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NCM 116 Lecture > Midterms_ Parkinson’s Disease > Flashcards

Midterms_ Parkinson’s Disease Flashcards

1
Q

is a chronic progressive disease of the nervous system characterized by the cardinal features of rigidity, bradykinesia tremor and postural instability

A

Parkinson’s disease (PD)

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2
Q

is a degenerative disease caused by depletion of dopamine, which interferes with the inhibition of excitatory impulses.

A

Parkinson’s disease

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3
Q

PD is a dysfunction of the_____

A

extrapyramidal system

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4
Q

Parkinson’s disease is a degenerative disease caused by ____________ which interferes with the inhibition of excitatory impulses.

A

depletion of dopamine,

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5
Q

Refers to a group of disorders that produce abnormalities of basal ganglia (BG) function.

A

PARKINSONISM

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6
Q

is the most common form.

A

PARKINSON’S DISEASE or IDIOPATHIC PARKINSONISM

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7
Q

results from a number of identifiable causes, including virus, toxins, drugs, tumors.

A

SECONDARY PARKINSONISM

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8
Q

refer to those conditions that mimic PD in some respects, but the symptoms are caused by some other neurodegenerative disorders.

A

PARKINSONISM-PLUS SYNDROMES:

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9
Q

Age and Gender Risk factor

A

60 and Male

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10
Q

Is Drug- or chemical-related.

A

Secondary, or iatrogenic, Parkinson’s Disease

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11
Q

Dopamine-depleting drugs

A

reserpine,phenothiazine, metoclopramide, tetrabenazine,and the butyrophenones (droperidol and
haloperidol) can lead to secondary
Parkinson’s Disease.

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12
Q

Cut section of the midbrain and see Diminished ______

A

substantia nigra as seen in PD

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13
Q

planning and programming of movement by selecting and inhibiting specific motor synergies.
Plays an important role in cognitive processes,

A

BASAL GANGLIA

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14
Q

One of the clinical hallmarks of Parkinson’s disease.

A

Rigidity

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15
Q

Defined as increased resistance to passive motion.

A

Rigidity

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16
Q

jerky, ratchet-like resistance to passive movement and muscles alternately tense and relaxed.

A

Cogwheel rigidity

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17
Q

no fluctuations, more sustained resistance to passive movements. Prolonged rigidity results in decreased range of motion and serious secondary complications of contractures and postural deformity.

A

Lead pipe rigidity

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18
Q

Clinical Presentations of PD

A

Rigidity
Bradykinesia
Tremor
Postural Instability
MOTOR PLANNING AND MOTOR LEARNING
Gait
Sensation
Speech, Voice, and Swallowing
Cognitive function and behavior
Autonomic Nervous System
Cardiopulmonary Function Orthostatic hypotension.

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19
Q

PRIMARY NURSING DIAGNOSIS

A

SELF-CARE DEFICIT RELATED TO RIGIDITY AND TREMORS

20
Q

Diagnostic Evaluation

A

through clinical findings rather than diagnostic tests. The Key To Diagnosis is the patient’s response to levodopa.

21
Q

Diagnostic Evaluation

A

Positron emission tomography (PET) and single photon emission computed tomography (SPECT) show decreased dopamine uptake in

22
Q

Manifests as _______of hand.

A

pill-rolling tremor

23
Q

an abnormally small handwriting that is difficult to read.

A

micrographia

24
Q

reduction in expressiveness of the face (masked face).

A

hypomimia

25
Q

Gait can be______ (a forward festinating gait) or_______ (a backward festinating gait).

A

anteropulsion

retropulsive

26
Q

contracture leads to toe walking and adds to postural instability.

A

Plantarflexion

27
Q

a sense of inner restlessness and need to move.

A

Akathisia

28
Q

excessive drooling) as there is increased salivary production and decreased swallowing.

A

sialorrhea

29
Q

disorders of intellectual function. It is characterized by a slowing of thought and information processing.

A

Bradyphrenia

30
Q

ANS system dysfunction occurs with PD.

A

Dysautonomia

31
Q

PD patients exhibit abnormally_____ pupillary responses to light and pain

A

slow

32
Q

Orthostatic hypotenstion

A

Lower forced vital capacity (FVC), forced
expiratory volume (FEV1) and higher residual
volume.

33
Q

A diagnosis of PD can be made if at least_____ of the four cardinal features are present.

A

two

34
Q

Medical Diagnosis

A

Longterm levodopa therapy

Autologous transplantation of small portions of the adrenal gland

thalamotomy or stereotaxic neurosurgery

35
Q

Pharmacologic Highlight’s

A

Levodopa (L-dopa);carbidopa-levodopa (Sinemet)

Amantadine hydrochloride(Symmetrel)

Trihexyphenidyl(Artane); benztropine mesylate (Cogentin)

Antihistamines

bromocriptine mesylate,

36
Q

★ Antiparkinson drugs

A

as Levodopa (L-dopa);carbidopa-levodopa (Sinemet) are used to control tremors and rigidity; converted to dopamine in basal ganglia.

37
Q

Antiviral agents such as _______l) is used to control tremor rigidity by increasing the release of dopamine to the basal ganglia.

A

Amantadine hydrochloride(Symmetre

38
Q

Synthetic anticholinergics such as_________ is used to block acetylcholine-stimulated nerves that lead to tremors.

A

Trihexyphenidyl(Artane); benztropine mesylate (Cogentin)

39
Q

are sometimes prescribed with the anticholinergics to inhibit dopamine uptake

A

Antihistamines

40
Q

a dopamine antagonist, is ordered to stimulate dopaminergic receptors.

A
41
Q

NURSING INTERVENTIONS

A

Assess neurological status.
➔ Assess ability to swallow and chew.
➔ Provide high-calorie, high-protein, high-fiber soft
diet with small,frequent feedings.
➔ Increase fluid intake to 2000 mL/day.
➔ Monitor for constipation.
➔ Promote independence along with safety
measures.
➔ Avoid rushing the client with activities.
➔ Assist with ambulation and provide assistive
devices.
➔ Instruct clients to rock back and forth to initiate
movement.
➔ Instruct the client to wear low-heeled shoes.
➔ Encourage the client to lift feet when walking
and avoid prolonged sitting.
➔ Provide a firm mattress, and position the client
prone, without pillow, to facilitate proper posture.
➔ Instruct in proper posture by teaching the client to hold the hands behind the back to keep the
spine and neck erect.
➔ Promote physical therapy and rehabilitation.
➔ Administer anticholinergic medications as
prescribed to treat tremors and rigidity and to
inhibit the action of acetylcholine.
➔ Administer antiparkinsonian medications
increase the level of dopamine in the CNS.
➔ Instruct the client to avoid foods high in vitamin B6 because they block the effects of
antiparkinsonian medications.
➔ Instruct the client to avoid monoamine oxidase
inhibitors because they will precipitate hypertensivecrisis.

42
Q

Nursing interventions:Diet

A

Provide high-calorie, high-protein, high-fiber soft
diet with small,frequent feedings.

43
Q

Nursing inteventions : Fluid

A

➔ Increase fluid intake to 2000 mL/day.

44
Q

Instruct the client to avoid foods high in ________because they block the effects of
antiparkinsonian medications.

A

vitamin B6

45
Q

Instruct the client to avoid___________
inhibitors because they will precipitate hypertensivecrisis.

A

monoamine oxidase

46
Q

DOCUMENTATION GUIDELINES

A

Ability to ambulate, perform the activities of daily living,progress in an exercise program
Use of verbal and nonverbal communication Statements about body image and self-esteem Discomfort during activity

47
Q

DISCHARGE AND HOME HEALTHCARE GUIDELINES

A
  1. medications
  2. Avoid the use of alcohol, reserpine, pyridoxine, and phenothiazine while taking levodopa.
    3.In general, recommend massage and relaxation techniques,

NCM 116 Lecture (11 decks)

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