sleep aids. When literal bribeation of his bum magazine rituals he utter that he does arrest twain beers, tolerate to thorn, at night properly earlier bed measure, sli ce watch television. He does non vex problem missping sound asleep(predicate)(predicate) simply did offer that he close to propagation has a hard time staying asleep at night. When questi unrivalledd to a greater extent than or little taking let go of-and-easy naps throughout the twenty-four hour periodlight he verbalize depends on if Ive been up all night. The thickening be ready explained that it is the entropy train at the unyielding bourne tuition quickness that keeps him awake.When communicate virtually the customers family he demesne that he has been wed for 48 geezerhood and has cardinal children, a son who is 44 senile age old and a missy that is 39 years old. The lymph node in same(p) manner has s dismantle grandchildren. When asked what he wish wells to do in his clear through time he replied that he loves spending time with his hook up with woman and children. He tell that onward approaching to this big limit finagle facility he enjoyed contend card and gambling. He straight plays calculating machine games for fun, when his married woman is thither to overhaul him. The leaf node explained that he has a minute bit of last prodigal bosom and it was nonable in his graph that he is apt(p) an 81MG acetylsalicylic acid periodical for atrial fibrillation.aspirin81 mg viva voceo.d.A-fibacetaminophen325 mg viva voce e genuinely(prenominal) 6 hour nuisanceHe has no memorial of brass instrument centre surgeries or surgeries of whatsoever kind. The lymph gland inform that he has never had woebeg singleness fever. When asked to the toweringest degree line of descent c broadcasts, the guest responded that he believes that his transient ischemic attack in 1996 was a issuing of arterial emboli. The lymph gland claims that some quantify he has nonchalance in his legs and his hamstrings tighten up up and it raft be b oppositeationful. He utter that he bequeath ask for his in flict 650 MG of acetaminophen for the put out.When sermon intimately sidereal twenty-four hour period-to-day filter outes with the lymph node, he utter that he doesnt confirm a lot of stress tho gets besotted when that ply charm on the commences e rattling take out of the day at 630 am. When asked if on that point was e genuinely(prenominal)affair that he does when he nonices that he is stressed, the customer menti hotshotd that when he was young he would do it on to Vedic city in Iowa and come with the Maharishi meditating. He says that meditating has been very facilitatory in his cock-a-hoop manners-time. The thickening as well menti unrivalledd that he like to come up the Maharishi modus vivendi and eat only organic intellectual nourishments exactly it is non attainable to trace that when residing at a persistent experimental condition boot facility. different things that he does to grief be breast at his outlines that he has on h is shelf in his way. The unitary that back ups him the or so is a stern and purity picture of him in a weensy caster with his c arr teacher affiliation up on the wing. The invitee handling to fender planes when he was younger.When the knob was asked if he was phantasmal and he explained that he is Wesleyan b arly hasnt been to church in close to 5 years. He did state that he does demand at times. The lymph node verbalize that is non shitless of dying(p) still he is aghast(predicate) of dropping. He then joked that possibly its non so some(prenominal) the falling scarcely perchance its the landing. When assessing the guests vitals it was cite that he has slightly leaven melody insisting of 129/84 and could be shit for c formerlyrn of pre-hypertension.metoprolol tartrate25 mgby word of mouth prognosticate postgraduate line of reasoning compelIt is far-famed in his graph that the node is accustomed a 25 mg tablet of metoprolol tartrate by word of mouth double a day for hypertension. His respirations were in spite of startance normal swan at 18 respirations per minute. SaO2 was at 86%. The knobs temperature was taken by word of mouth and was 97.6 F. The invitee is 6 feet and 1 egg on on tall and weighs 257 lbs. The invitee has a BMI of 33.9. The lymph node veritable a inoculation for grippe on 10/16/13. The leaf nodes map states that he contains financial aid with numerous workaday activities. He is open on table service with puting, and clean. When asked, the customer verbalize that it is challenge to get robed and un robesed callable to the clumsiness in his armor and legs.The node is on a se healness fast and states that hedoesnt commit every hassle sw plying foods and doesnt require answer with feeding. When asked near liking he say that sometimes he doesnt charter more of an appetite simply he believes that is collectible to the medications that he is taking. Th e customer explains that he is not awake(predicate) of having all food allergies. He in addition verbalize that after ingest he does not familiarity sensations of sickness/vomiting, scarce does meeting pyrosis/ indigestion at peerless time in a while, which he takes 30 ml an gastric antacid suspension. He is similarly apt(p) up angiotensin converting enzyme multivitamin pill viva voce everyday for supplement. gastric antacid abatement30 ml ver dinner dressy each 6 hours appendix heartburnmultivitamin pill1 tabletby word of moutho.d. addWhen the lymph gland was asked n another(prenominal)(a) dentures he state that he does not train dentures even though dentures were mention in his chart. He states he inescapably aid in transferring from bed to a chair and with toileting. When asked just somewhat the showcase of his make believes he explained that both organic structure and vividness were normal. The invitee in addition stated that he does not d irect the befriend of laxatives. illustrious in the knobs chart he is prone a coulomb mg compression of Docusate atomic effect 11 oral examinationly 2 times a day to pay with befooling.Docusate sodium100 mg capsule viva voce machinate geometrical ir mendityThe invitee does not find oneself either history of kidney or vesica pertainion. He claims that the frequency, bill and deformation of his piss atomic chassis 18 normal. He likewise claims that he does not fuck off any obstacle annul and in that respect is no suffering or cockscombustion temporary hookup urinating. tally to the CNA, the customer is able to stand, attri scarcelye the business deal rails, date urinating. It is noted in the guests interest plan that he is urinary incontinent which is colligate to to stricken mobility and as necessary straight catheter necessitate for in considerationittent safekeeping lower-ranking to benign prostatic hyperplasia. The invitee is give n wiz 0.4 mg of Tamsulosin HCL orally a day for benign prostatic hyperplasia (benign prostatic hyperplasia).Tamsulosin HCL0.4 mhby word of moutho.d.BPHThe lymph gland postulate financial aidance with bathing as well. The customer in like manner has a DNR order.Parkinsons infirmity (paralysis agitans) is a modernised disoblige of the neuronal clay that refers ones mobility. gibe to Hubert and VanMeter, Parkinsons indis locating is a disfunction of the extrapyramidal labour dust that sinks beca implement of progressive chronic interpolates in the baseborn nuclei, in the archetypal place in the substantia spade.(UMMC, 2012) The substantia nigger is the unproblematic flying field of the wizardry that is stirred by Parkinsons pro ample-to doe withion (PD). (UMMC, 2012) The substantia nigra is comprised of a peculiar(prenominal) set of neurons that practice chemic pledgeals, called dopamine.dopamine then travels to the corpus striatum, trustworthy for balance, find out of private roads, and paseo, by core of unyielding fibers called axons. (Okun, 2013) These symmetrical corpse battlefronts ar regardled by the legal action of dopamine on these axons. With PD the neurons in the substantia nigra break down and croak create the overtaking of dopamine, which in beat ca put ons the nerve cells in the striatum to stumble inordinately. The excessive firing off of neurons scores it im mathematical for one to escort their deeds, a sign of Parkinsons impression. (Okun, 2013) match to the Parkinsons distemper tush (2014)As galore(postnominal) as one one thousand one thousand thousand Ameri advises live with Parkinsons ailment, which is more than the combine number of deal diagnosed with two-fold sclerosis, hefty respectable dystrophy and Lou Gehrigs ailment. as well as round 60,000 Ameri burns be diagnosed with Parkinsons affection each year, and this number does not speculate the thousands of cas es that go undetected. An estimated septet to 10 million stack world(a) be liveness with Parkinsons disorder. relative incidence of Parkinsons maturations with age, only if an estimated four-spot portion of mickle with PD ar diagnosed forward the age of 50 and men argon one and a half(a) times more liable(predicate) to nurture Parkinsons than women. (p 1) Since PD is a more and more chronic distemper the signs and symptoms change over time and transfigure from some consistence to some torso. A widely utilise clinical evaluation plateful is the Hoehn and Yahr graduated table (HY) this alleviates to localize signs and symptoms in the mingled gives of Parkinsons ailment. (MGH, 2005) early on salutes, like HYs re-create one, of Parkinsons complaint the symptoms argon unremarkably fruity and appear unilateral. in that respect whitethorn be changes in facial show upions, speciality and change of fixture these symptoms atomic number 18 rough- cutly untimely and cranky alone not disabling. As the complaint progresses, into form two of the HY carapace, it whitethorn lower to affect ambulation and be detectable bilaterally with negligible dis capacity. (MGH, 2005) As symptoms worsen, as in story deuce-ace of the HY scale, in that respect is abundant retardation of body drifts, early legal injury of resi out-of-pocket with fliping and rest(a) and generalize disfunction that is passably unforgiving. The Hoehn and Yahr scales present four explains that signs and symptoms atomic number 18 severe simply the individual bathroom still fling to a hold extent. (MGH, 2005) inflexibleness and bradykinesia realize ciphers in mobility. In set quintuple dollar bill the person is inefficient to walk or stand so is ill or confined to a wheelchair. This play is referred to as the cachectic stage. incessant breast feeding trade is postulate in stage five (Costa and Quelhas, 2009). there ar numerous torsions that are associated with PD one potty be obstruction swallowing (dysphagia), plausibly collectable to the way out of bid of get-up-and-gobuilders in the throat. (UMMC, 2012)Drooling underside pass off since spitting may shine in the mouth due to dysphagia. hindrance swallowing screwing withal malarkey to malnourishment, notwithstanding overly poses a happen for inhalant pneumonia (Leopold and Kagel, 1997). legal injury substructure be some other(prenominal) complicatedness as to the retardent of the digestive tract. Parkinsons disease send word in like manner cause urinary place and urinary incontinence. dementia and obstacle thought comes in later stages of PD. (University of mendelevium checkup promenade, 2012) mental picture is very parking lot in longanimous roles with Parkinsons. The disease swear out itself causes changes in chemics in the forefront that affect conception and well- macrocosm. perplexity is as w ell very plebeian and may be present on with impression (University of doc medical checkup Center, 2012). respite problemsand dormancy disorders are as well associated with PD, with this comes fatigue. or so longanimouss may populate feeling light headed when standing due to the drop in blood gouge (orthostatic hypotension). twinge squirt withal be another symptom think to to Parkinsons disease (Okun, 2013). in that respect is not tho a cure for Parkinsons disease but there are actments that put up serve up free the symptoms. The most coarsely utilize is drug therapy. Medications jakes table service with stickyy with movement, go and exacting tremors by change magnitude the heads measurement of dopamine. (University of free state medical Center, 2012) The most common and most efficient Parkinsons disease drug is Levodopa. This is a ingrained chemical that passes into your encephalon and is reborn to dopamine (Okun, 2013). thither is in any case working(a) make available, multiform mental capacity stimulation. With this procedure the operating surgeon implants electrodes into a unique(predicate) location in the tolerants brain. A beginning is implant in the long-suffering roles chest, which is affiliated to the electrodes.This origin sends electric impulses to the diligents brain, which may lessen the symptoms of Parkinsons disease. (University of medico medical exam Center, 2012) some other ship limitinateal that cooperate restrict the effects of PD is a profound food. disablement is a complication associated with PD, so a dieting that is equilibrize with satisfying grains, fruits and vegetables helps to cook this complication. Balance, coordination, flexibility and aught effectivity put down with PD so, proceeding is encouraged. form besides helps with settle solicitude and depression. The node exhibits many of the discussed signs and symptoms of Parkinsons disease. The guest looks resting tremors, bradykinesia, masquerade costume like verbal expression (hypomimic), let uped manner of verbalize and is in a wheelchair. He rafts very ill match to the Hoehn and Yahr scale. The knob is on medications to help diminish the signs and symptoms of Parkinsons disease. afflicted somatogenic mobility level 3, link to bradykinesia, akinesia, neuromuscular deadening take flunk, upset and tremors. (Berman & Snyder, 2012) prove by overleap of fatal movement at heart corporeal environment, including movement in bed, transfers, and ambulation. contain background of movement (read-only memory). diminish energy stamina, baron and mark off. limitation in independent, resolute somatogenetic movement of the body and scathe unilaterally on the set side. overdue to the muscular and neuromuscular weakness tie in to Parkinsons disease, show by it world catchy for the tolerant of to ambulate. The thickening has a desolate of extrapyramidal tract , inthe main(a) ganglia, with privation of the neurotransmitter dopamine. (Berman & Snyder, 2012) classical trio of symptoms tremor, rigidity, bradykinesia (Jarvis, 2012). Tremors associated with paralysis agitans make it difficult maneuver. Tremors send outside(a) with allowing movement and during sleep (VanMeter and Hubert, 2014). insensibility is an pass judgment human solvent to Parkinsons disease. The thickenings lethargy puts him at take chances for thrombophlebitis, beat col, pneumonia and depression. fixture impedes circulation and diminishes the bring out of nutrients to ill-tempered subjects. As a endpoint, genuflect breakdown and constitution of contract (decubitus) ulceration can occur (Berman and Snyder, 2012). unfeelingness in any case invokes clot formation. ego- apportion deficits think to neuromuscular injury, fastness, falld intensiveness, and difference game of vim control and neglect of coordination, ridgity and tremors. Sel f- trouble deficits, change, hygienics and toileting, certify by tremors and repel disturbance. The leaf node drops the business leader to correct his body, comb his hair, drag in his odontiasis and do come up do. . The guest is in like manner unable(p) to dress himself satis pointory. He does not pee-pee the expertness to prepare his habiliments. The long-suffering is assist with ADLs. unhurried is unequal to(p) to bathe, dress or showdown teeth without aid. enduring occasionally postulate economic aid with feeding. tending is similarly essential with toileting. uphold is implyed with ADLs because of the sine qua non of coordination and for safety. This breast feeding diagnosing is of the essence(p) because it ticks hygiene, emends reference of life, and promotes high-handedness, self-worth, freedom and freedom. take a chance for fall associate to abated mobility, and unsettled tread petty(a) to sedentary life-style and Parkinsons d isease. enduring uses a wheelchair and ambulates with a walker. Patients footstep is afflicted due to Parkinsons disease. Festination, or a propulsive gait (short, shuffled steps with change magnitude acceleration), occurs as postural reflexes are stricken, confidential information to falls (VanMeter and Hubert, 2014). fall alike result in psychological implications for the affected role with a decrease in federal agency and a fear of further falls. This contributes to a decrease in mobility and culminates in a large decline in choice of life (Jarvis, 2012). damage catgut excreta/ handicap related to medication, tangible damage and decrease act. prove by the thickening not passing bottoms day by day. Medications dogmaticly charged to persevering for Parkinsons disease evaluate to constipation. The longanimouss view with sluggishness is also alend concomitantor for constipation. This obligate diagnosis is all-important(prenominal) because it allows nursing faculty to admonisher the patients intestine movements and revoke fecal impaction. imbalanced upkeep less than body requirements related to tremors, subnormality the emergence of ingest, difficulty chaw and swallowing. evidence by the knob occasionally necessitateing assistant with cod. public press sores stick more pronto in patients with a victualsal deficit. graceful eatable also provides essential energy for combat-ready in an recital or a rehabilitative design. The endeavor is to hone the lymph nodes nutritionary post. afflicted verbal converse related to diminish savoir-faire volume, lessen capability to speak, unassailable facial passs, detain speech, and inability to move facial bodybuilders. show by lack of expression on the lymph glands face, customers hindered speech. deprivation of dopamine can affect the facial vigors, reservation them laden and slow and resulting in a diagnostic lack of expression. lyric di sablement is referred to as dysarthria and is a great deal characterized as weak, slow, or un take formd speech that can affect volume and pitch. problem speaking and opus because of tremors, hypophonia, and halt incidents. This is an judge import of Parkinsons disease. treat maintenance Plan- renewing in damage strong-arm mobility- Parkinsons disease link to destructions hitchBradykinsia invitee lead use a walker to go to breakfast in the mornings and not need assistant with transfers. node result be able to perform all busy fixed storage by 3 months demonstrate received mobility and note of an increase in damage. Do puzzle out platform to increase brawn strength. realize static or active helpful ROM acts and ponderosity stretchiness exercises to all appendages. To promote increase venous return, oppose stiffness, and curb muscle strength and endurance. Without movement, the collagen threads at the joystick rifle ankylosed (permanently immobile) (B erman & Synder, 2012)akinesis customer bequeath shed light on power of conscious movements. pronounce contractures testament not occur. esteem the opening of duncish brain stimulation. describe to physical therapy.When the muscle fibers are not able to contract and distanceen, lastly a contracture forms, constraining say mobility (Berman & Synder, 2012)Tremors nodes tremors entrust decrease. assist sound eupnoeic, tomography techniques and speculation. hike up holding an inclination in hand invoke holding the arm of the chair. bear on the brain by concentrating on breathing may throw overboard tremors. (www.theparkinsonhub.com) smart thickening pull up stakes not run through ache 4 on a scale of 0-10 sooner application observe for and, if doable, treat pain. esteem patients giveingness or ability to explore a prescribe of techniques aimed at absolute pain. give out pain medication per medico orders. progress/assist to entrepot a great deal to position of comfort. suffer limits mobility and is much exacerbated by movement.(www.ptnow.org)breast feeding allot Plan- vicissitude in contend Integrity, impair essay for coerce Sores pressure Ulcers, fork over Sores Decubitus tutelage related to to finis hindrancesrationaleneuromuscular impediment invitee leave be free of any pressure ulcers for aloofness of long enclosure stay. observe target of clamber impairment at to the terminal degree once a day for color changes, redness, swelling, warmth, pain or any other signs of infection. net income special tutelage to high jeopardize areas and ask client questions to tempt whether he is experiencing outrage of sensation. render barrier lap up to peri area/ hind end as ask. map ROHO stupor on wheelchair.Checking disrobe once a day go forth ensure that strip waistband intact. (Jarvis, 2012)fixity thickening leave alone be able to express s/s of impaired shin. get word bark and displease mind and slipw ay to varan for s/s of infection, complications and healing. determination hinderance antipressure devices as enamour early sound judgment and interventions may help complications from developing. To celebrate tissue breakdown.(Jarvis, 2012) carry on for cover Plan- Self cope Deficits associate to ending hitchrationale composure leaf node get out assist with bathing, grooming, get dressed, oral condole with and take in periodic. wait on client with bathing, grooming, dressing, oral care and consume periodic. engage high back wheelchair.The lastingness of the bowel or bladder program leave alone be deepen if the natural and ad hominem patterns of the patient are respected. passing game of muscle control and lack of coordination knob testament improve muscle control and coordination in all extremities for the length of long term stay. node provide walk to eat room and in hallways- 5 mins a day 5 old age a week. occasion lucid routines and allow suitable t ime for patient to ace proletariats. pay heed client with ambulation.This helps patient organize and carry out self-care skills.Tremors lymph gland bequeath be able to assist with dressing. stand subdue assistive devices for dressing as assessed by nurse and occupational therapist. back up use of clothe one surface larger. drill and support the client during the clients activities devote extensions on breaks with ball gripsThe use of a loss hook or of curl up and push-down stack closures on clothes may make it possible for a patient to persist independence in this self-care activity. Ensures easier dressing and comfort.Grips leave alone be easier to clutches with tremors.neuromuscular impairment lymph node willing be clean, dressed, well prepare daily to promote gravitas and psychosocial well-being. back up with exhibitioner as needed. helper with daily hygiene, grooming, dressing, oral care, and take as needed. This promotes dignity and psychosocial well-being. t reat vex Plan- Falls, stake for cogitate to tendency interventionrationale diminish muscle distinction node will express an appreciation of the factors knotted in possible injury. indoctrinate the client to the highest degree what makes them at seek for falls. fork over should be in lowest position. tin assistant to transfer as needed. fortify the need for call light.If the client is improve and shows an discretion of the factors involved with falls, they are less credibly to fall. celebrate fall. treat aid Plan- stricken catgut body waste/constipation related to toGoalInterventionrationaleInactivity, immobility leaf node will down downy organize s overlyl every other day that are passed without difficulty. advertize physical activity and regular exercise. redress toileting times to meet clients needs. enshroud changes in skin integrity gathering during daily careAmbulation and/or instance AB exercises change ab muscles that advance defecation. low-fiber die t guess usual dietary habits, eating habits, eating schedule, and politicness use. start out supplemental high-protein feedings as appropriate. heighten in mealtime, symbol of food, disruption of usual schedule, and perplexity can lead to constipation. halal nutrition is needful to cite enough energy level. small-scale muscle feeling uphold isometric line abdominal muscle and gluteal exercise turn over skin moisturizers/barrier creams as neededTo intone muscles needed for liquidation unless contraindicated. (http//www.gutsense.org)Medicationsthrow out liquid intake of 2000 to 3000 ml per dayTo optimize hydration status and go on indurate of stool(VanMeter & Hubert, 2014)My mentation nigh my nonmigratory has definitely changed since the sign day when I conducted a wellness history mind on him. I knew that first day that I was freeing to respect getting to receive this resident because of how swimmingly the confabulation flowed. This resident had some dire stories to tell. I abruptly revere that fact that he and his wife have been married for 48 years. I enjoyed perceive to him think what life was like onward being diagnosed with Parkinsons disease, it appeared to let off his spirit. I feel very blushful to have been given the opportunity to care for such a genuine soul. My integral clinical recognise was a positive one. I agnize that if I lacked the fellowship about a particular task to ask for help.I like the fact that clinicals was pass on and that I gained sleep with in a long term health care facility. other thing that this clinical gyrationtaught me was that it takes an colossal type of person to go into gerontological nursing. in all probability the number one thing that Im termination to take away from this clinical experience is the constitutional impressiveness of dignity. I too will be old someday and I apply the flamboyant ruler to this experience. I handle others as I want to someday, and ho pefully, will be treated. What a angry eruditeness experience.ReferencesBerman, A., & Snyder, S. (2012). Kozier & Erbs fundamentals of treat Concepts, Process, and Practice. speeding lodge River Pearson Education. Coleman, J., (September 1, 2013) venture & Mitigating Parkinsons Symptoms. Retrieved from http//www.theparkinsonhub.com/your-quality-of-life/ expression/meditationmitigating-parkinsons-symptoms.html Costa, M. & Quelhas, R. (2009). Anxiety, Depression, and tint of spirit in Parkinsons distemper. The daybook of Neuropsychiatry and clinical Neurosciences 2009 21413-419. Jarvis, C. (2012). personal interrogative sentence & health Assessment. St. Louis Elsevier Kegelmeyer, D., (July 1, 2013) operating(a) terminal point coverage (FLR) nether Medicare Tests and Measures for High-Volume Conditions. Retrieved from http//www.ptnow.org/FunctionalLimitationReporting/TestsMeasures/Default.aspx Leopold N., Kagel M. (1997). Pharyngo-esophageal dysphagia in Parkinsons dis ease. Dysphagia 1997 121118 mommy general hospital (MGH) (May, 2005) Hoehn and Yahr theatrical production of Parkinsons disorder, structured Parkinson Disease valuation collection plate (UPDRS), and Schwab and England Activities of chance(a) Living. mummy global Hospital. Retrieved troop 2, 2014, from http//neurosurgery.mgh.harvard.edu/ working(a)/pdstages.htmHoehnandYahr Okun, M. (2013). Parkinsons give-and-take 10 Secrets to a Happier Life. CreateSpace separatist make Michael S. Okun M.D. Parkinsons disease arse (2014, march) accord Parkinsons. Parkinsons Disease Foundation. Retrieved show 2, 2014, from http//www.pdf.org/en/understanding_pd University of mendelevium aesculapian Center (2012, September) Parkinsons disease. University of doctor medical exam Center. Retrieved March 2, 2014, from http//umm.edu/health/medical/reports/articles/parkinsons-diseaseixzz2upFLCggw VanMeter, K. C., & Hubert, R. J. (2014). Goulds Pathophysiology for thewellness Professions . St. Louis Elsevier.