Exam 4 - Parkinsons

Question 1

Parkinson’s is an imbalance of which neurotransmitter

Answer 1

dopamine

Question 2

TRAP

Answer 2

tremors
rigidity
akinesia, bradykinesia
postural instability

Question 3

incidence of Parkinson’s increases with ___

Answer 3

age

Question 4

are men or women more likely to develop Parkinson’s

Answer 4

men

Question 5

cause of Parkinson’s

Answer 5

unknown; idopathic

Question 6

possible risks for Parkinson’s

Answer 6

well water
pesticides
herbicides
industrial chemicals
wood pulp mills
rural residence

Question 7

the onset of Parkinson’s is ___ and ___ with ongoing remission

Answer 7

gradual; insidious

Question 8

s/sx at the beginning of Parkinson’s

Answer 8

mild tremor
slight limp
decrease arm swing
difficulty writing

Question 9

s/sx in later stage of Parkinson’s

Answer 9

shuffling
propulsive gait, arms flexed
loss of postural reflexes

Question 10

is the Parkinson’s tremor bilateral or unilateral

Answer 10

unilateral

Question 11

aggravating factors for tremor

Answer 11

emotional stress

increased concentration

Question 12

occurs during voluntary movement, has more rapid frequency, is familiar

Answer 12

essential tremor

not associated with Parkinson’s

Question 13

increased resistance to passive motion when limbs are moved through their ROM

Answer 13

rigidity

Question 14

cogwheel rigidity

Answer 14

jerky quality

intermittent catches in passive movements of joint

Question 15

rigidity can cause what?

Answer 15

sustained muscle contraction

c/o soreness, tired, achy
pain in head, upper body, spine, or legs

Question 16

absence of loss of control of voluntary muscle movements

Answer 16

Akinesia

Question 17

slowness of movement

particularly evident in the loss of autonomic movements

Answer 17

bradykinesia

Question 18

loss of autonomic movement can cause what

Answer 18

stooped posture
masked face
drooling
festination (shuffling gait)

Question 19

nonmotor symptoms r/t Parkinson’s

Answer 19

depression, anxiety, apathy
fatigue
pain
urinary retention
constipation
ED
memory changes

Question 20

sleep problems r/t dementia

Answer 20

difficulty staying asleep
restless sleep
nightmares
daytime drowsiness
REM sleep behavior disorder
*violent dreams; potentially dangerous motor activity; spouse to have separate bed

Question 21

dysphasia can result in ___ or ___

Answer 21

malnutrition

aspiration

Question 22

Dx of Parkinson’s is based on ___

Answer 22

H&P

*will give Parkinson’s drug; if + effect, will be Dx

Question 23

Antiparkinson’s drugs will either ___ ___ or ___ ___

Answer 23

increase dopamine

block acetylcholine (anticholinergic)

Question 24

primary drug of choice for Parkinson’s

Answer 24

Levodopa + Carbidopa (Sinemet)

Question 25

antiviral for Parkinson’s

Answer 25

amantadine

increases dopamine

Question 26

purpose of anticholinergics

Answer 26

decrease activity of acetylcholine (ACh)

Question 27

action of MAO-B inhibitors

Answer 27

increase dopamine (DA)
prolong half-life of levodopa

Question 28

which drugs prolong the effect of Sinemet

Answer 28

Entacapone
tolcapone

COMT inhibitors

Question 29

excessive dopaminergic drugs can lead to ___ ___

Answer 29

paradoxic intoxication

*reverse effect

Question 30

hypomobility occurs within ___ to ___ years

Answer 30

3-5

Question 31

most common surgical intervention for Parkinson’s

Answer 31

deep brain stimulator (DBS)

helps decrease symptoms
reversible, programmable

Question 32

Parkinson’s nutrition therapy should allow for adequate ___, ___, and ___

Answer 32

fruit
fiber
fluid

Question 33

how many meals should Parkinson’s individuals eat

Answer 33

6 small meals

Question 34

levodopa absorption can be impaired by ___ and ___ ingestion

Answer 34

protein

vitamin b6

Question 35

Masked expression from Parkinson’s can impair blinking therefore pts should be given ___ ___

Answer 35

artificial tears

Question 36

what can be done to help with depth perception between bottom step and the floor

Answer 36

paint a red/orange strip on the bottom step