Care for a Patient With Experience of a Sudden Fall

Topic: Diagnostics
Words: 868 Pages: 3

At 7:56 P.M., on October 11, a patient named Daisy Loo was admitted to the ER. The patient was hospitalized after she experienced a sudden fall. She was working in the garden with her wife when the incident occurred. Subsequently, Ms. Loo arrived at the hospital for diagnostic and treatment of possible injuries incurred as a result of the fall. The patient is a 67-year-old Caucasian female with a history of rheumatoid arthritis and migraines. According to Ms. Loo’s statement, she has been experiencing continuous muscle stiffness and tremors. These symptoms have been observed for the past few months, both during activity hours and at rest. The condition interferes with the daily life of the patient, making it difficult for her to perform actions that require the use of her fine motor skills. In addition, she has been experiencing sleep issues, whereas her wife reports that Ms. Loo has been feeling frustrated about her persistent symptoms. Allegedly, the source of the frustration lies in the psychological stress about the potential neurological issues that have caused the emergence of the symptoms.

Upon admission, the patient was assisted by the hospital’s team. The primary goal was to examine the current condition of Ms. Loo and determine whether she suffered from any injuries after her fall. The patient’s body temperature was registered at the level of 37.1o C, blood pressure – 112/84, oxygenation – 99%. The vital signs of the patient do not cause any serious concerns, as they are within the normal range. At the same time, Ms. Loo did not report any pain at the moment of the examination. The patient takes several medicines, such as abatacept, metoclopramide, adalimumab, and celecoxib. Upon the completion of initial procedures, the patient was not diagnosed with any fall-related injuries. However, her reported symptoms, including stiffness and tremor, were taken into consideration by the medical team, who referred Ms. Loo to a neurologist.

Considering the persistent symptoms exhibited by Ms. Loo’s body, the neurologist has diagnosed her with Parkinson’s disease- Braak stage 2. Hauser (2019) provides a list of initial signs that indicate the likelihood of such a diagnosis. Among them are tremors, dexterity decrease, sleep disturbance, and depression. These symptoms have been reported by Ms. Loo and her wife, subsequently confirmed by the medical specialist. Furthermore, according to Hauser (2019), resting tremor indicates Parkinson’s disease in its progressive stage, which corresponds with the condition of Ms. Loo. Thus, the registered case of worsening dyspraxia and bradykinesia have confirmed the initial suspicions of the likelihood of this diagnosis. Hauser (2019) equally states that Parkinson’s disease remains one of the “most common neurologic disorders, affecting approximately 1% of individuals older than 60 years” (p. 1). As such, Ms. Loo is in the risk group because of her age. However, the progression of the disease, as well as the acuity of its symptoms, can be slowed with an appropriate intervention that includes pharmacological and physical therapy.

In the case of Parkinson’s disease, the focus of attention shifts toward the management of the symptoms exhibited by the patient as a result of the condition’s onset and development. As per the information provided by Hauser (2019), symptomatic drug therapies account for the increased control of motor signs affected by Parkinson’s disease for four to six years after the condition’s onset. Carbidopa prescriptions are usually the first solution for symptom management, which mitigates the impact of the disease on the patient’s daily functioning. Additional medication can be prescribed in the case of specific symptoms, such as fatigue or autonomic dysfunction. However, in the case of Ms. Loo, these signs are not observed, which eliminates the necessity of other drugs. If the progression of the disease is not slowed and becomes a major threat to the patient’s life, deep brain stimulation can be prescribed, including surgical procedures of choice. As humanity does not currently possess the instruments to cure Parkinson’s disease completely, the emphasis remains on preserving the patient’s autonomy and ability to enjoy life for the longest duration possible.

The case of Ms. Loo has not passed the threshold of extreme severity, which is why the medical team is hopeful in terms of the proposed intervention’s effectiveness. Following the examination, the patient has prescribed 25 mg of carbidopa orally as the primary instrument of symptom management. Based on their experience in the medical practice, this solution is expected to alleviate the presence of tremors and stiffness, increasing Ms. Loo’s comfort in daily life. It is yet to be determined if the patient’s fall was the result of Parkinson’s disease. According to Hauser (2019), postural instability is a late occurrence that indicates the significant progression of the disease. However, Ms. Loo’s fall has been a single incident so far, and the lack of repetition will indicate the absence of the balance impairment.

Nevertheless, the patient will require further consultation and regular examination that will allow neurologists to monitor the dynamics of her condition. A special emphasis should be laid on the mental comfort of Ms. Loo, as she already exhibited anxiety surrounding her health. Ideally, pharmacological intervention will not be necessary in this regard, but mental stability and peace of mind are essential components of facilitated Parkinson’s disease management.

Reference

Hauser, R. A. (2019). Parkinson disease. Web.