ATI Ch 7 Parkinson's

Question 1

4 primary sx of parkinson’s

Answer 1

tremor, muscle rigidity, bradykinesia and postural instability

Question 2

How to tx parkinson’s

Answer 2

increase dopamine or decrease Ach

Question 3

Parkinson’s stage 1

Answer 3

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

Question 4

Parkinson’s stage 2

Answer 4

bilateral limb involvement, making walking and balance very difficult

Question 5

Parkinson’s stage 3

Answer 5

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

Question 6

Parkinson’s stage 4

Answer 6

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

Question 7

Parkinson’s stage 5

Answer 7

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

Question 8

Parkinson’s statistics

Answer 8

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

Question 9

Parkinson’s s/sx

Answer 9

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

Question 10

Parkins diagnosis

Answer 10

no lab tests to confirm, done by s/sx

Question 11

Medication time frame

Answer 11

can take weeks to see any result

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

Question 12

Dopaminergics

Answer 12

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

Question 13

Dopamine agonists ex

Answer 13

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

Question 14

Dopamine agonists function

Answer 14

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

Question 15

Dopamine agonists nursing consideratios

Answer 15

Monitor for orthostatic hypotension, dyskinesias, and hallucinations

Question 16

Anticholinergics ex

Answer 16

benztropine (Cogentin) and trihexyphenidyl (Artane)

Question 17

Anticholinergics function

Answer 17

control tremors and rigidity

Question 18

Anticholinergics nursing considerations

Answer 18

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

Question 19

Catechol O-methyltransferase (COMT) inhibitors ex

Answer 19

entacapone (Comtan)

Question 20

Catechol O-methyltransferase (COMT) inhibitors function

Answer 20

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

Question 21

Catechol O-methyltransferase (COMT) inhibitors nursing considerations

Answer 21

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

Question 22

Antivirals ex

Answer 22

amantadine (Symmetrel)

Question 23

Antivirals function

Answer 23

stimulate release of dopamine and prevent its reuptake

Question 24

Antivirals nursing considerations

Answer 24

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

Question 25

Parkinson's surgical interventions

Answer 25

Stereotactic pallidotomy | Deep brain stimulation

Question 26

Stereotactic pallidotomy

Answer 26

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

Question 27

Deep brain stimulation

Answer 27

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

Question 28

Parkinson's surgical interventions nursing considerations

Answer 28

look for any signs of hemorrhage/stroke like syndromes