Parkinson's disease Flashcards
What is Parkinson’s disease?
slowly progressing neurologic movement disorder that leads to disability
What age does Parkinson’s disease occur?
greater than 40
Parkinson’s disease affects more ___ than ___
men than women
Parkinson’s disease is usually ___
idiopathic
What secondary issues can cause Parkinson’s?-6
- atherosclerosis
- excess free radicals
- viral infections
- head trauma
- chronic antipsychotic meds
- environmental exposures
Parkinson’s disease is associated with decreased levels of ___
dopamine
cardinal symptoms of Parkinson’s disease (must have ___ of these symptoms)
- tremor
- rigidity
- bardykinesia
- postural instability
- must have 2
tremor characteristics -5
- slow
- unilateral
- resting (disappears with purposeful movement, not present during sleep)
- pronation/supination forearm and hand
- motion of thumb against fingers (pill rolling)
rigidity characteristics- 4
- muscle rigidity
- passive movement of extremities happens in jerky increments
- cog wheel movements
- stiffness in neck/shoulders
bradykinesia characteristics-4
- slowing of active movements
- takes longer to complete activities
- difficulty in initiating movement
- give these patients extra time to do activities
postural instability characteristics- 4
- shuffling gait
- stooped posture, head bent forward
- loss of balance
- difficulty pivoting
Autonomic symptoms of PD-17
-excessive sweating
-drooling
-flushing
• Orthostatic hypotension
• Gastric retention
• Urinary retention
• Constipation
• Sexual disturbances
• Speech disturbance
• Sleep difficulties
• Dysphagia
• Anxiety
• Constipation
• Numbness/tingling
• Dementia
• Depression
• Micrographia
PD assessment and dx-3
based on patients hx (age, gender, family hx, head trauma)
presence of 2 or more of cardinal symptoms
diagnosis can be confirmed by positive response to levodopa
Medical goal for PD
manage symptoms and maintain functional independence
PD meds
levodopa and carbidopa (taken together)
What does levodopa do
it is converted to dopamine in basal ganglia
What does carbidopa do
added to tx to prevent metabolism of levodopa before it reaches the brain
SE carbidopa-7
N/V, hypotension, loss of appetite, confusion, dystonia, dyskinesia
other classes of meds used for PD-4
- anticholinergics
- antivirals
- dopamine agonists
- monoamine oxidase-inhibitors
What do anticholinergics do in PD
counteract acetylcholine, control tremors
ex anticholinergics
apo-trihex
congentin
SE apo-trihex -6
- blurred vision
- flushing
- rash
- constipation
- urinary retention
- acute confusional state
When is congentin contraindicated
in patients with narrow-angle glaucoma
what do antivirals do in PD
reduce tremor, rigidity, bradykinesia, postural changes
ex antiviral
symmetrel
SE symmetrel-5
- psychiatric disturbances
- lower extremity edema
- nausea
- epigastric pain
- urinary retention
what are dopamine agonists used for in PD
used in early PD or when levodopa/carbidopa don’t work anymore
ex dopamine agonist
parlodel, premix
se parlodel-5
- N/V/D
- lightheadedness
- hypotension
- impotence
- psychiatric effects
What do monoamine oxidase-inhibitors do in PD
inhibits dopamine breakdown (antidepressant)
ex monoamine oxidase-inhibitors
Emma, axilect
SE emsam-2
-stomatitis, postural hypotension
What does a deep nerve stimulator do?
blocks nerve pathways associated with tremors
candidate for deep nerve stimulator-3
- med not working
- debillitating muscle spasms
- severe SE of levodopa/carbidopa
Nursing interventions PD-7
- improve mobility
- promote self-care activities
- maintain adequate nutrition
- enhance swallowing
- maintain bowel/bladder function
- improve communication
- promote effective coping mechanisms
promoting self care activities-2
- Encourage to do ADLs within their abilities
* Environmental modifications may be necessary
enhance swallowing-3
- Have pt sit in upright position
- Semisolid diet with thick liquids are easier to swallow than solids
- Thin liquids should be avoided
