ATI Ch 7 Parkinson's Flashcards

1
Q

4 primary sx of parkinson’s

A

tremor, muscle rigidity, bradykinesia and postural instability

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2
Q

How to tx parkinson’s

A

increase dopamine or decrease Ach

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3
Q

Parkinson’s stage 1

A

unilateral shaking or tremor of one limb, it can be very minimal, just a couple fingers to begin with

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4
Q

Parkinson’s stage 2

A

bilateral limb involvement, making walking and balance very difficult

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5
Q

Parkinson’s stage 3

A

the physical movement slow down significantly making walking more and more difficult

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6
Q

Parkinson’s stage 4

A

the tremors may slow down, but the akinesia and rigidity may make it difficult to achieve ADLs

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7
Q

Parkinson’s stage 5

A

the client is usually able to difficulty standing and walking and are dependent for all their care, they may also show signs of dementia

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8
Q

Parkinson’s statistics

A

usually males between 40-70 yo
genetic predisposition
possible risk from environmental toxins

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9
Q

Parkinson’s s/sx

A

tremors-pill rolling
mask like expression
bradykinesia/akinesia
orthostatic hypotension

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10
Q

Parkins diagnosis

A

no lab tests to confirm, done by s/sx

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11
Q

Medication time frame

A

can take weeks to see any result

PTs can have a weaning off phenomenon and may need a medication holiday

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12
Q

Dopaminergics

A

given PO, increase dopamine, used w/ other meds like carbadopa to decrease levodopa metabolism

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13
Q

Dopamine agonists ex

A

bromocriptine (Parlodel), ropinirole (Requip), and pramipexole (Mirapex),

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14
Q

Dopamine agonists function

A

activate the release of dopamine, can be used in conjunction w/ dopaminergic

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15
Q

Dopamine agonists nursing consideratios

A

Monitor for orthostatic hypotension, dyskinesias, and hallucinations

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16
Q

Anticholinergics ex

A

benztropine (Cogentin) and trihexyphenidyl (Artane)

17
Q

Anticholinergics function

A

control tremors and rigidity

18
Q

Anticholinergics nursing considerations

A

Monitor for anticholinergic effects (dry mouth, constipation, urinary retention, acute confusion)

19
Q

Catechol O-methyltransferase (COMT) inhibitors ex

A

entacapone (Comtan)

20
Q

Catechol O-methyltransferase (COMT) inhibitors function

A

decrease the breakdown of levodopa making more available to the brain as dopamine
combined w/ dopaminergic and dopamine agonist for better results

21
Q

Catechol O-methyltransferase (COMT) inhibitors nursing considerations

A

Monitor for dyskinesia/hyperkinesia when used with levodopa. Assess for diarrhea. Dark urine is a normal finding

22
Q

Antivirals ex

A

amantadine (Symmetrel)

23
Q

Antivirals function

A

stimulate release of dopamine and prevent its reuptake

24
Q

Antivirals nursing considerations

A

Monitor for swollen ankles and discoloration of skin. PT may also have atropine-like effects.

25
Q

Parkinson’s surgical interventions

A

Stereotactic pallidotomy

Deep brain stimulation

26
Q

Stereotactic pallidotomy

A

destroy a small portion of the brain to reduce tremors and rigidity

27
Q

Deep brain stimulation

A

electrode is place into the thalamus, turned on w/ a magnet

28
Q

Parkinson’s surgical interventions nursing considerations

A

look for any signs of hemorrhage/stroke like syndromes