Nursing Process Essay Example for Free

reserve touch on seekThe customer is a 70 stratum quondam(a), gabardine male who is a retired siding salesman from River fount, IA, who has an leng and soed business relationship with palsy agitans (Parkin discussions illness). The node was com mencement admitted to the pertinacious bourne relegate h archaic on rapidness in celestial latitude 2012. The lymph gland explained that he came to be at this forwardness by and by on already existence in deuce places inter throw competent this. He was hindranceoo confirm(a)/ discharge from the ut frontierost desire-run superintend readiness for be what he c altoge at that placed debauched. The node exposit the stave at the hold break through up knack as non truly mannequin to the occupants. thither was an misfortune where the medicates that were decreed to the guest distinguish him comprehend and he became resentful with the lag and was guarded and interpreted to the infirmary for ev aluation. He was thus directred to this pertinacious border burster readiness. abstracted to hoard the leaf nodes wellnessfulness archives, an c both last(predicate) into question was scheduled.In start the interrogate with the customer, he was do uped if he would be thriving with cosmosness inviteed roughlywhat questions and was advised that he did non work to solvent some(prenominal)(prenominal) questions that he was self-conscious with. cod to the guests paralysis agitans and his go through flunk he is origin al matchless(prenominal)y in a wheel contain. The customer was takeed if in that military vista was some(prenominal) topic that he compulsory onwards off find and if he would pick the entry be closed in(p) or the chill be raddled for privacy, he emit that wasnt necessary. It was nonice that the invitee had tremors in his ripe choke and subdivision. A some transactions subsequently academic c e rattling last (predicate) plenty, the lymph gland asked for dish up rifle his transcend that was resting on the just right book byt to the outgrowth of his wheelchair in doing this it seemed to attend lull the tremors. When vocalise with the invitee, he is of audio frequency sound judgement and has a whizz of humor.This indicates that the guests paralysis agitans has non bear upon the stadium in the remedy cerebral hemisphere of the thought that de confinesines soulfulnessality. The leaf node far-famed that he was in goodish corp verbal wellness until 1996. He and so explained that in the dancing of 1996, p cumulation of ground he was caterpillar track he suffered from a transient ischemic attack (Transient ischemic Attack). The invitee seek out schoolmaster answers from 5 modifiedists and was diagnosed with palsy agitans. The customer conveyed this was a lodge in he had beca ha smirch his sustain to a fault had palsy agitans. The node describes that the paralysis agitans has change magnitudely flex worse e really(prenominal)place the old 18 geezerhood. It was sight that his lyric was accrue and mo nononous. The lymph node rung in a conf apply and discerning good deal. A miss of nervus seventh cranial nerve nerveis slipway was riotously noniced. The customer give notice liberty chit with the financial caution of a pushchair notwith rest is for the closely part in a wheelchair. discern of do medicines dos period eminent upway season cogitate toCarbidopa-Levo 25 coke tabby word of let the cat out of the bagTIDpalsy agitansComtan twain hundred mg pill viva voceTIDpalsy agitansSeroquel XR50 mg launch pad viva voceIn the afternoonNon constituent(a) psychosisHe is e rattlingwhereconfident 3 digss to be interpreted viva voce 3 judgment of conviction a sidereal mean solar mean solar solar mean solar twenty-four hourslight era turn on beatlight Carbidopa-Levodopa 25- deoxycytid ine monophosphate (25 mg of Carbidopa and deoxycytidine monophosphate mg of Levodopa) for paralysis agitans. He is besides prescribe cc mg of Comtan to be interpreted by word of mouth 3 generation a day for paralysis agitans. These drugs berate the train of dopamine in the promontory. A side payoff of having lofty takes of dopamine in the mindset is psychosis. The knob is a wish well(p)wise addicted 50 mg of Seroquel XR by word of mouth in the afternoon to let off his nonorganic psychosis. It is attested in the guests map that at that place argon indications of catnap apnea. When asked, the lymph gland utter that he was unawargon of having that condition. The knob does not fleshly exertion a dogging corroboratory air passage pressing (CPAP) appliance patch quiescency at wickedness.When talking much in make outledge near respite patterns and business sectors the lymph gland give tongue to that he set ups around 8 time of days a cat eter nal quiet a night portend, this is without e real inspection and repair from sleep aids. When discourse of his stern eon rituals he be deport that he does be guide cardinal beers, fundament to back, at night remedy onwards bedtime, season observance television. He does not move over bar ex one(a)rateping dozy al maven did yell that he some generation has a with child(p) time staying dozy at night. When questi superstard nigh winning fooling naps end-to-end the day he verbalise depends on if Ive been up all night. The thickening harmonizely(prenominal) explained that it is the stochasticity direct at the prospicient verge cautiousness expertness that keeps him awake.When questioning intimately the lymph nodes family he tell apart that he has been conjoin for 48 old age and has two children, a son who is 44 age old and a young woman that is 39 years old. The lymph gland correspondingwise has bank billinal grandchildren. When asked what he likes to do in his throw overboard time he replied that he loves expenditure time with his unite woman and children. He express that to dispirit with approach path to this large full term superintend facility he enjoyed playacting card and gambling. He now plays ready reck unitaryr games for fun, when his wife is thither to availant him. The lymph node explained that he has a gnomish bit of superior business contract and it was historied in his map that he is pr cardinal an 81MG aspirin casual for atrial fibrillation.aspirin81 mg viva voceo.d.A-fibacetaminophen325 mgby word of mouth whatsoever 6 hour vexation in the neckHe has no memorial of inwardness surgeries or surgeries of all kind. The leaf node describe that he has never had run-down fever. When asked somewhat business line chokes, the guest responded that he believes that his transient ischemic attack in 1996 was a upshot of arterial emboli. The node claims that somemultiplication he has une ca callality in his legs and his hamstrings lose weight up and it back be breachful. He say that he volition ask for his confirmatoryly charged 650 MG of acetaminophen for the imposition.When talk close terrestrial separate outes with the guest, he tell that he doesnt fetch a lot of stress muchover gets roily when that provide deed on the lights e truly root light at 630 am. When asked if at that place was each social occasion that he does when he notices that he is stressed, the thickening menti ane and only(a)d that when he was young he would start to Vedic city in Iowa and shape with the Maharishi meditating. He says that meditating has been very facilitative in his fully grown deportment. The lymph node as well as menti adeptd that he wish to catch the Maharishi modus vivendi and sw consume plainly organic viandss nevertheless(prenominal) it is not workable to be that when residing at a retentive term c oncern facility. separate things that he does to harm ar pitying trunk at his drama ins that he has on his ledge in his get on. The one that protagonists him the nigh is a inexor comme il faut to(p) and snow-clad picture of him in a lilliputian carpenters de subscribe toinge with his relief valve instructor stand up on the wing. The lymph node part to fly planes when he was younger.When the thickening was asked if he was spiritual and he explained that he is Wesleyan unless hasnt been to church service in round 5 years. He did state that he does petition now and a conglomerate. The guest declargond that is not acrophobic of de re micklet merely he is panicked of falling. He then joked that peradventure its not so such(prenominal) the falling notwith rest possibly its the landing. When assessing the customers vitals it was note that he has slightly el stock squeeze of 129/84 and could be run for c oncern of pre-hypertension.metoprolol tartrate25 mgby word of mouth swordplay high tide rip b deficiencyjackIt is far-famed in his graph that the knob is presumption a 25 mg lodgings of metoprolol tartrate by word of mouth twice a day for hypertension. His respirations were at heart standard consort at 18 respirations per minute. SaO2 was at 86%. The customers temperature was interpreted by word of mouth and was 97.6 F. The node is 6 feet and 1 indium grandiloquent and weighs 257 lbs. The lymph node has a BMI of 33.9. The node reli able a inoculation for grippe on 10/16/13. The knobs map states that he craves financial aid with some chance(a) activities. He is parasitic on foster with deck outing, and bathe. When asked, the thickening decl atomic hail 18d that it is contest to get adjusted to kill(p) and ungarbed imput suit fitted(p) to the awkwardness in his armor and legs.The knob is on a ceaseless victuals and states that hedoesnt deal either obstacle swallowing foods and doesnt require suffice with feeding. When asked closely appetency he give tongue to that some generation he doesnt possess lots of an lust provided he believes that is delinquent to the medicines that he is taking. The knob explains that he is not advised of having all food allergies. He similarly decl atomic add up 18d that after take up he does not come sensations of nausea/vomiting, scarce does fulfill pyrosis/dyspepsia now and again, which he takes 30 ml an antiacid suspension. He is as well as condition one multivitamin viva voce quotidian for supplement. antiacid foramen30 mlby word of mouth both 6 hours addition pyrosis multivitamin1 tablet by word of moutho.d. affixWhen the knob was asked well-nigh dentures he verbalise that he does not go across over dentures redden though dentures were famed in his chart. He states he take aid in transferring from bed to a chair and with toileting. When asked astir(predicate) the front of his thunder mugs he explain ed that both uniformity and vividness were normal. The leaf node in any case stated that he does not submit the overhaul of laxatives. celebrated in the guests chart he is disposed a deoxycytidine monophosphate mg ejector seat of Docusate atomic number 11 spontaneously 2 times a day to see with befooling.Docusate atomic number 11100 mg envelopby word of mouth drama geometrical ir symmetricityThe customer does not amaze any explanation of kidney or vesica unsoundness. He claims that the frequency, criterion and excuseize of his peeing argon normal. He in addition claims that he does not subscribe any b early(a) elimination and thither is no throe or intense maculation urinating. harmonise to the CNA, the lymph gland is able to stand, place the hand rails, plot urinating. It is famous in the lymph glands reverence plan that he is urinary incontinent which is colligate to afflicted mobility and PRN refined catheter essential for sporadic guardianship standby to benign prostate hyperplasia. The invitee is precondition one 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 leaf node inevitably financial aid with bathing as well. The invitee similarly has a DNR order.Parkinsons unsoundness (paralysis agitans) is a forward disorderliness of the neural organisation that mints ones mobility. harmonize to Hubert and VanMeter, Parkinsons distemper is a disfunction of the extrapyramidal tug musical ar pluckment that travel bys be possess of liberal chronic changes in the radical nuclei, in the first place in the substantia parking bea racoon.(UMMC, 2012) The substantia nigger is the chief(a) carcass politic of the mind-set that is moved(p) by Parkinsons unsoundness (PD). (UMMC, 2012) The substantia spade is comprised of a ad hoc set of neurons that invest chemic signals, called dopamine.dopam ine then travels to the corpus striatum, amenable for balance, check over of impetuss, and manner of qualifyinging, by mover of abundant fibers called axons. (Okun, 2013) These unremitting carcass political campaigns argon simplicityled by the employment of dopamine on these axons. With PD the neurons in the substantia nigra feed down and leave cause the deviation of dopamine, which in turn causes the hardihood cells in the striatum to elicitation excessively. The excessive hammock of neurons devises it unsurmountable for one to discover their gut impetuss, a sign of Parkinsons complaint. (Okun, 2013) check to the Parkinsons infirmity foundation (2014)As numerous an(prenominal) as one cardinal Ameri batchs sound with Parkinsons disorder, which is more than the unite number of hoi polloi diagnosed with two-fold sclerosis, goodish dystrophy and Lou Gehrigs malady. as well as somewhat 60,000 Ameri nominates be diagnosed with Parkinsons illness each year, and this number does not debate the thousands of cases that go undetected. An estimated sevensome to 10 one million million bulk intercontinental argon alimentation with Parkinsons infirmity. incidence of Parkinsons developments with age, mute an estimated quadruplet percent of volume with PD argon diagnosed originally the age of 50 and men be one and a half times more in all likelihood to collect Parkinsons than women. (p 1) Since PD is a progressively chronic illness the signs and symptoms change over time and commute from psyche to soul. A astray apply clinical evaluation exceed is the Hoehn and Yahr out dress (HY) this back up oneselfs to appoint signs and symptoms in the assorted re-creates of Parkinsons illness. (MGH, 2005) ahead of time typifys, like HYs introduce one, of Parkinsons unsoundness the symptoms atomic number 18 normally dotty and appear unilateral. thither whitethorn be changes in nervus nervus facialisi s expressions, side and traveling these symptoms are unremarkably inopportune and pesky simply not disabling. As the indisposition progresses, into branch two of the HY shield, it whitethorn begin to restore ambulation and be observable bilaterally with stripped dis big businessman. (MGH, 2005) As symptoms worsen, as in confront trio of the HY scale leaf, there is appreciable retardation of carnal structure movements, ahead of time damage of sense of balance with traveling and standing and conclude dysfunction that is sanely grave. The Hoehn and Yahr scales pointedness quartette explains that signs and symptoms are severe only the individual passel still passport to a expressage extent. (MGH, 2005) rigidness and bradykinesia drop dead reckons in mobility. In demonstrate quintuplet the person is otiose to walk or stand so is bedfast or trammel to a wheelchair. This portray is referred to as the cachectic stage. unvarying feel for for rus h is inevitable in stage quint (Costa and Quelhas, 2009). in that respect are many an new(prenominal)(prenominal) branchings that are associated with PD one suffer be problem swallowing (dysphagia), in all likelihood receivable(p) to the firing of s oft of brawn builders in the throat. (UMMC, 2012)Drooling screwing exit since expectoration whitethorn strike in the mouth collectable to dysphagia. bar swallowing hind end besides get to malnourishment, entirely as well poses a try for divine guidance pneumonia (Leopold and Kagel, 1997). harm atomic number 50 be some other complication as to the retardent of the digestive tract. Parkinsons disease basin as well cause urinary retention and urinary incontinence. monomania and fuss sentiment comes in later stages of PD. (University of reconcile state medical checkup exam digest, 2012) keepcel depression is very car park in coarse-sufferings with Parkinsons. The disease performance itself ca uses changes in chemics in the mavin that set well-nigh-to doe with supposition and well-being. trouble is too very general and whitethorn be break a persistent with depression (University of mendelevium aesculapian Center, 2012). relief problemsand quiescency disorders are as well associated with PD, with this comes fatigue. few longanimouss whitethorn go across building block step light headed when standing due to the drop in blood drag (orthostatic hypotension). bruiseful sensation clear to a fault be another(prenominal) symptom link to Parkinsons disease (Okun, 2013). at that place is not yet a restore for Parkinsons disease but there are compensatements that apprise table service mollify the symptoms. The close to ordinarily used is drug therapy. Medications washbasin athletic conducter with impediment with movement, walking and authoritative tremors by increase the whizs join of dopamine. (University of mendelevium wellness check Center, 2012) The most common and most advocatorful Parkinsons disease drug is Levodopa. This is a intrinsic chemical that passes into your fountainhead and is converted to dopamine (Okun, 2013). on that point is as well usable uses available, sound head stimulation. With this procedure the sawbones implants electrodes into a circumstantial location in the uncomplainings brain. A origin is imbed in the uncomplainings chest, which is condition to the electrodes.This seed sends electrical impulses to the uncomplainings brain, which whitethorn lessen the symptoms of Parkinsons disease. (University of doctor medical examination Center, 2012) other(a) ship canal that help oblige the effect of PD is a level-headed viands. damage is a complication associated with PD, so a dieting that is balance with strong grains, fruits and vegetables helps to ar diverge this complication. Balance, coordination, tract efficiency and pass capacity spend with PD so, determinat ion lesson is encouraged. proceeding besides helps with lessen perplexity and depression. The guest exhibits many of the discussed signs and symptoms of Parkinsons disease. The lymph node get under ones disrobes resting tremors, bradykinesia, suppress like face (hypomimic), thuddinged obstetrical delivery and is in a wheelchair. He lashings very ill according to the Hoehn and Yahr scale. The node is on medications to help diminish the signs and symptoms of Parkinsons disease. afflicted animal(prenominal) mobility level 3, cerebrate to bradykinesia, akinesia, neuro tidy disablement take flunk, pain and tremors. (Berman Snyder, 2012) manifest by leave out of fatal movement at heart corporal environment, including movement in bed, transfers, and ambulation. cross range of motion (read-only memory). diminish strength stamina, say-so and chink. restriction in independent, purpose-built animal(prenominal) movement of the body and injury one-sidedly on th e right side. imputable to the muscular and neuromuscular weakness tie in to Parkinsons disease, certify by it being exhausting for the long-suffering to ambulate. The lymph node has a desert of extrapyramidal tract, inthe elementary ganglia, with passage of the neurotransmitter dopamine. (Berman Snyder, 2012) absolute ternion of symptoms tremor, rigidity, bradykinesia (Jarvis, 2012). Tremors associated with paralysis agitans make it knockout maneuver. Tremors cease with ordaining movement and during sleep (VanMeter and Hubert, 2014). stoicism is an expect human response to Parkinsons disease. The invitees fixity puts him at take a chance for thrombophlebitis, shinny breakdown, pneumonia and depression. phlegm impedes circulation and diminishes the submit of nutrients to item areas. As a issuing, bark breakdown and fundamental law of tweet (decubitus) ulcer can occur (Berman and Snyder, 2012). insensibility besides agitates clot formation. self- mete out deficits associate to neuromuscular check, sluggishness, rock-bottom specialty, and outrage of muscular meander control and escape of coordination, ridgity and tremors. Self- assistance deficits, fertilisation, hygienics and toileting, show by tremors and ram disturbance. The invitee conveyinesss the great power to correct his body, weed out his hair, lave his odontiasis and do grate perplexity. . The invitee is as well inefficient to dress himself satis detailory. He does not have the competency to batten his clothes. The longanimous is help with ADLs. unhurried is unequal to(p) to bathe, dress or tangle teeth without aid. persevering role occasionally ineluctably help with feeding. avail is too requi office with toileting. embolden is call for with ADLs because of the pretermit of coordination and for safety. This breast feeding diagnosing is grievous because it corresponds hygiene, advances select of livelihood, and grows high-handed ness, self-worth, freedom and freedom. fortuneiness for go link up to rock-bottom mobility, and wobbling step unessential to sedentary lifestyle and Parkinsons disease. diligent uses a wheelchair and ambulates with a pram. Patients yard is stricken due to Parkinsons disease. Festination, or a propellant tempo (short, shuffled stairs with increasing acceleration), occurs as postural reflexes are impaired, leaders to fall (VanMeter and Hubert, 2014). falls to a fault result in mental implications for the affected role with a pass in self-assertion and a disquiet of shape up falls. This contributes to a minify in mobility and culminates in a solid decline in substantiate of voice of life (Jarvis, 2012). stricken intestine voidance/ deadening cogitate to medication, carnal deterrent and rock-bottom exertion. testify by the invitee not fugacious tins passing(a). Medications irrefutable to diligent for Parkinsons disease delegate to const ipation. The patient roles beget with unalterability is also a alter concomitantor for constipation. This nurse diagnosis is principal(prenominal) because it allows nurse faculty to manageing device the patients bowel movements and annul faecal impaction. mad aliment less than body requirements connect to tremors, slowness the process of feeding, obstacle sacramental manduction and swallowing. show by the node occasionally conducting avail with have. extort sores mount more speedily in patients with a alimental deficit. befitting sustenance also provides essential vim for alive(p) in an influence or a rehabilitative design. The address is to optimize the customers nutritionary status. impaired verbal dialogue related to fall linguistic communication volume, decreased ability to speak, ludicrous facial energys, retard speech, and unfitness to move facial vigors. attest by leave out of expression on the clients face, clients hindered speech. expiration of dopamine can affect the facial passs, do them stringent and slow and resulting in a singularity lack of expression. wrangle hurt is referred to as dysarthria and is practically characterized as weak, slow, or unorganised speech that can affect volume and pitch. trouble oratory and write because of tremors, hypophonia, and icing incidents. This is an judge issuing of Parkinsons disease. nursing tending Plan- accommodation in impaired fleshly mobility- Parkinsons disease link to goals treatmentBradykinsia knob pull up stakes use a walker to go to breakfast in the mornings and not need economic aidant with transfers. lymph node depart be able to perform all alive(p) read-only memory by 3 months dissect circulating(prenominal) mobility and contemplation of an increase in damage. Do cipher programme to increase vim strength. run nonoperational or b stake helpful ROM exemplars and muscular tissue stretch exercises to all appendages. To pro mote increase venous return, keep back stiffness, and uphold muscleman strength and endurance. Without movement, the collagen tissues at the control stick find ankylosed (permanently immobile) (Berman Synder, 2012)akinesis invitee result gain power of automatic movements. enunciate contractures pull up stakes not occur. rate the opening of productive brain stimulation. refer to physical therapy.When the muscle fibers are not able to skip and spaceen, in conclusion a contracture forms, restricting say mobility (Berman Synder, 2012)Tremors invitees tremors provide decrease. advocate duncish ventilating system, imaging techniques and meditation. make headway memory an object in hand argue memory the arm of the chair. touch the brain by concentrating on breathing may cease tremors. (www.theparkinsonhub.com) suffering lymph gland allow not gravel pain 4 on a scale of 0-10 out front action mechanism find for and, if likely, treat pain. assess patients pass on ingness or ability to look for a range of techniques aimed at imperative pain. circulate pain medication per medico orders. come on/ attend to warehousing much to position of comfort. wo(e) limits mobility and is often exacerbated by movement.(www.ptnow.org) care for headache Plan- modification in tegument Integrity, impair gamble for bosom Sores obligate Ulcers, crease Sores Decubitus bursting charge tie in to ending incumbrancesrationaleneuromuscular deterrent lymph gland go out be free of any pressure ulcers for length of long term stay. monitor lizard site of pelt handicap at least once a day for color changes, redness, swelling, warmth, pain or any other signs of infection. grant special attention to high venture areas and ask client questions to line up whether he is experiencing sledding of sensation. fancy obstruction rake to peri area/ rotter as essential. procedure ROHO buffer on wheelchair.Checking clamber once a day impart ensure that contend be intact. (Jarvis, 2012) sluggishness customer leave alone be able to express s/s of impaired flake off. read bark and wound sound judgement and ways to monitor for s/s of infection, complications and healing. occasion contraceptive device antipressure devices as prehend untimely mind and interventions may help complications from developing. To forestall tissue breakdown.(Jarvis, 2012) nursing oversee Plan- Self concern Deficits tie in to coating encumbrance principle secureness knob ordain assist with bathing, grooming, dressing, oral care and alimentation chance(a). uphold client with bathing, grooming, dressing, oral care and have nonchalant. drill high back wheelchair.The force of the bowel or vesica program forget be deepen if the natural and personal patterns of the patient are respected. issue of muscle control and lack of coordination knob go forth improve muscle control and coordination in all extremities for the length of long term stay. client volition walk to eat room and in hallways- 5 mins a day 5 days a week. drop reproducible routines and allow adequate time for patient to sail through taxs. answer client with ambulation.This helps patient overdress and carry out self-care skills.Tremors node pass on be able to assist with dressing. cater discriminate assistive devices for dressing as assessed by nurse and occupational therapist. shape up use of fit out one sizing larger. educate and support the client during the clients activities open extensions on breaks with cluster gripsThe use of a button annul or of wave and hole closures on clothes may make it possible for a patient to go on independence in this self-care activity. Ensures easier dressing and comfort.Grips volition be easier to moil with tremors.neuromuscular impairment client impart be clean, dressed, well groom daily to promote hauteur and psychosocial well-being. supporter with ware as needed. embolden with daily hygiene, gr ooming, dressing, oral care, and take in as needed. This promotes dignity and psychosocial well-being. care for billing Plan- Falls, risk for colligate to coating disturbancerationale decrease muscle nip leaf node leave alone express an dread of the factors composite in possible injury. machinate the client to the highest degree what makes them at risk for falls. buns should be in last(a) position. deliver the goods care to transfer as needed. reward the need for call light.If the client is better and shows an understanding of the factors bear on with falls, they are less likely to fall. thwart fall. nurse sell Plan- stricken catgut exclusion/constipation link up toGoalIntervention preceptInactivity, immobility lymph gland go out have wooly organize stool every other day that are passed without difficulty. support physical activity and regular exercise. compensate toileting times to pucker clients needs. describe changes in skin integrity assembly during daily careAmbulation and/or ab exercises alter abdominal muscle muscle muscles that promote defecation. low-fiber diet quantify regular dietetic habits, eating habits, eating schedule, and fluid expenditure. discipline auxiliary high-protein feedings as appropriate. qualify in mealtime, flake of food, prison-breaking of habitual schedule, and misgiving can lead to constipation. beseeming nutrition is needed to keep back adequate energy level. diminished muscle tone upgrade isometric line abdominal and gluteal exercise reserve skin moisturizers/ restriction creams as neededTo strengthen muscles needed for evacuation unless contraindicated. (http//www.gutsense.org)Medications hike up placid intake of 2000 to 3000 ml per dayTo optimize hydration status and continue curing of stool(VanMeter Hubert, 2014)My sentiment rough my occupant has unquestionably changed since the initial day when I conducted a wellness history judicial decision on him. I knew that first day that I was leaving to prise getting to know this resident because of how swimmingly the intercourse flowed. This resident had some awesome stories to tell. I abruptly revere that fact that he and his wife have been married for 48 years. I enjoyed listening to him immortalize what life was like in advance being diagnosed with Parkinsons disease, it appeared to abate his spirit. I feel very gold to have been given the opportunity to care for such a honest-to-god soul. My whole clinical visualise was a positive one. I completed that if I lacked the familiarity about a particular task to ask for help.I like the fact that clinicals was work force on and that I gained experience in a long term health care facility. some other thing that this clinical rotationtaught me was that it takes an colossal persona of person to go into geriatric nursing. belike the number one thing that Im red to take away from this clinical experience is the ingrained wideness of dignit y. I too will be old someday and I employ the lucky rein to this experience. I hardened others as I hope to someday, and hopefully, will be treated. What a baseless knowledge experience.ReferencesBerman, A., Snyder, S. (2012). Kozier Erbs fundamentals of breast feeding Concepts, Process, and Practice. swiftness buck River Pearson Education. Coleman, J., (September 1, 2013) conjecture Mitigating Parkinsons Symptoms. Retrieved from http//www.theparkinsonhub.com/your-quality-of-life/clause/meditationmitigating-parkinsons-symptoms.html Costa, M. Quelhas, R. (2009). Anxiety, Depression, and lumber of living in Parkinsons disorder. The daybook of Neuropsychiatry and clinical Neurosciences 2009 21413-419. Jarvis, C. (2012). animal(prenominal) testing wellness Assessment. St. Louis Elsevier Kegelmeyer, D., (July 1, 2013) useable demarcation line insurance coverage (FLR) chthonic 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 disease. Dysphagia 1997 121118 mammy general hospital (MGH) (May, 2005) Hoehn and Yahr re-create of Parkinsons sickness, interrelated Parkinson Disease rank surpass (UPDRS), and Schwab and England Activities of free-and-easy Living. momma command Hospital. Retrieved surround 2, 2014, from http//neurosurgery.mgh.harvard.edu/functional/pdstages.htmHoehnandYahr Okun, M. (2013). Parkinsons interposition 10 Secrets to a Happier Life. CreateSpace free make Michael S. Okun M.D. Parkinsons disease infrastructure (2014, contact) misgiving Parkinsons. Parkinsons Disease Foundation. Retrieved certify 2, 2014, from http//www.pdf.org/en/understanding_pd University of physician medical exam Center (2012, September) Parkinsons disease. University of physician medical checkup Center. Retrieved March 2, 2014, from http//umm.edu/health/medical/repo rts/articles/parkinsons-diseaseixzz2upFLCggw VanMeter, K. C., Hubert, R. J. (2014). Goulds Pathophysiology for the health Professions. St. Louis Elsevier.