Exam 4 - Parkinsons Flashcards
Parkinson’s is an imbalance of which neurotransmitter
dopamine
TRAP
tremors
rigidity
akinesia, bradykinesia
postural instability
incidence of Parkinson’s increases with ___
age
are men or women more likely to develop Parkinson’s
men
cause of Parkinson’s
unknown; idopathic
possible risks for Parkinson’s
well water pesticides herbicides industrial chemicals wood pulp mills rural residence
the onset of Parkinson’s is ___ and ___ with ongoing remission
gradual; insidious
s/sx at the beginning of Parkinson’s
mild tremor
slight limp
decrease arm swing
difficulty writing
s/sx in later stage of Parkinson’s
shuffling
propulsive gait, arms flexed
loss of postural reflexes
is the Parkinson’s tremor bilateral or unilateral
unilateral
aggravating factors for tremor
emotional stress
increased concentration
occurs during voluntary movement, has more rapid frequency, is familiar
essential tremor
not associated with Parkinson’s
increased resistance to passive motion when limbs are moved through their ROM
rigidity
cogwheel rigidity
jerky quality
intermittent catches in passive movements of joint
rigidity can cause what?
sustained muscle contraction
c/o soreness, tired, achy
pain in head, upper body, spine, or legs
absence of loss of control of voluntary muscle movements
Akinesia
slowness of movement
particularly evident in the loss of autonomic movements
bradykinesia
loss of autonomic movement can cause what
stooped posture
masked face
drooling
festination (shuffling gait)
nonmotor symptoms r/t Parkinson’s
depression, anxiety, apathy fatigue pain urinary retention constipation ED memory changes
sleep problems r/t dementia
difficulty staying asleep restless sleep nightmares daytime drowsiness REM sleep behavior disorder *violent dreams; potentially dangerous motor activity; spouse to have separate bed
dysphasia can result in ___ or ___
malnutrition
aspiration
Dx of Parkinson’s is based on ___
H&P
*will give Parkinson’s drug; if + effect, will be Dx
Antiparkinson’s drugs will either ___ ___ or ___ ___
increase dopamine
block acetylcholine (anticholinergic)
primary drug of choice for Parkinson’s
Levodopa + Carbidopa (Sinemet)
antiviral for Parkinson’s
amantadine
increases dopamine
purpose of anticholinergics
decrease activity of acetylcholine (ACh)
action of MAO-B inhibitors
increase dopamine (DA) prolong half-life of levodopa
which drugs prolong the effect of Sinemet
Entacapone
tolcapone
COMT inhibitors
excessive dopaminergic drugs can lead to ___ ___
paradoxic intoxication
*reverse effect
hypomobility occurs within ___ to ___ years
3-5
most common surgical intervention for Parkinson’s
deep brain stimulator (DBS)
helps decrease symptoms
reversible, programmable
Parkinson’s nutrition therapy should allow for adequate ___, ___, and ___
fruit
fiber
fluid
how many meals should Parkinson’s individuals eat
6 small meals
levodopa absorption can be impaired by ___ and ___ ingestion
protein
vitamin b6
Masked expression from Parkinson’s can impair blinking therefore pts should be given ___ ___
artificial tears
what can be done to help with depth perception between bottom step and the floor
paint a red/orange strip on the bottom step
