Parkinson Disease Flashcards
What is the basic physiologic problem that causes Parkinson’s disease?
progressive neurodegenerative disorder resulting from decreased dopamine levels.
Tremor
Rigidity of muscles
Akinesia (loss of muscle movement)
Postural instability
Based on the functions of dopamine, what will you expect occur to those specific functions?
There will be?
There will be delayed and uncoordinated movements
Memory
attention
Problem solving
What are the characteristics of the Tremor associated with Parkinson’s disease?
What does the tremor look like?
Starts on?
Happens when?
Most visible manifestation
Pill rolling tremor
Tremor starts on one side and progresses to both sides
Limb is supported and at rest
Disappears with movement and sleep.
What are the characteristics of the Rigidity associated with Parkinson’s disease?
Resistance to passive motion when the limbs are moved through range of motion.
Involves jerky, cogwheel-type or ratchet-like movements that require considerable energy to perform.
This causes soreness and feeling tired/achy.
Flexion contractures may develop due to the rigidity.
Starts on one side but progresses to both sides
Bradykinesia
What is it?
Difficulty with?
Slowness in initiating and performing movements
Difficulty with sudden, unexpected stopping of voluntary movements.
Unconscious associative movements occur in a series of disconnected steps rather than in a smooth, coordinated manner.
Akinesia
Absence or loss of control of voluntary muscle movements.
Blinking
Swinging arms while walking
Swallowing saliva
They have difficulty initiating walking and difficulty turning. They may freeze in place and feel as if their feet are glued to the floor, especially when moving through a doorway or preparing to turn
What are the characteristics of the Postural instability associated with Parkinson’s disease?
Inability to?
Inability to stop themselves from going forward (propulsion) or backwards (retropulsion)
Falls, often backwards
How will the RN perform the Pull Test?
Nurse stands behind patient and gives a tug backward on the shoulder, causing the patient to lose his/her balance and fall backward.
What clinical manifestations may be present if the patient has Parkinson’s disease due to damage to the basal ganglia?
Excessive and uncontrolled
Sweating
Sebaceous gland secretion
Salivation
What is DaTscan? Why is it used?
How is it done?
Area shows?
A radioactive tracer that is injected in the bloodstream to the brain.
Helps distinguish the diagnosis of essential tremor from Parkinson-like syndromes, Parkinson’s disease or Parkinson’s disease dementia.
The area will show dark if there is a deficiency of dopamine
Explain the rationale of using levodopa and carbidopa in the treatment of Parkinson’s disease.
Levodopa is converted to dopamine in the basal ganglia.
Levodopa is given with carbidopa because carbidopa prevents levodopa from being broken down in the bloodstream
Carbidopa is the bodyguard
Why are MAO inhibitors used to treat Parkinson’s disease?
Increases the amount of dopamine
available to the brain
Why is Parlodel used to treat Parkinson’s disease?
Exam question
What are the side effects associated with this drug? 3
Stimulate dopamine receptors
Not first line because of side effects
Elevated blood pressure!!!
Seizure activity!!!
Stroke!!!!
