Midterms_ Parkinson’s Disease

Question 1

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

Answer 1

Parkinson’s disease (PD)

Question 2

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

Answer 2

Parkinson’s disease

Question 3

PD is a dysfunction of the_____

Answer 3

extrapyramidal system

Question 4

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

Answer 4

depletion of dopamine,

Question 5

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

Answer 5

PARKINSONISM

Question 6

is the most common form.

Answer 6

PARKINSON’S DISEASE or IDIOPATHIC PARKINSONISM

Question 7

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

Answer 7

SECONDARY PARKINSONISM

Question 8

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

Answer 8

PARKINSONISM-PLUS SYNDROMES:

Question 9

Age and Gender Risk factor

Answer 9

60 and Male

Question 10

Is Drug- or chemical-related.

Answer 10

Secondary, or iatrogenic, Parkinson’s Disease

Question 11

Dopamine-depleting drugs

Answer 11

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

Question 12

Cut section of the midbrain and see Diminished ______

Answer 12

substantia nigra as seen in PD

Question 13

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

Answer 13

BASAL GANGLIA

Question 14

One of the clinical hallmarks of Parkinson’s disease.

Answer 14

Rigidity

Question 15

Defined as increased resistance to passive motion.

Answer 15

Rigidity

Question 16

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

Answer 16

Cogwheel rigidity

Question 17

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.

Answer 17

Lead pipe rigidity

Question 18

Clinical Presentations of PD

Answer 18

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.

Question 19

PRIMARY NURSING DIAGNOSIS

Answer 19

SELF-CARE DEFICIT RELATED TO RIGIDITY AND TREMORS

Question 20

Diagnostic Evaluation

Answer 20

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

Question 21

Diagnostic Evaluation

Answer 21

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

Question 22

Manifests as _______of hand.

Answer 22

pill-rolling tremor

Question 23

an abnormally small handwriting that is difficult to read.

Answer 23

micrographia

Question 24

reduction in expressiveness of the face (masked face).

Answer 24

hypomimia

Question 25

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

Answer 25

anteropulsion retropulsive

Question 26

contracture leads to toe walking and adds to postural instability.

Answer 26

Plantarflexion

Question 27

a sense of inner restlessness and need to move.

Answer 27

Akathisia

Question 28

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

Answer 28

sialorrhea

Question 29

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

Answer 29

Bradyphrenia

Question 30

ANS system dysfunction occurs with PD.

Answer 30

Dysautonomia

Question 31

PD patients exhibit abnormally_____ pupillary responses to light and pain

Answer 31

slow

Question 32

Orthostatic hypotenstion

Answer 32

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

Question 33

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

Answer 33

two

Question 34

Medical Diagnosis

Answer 34

Longterm levodopa therapy Autologous transplantation of small portions of the adrenal gland thalamotomy or stereotaxic neurosurgery

Question 35

Pharmacologic Highlight’s

Answer 35

Levodopa (L-dopa);carbidopa-levodopa (Sinemet) Amantadine hydrochloride(Symmetrel) Trihexyphenidyl(Artane); benztropine mesylate (Cogentin) Antihistamines bromocriptine mesylate,

Question 36

★ Antiparkinson drugs

Answer 36

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

Question 37

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

Answer 37

Amantadine hydrochloride(Symmetre

Question 38

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

Answer 38

Trihexyphenidyl(Artane); benztropine mesylate (Cogentin)

Question 39

are sometimes prescribed with the anticholinergics to inhibit dopamine uptake

Answer 39

Antihistamines

Question 40

a dopamine antagonist, is ordered to stimulate dopaminergic receptors.

Question 41

NURSING INTERVENTIONS

Answer 41

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.

Question 42

Nursing interventions:Diet

Answer 42

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

Question 43

Nursing inteventions : Fluid

Answer 43

➔ Increase fluid intake to 2000 mL/day.

Question 44

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

Answer 44

vitamin B6

Question 45

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

Answer 45

monoamine oxidase

Question 46

DOCUMENTATION GUIDELINES

Answer 46

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

Question 47

DISCHARGE AND HOME HEALTHCARE GUIDELINES

Answer 47

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