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G240 Exam #4 > Parkinson's disease > Flashcards

Parkinson's disease Flashcards

1
Q

What is Parkinson’s disease?

A

slowly progressing neurologic movement disorder that leads to disability

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2
Q

What age does Parkinson’s disease occur?

A

greater than 40

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3
Q

Parkinson’s disease affects more ___ than ___

A

men than women

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4
Q

Parkinson’s disease is usually ___

A

idiopathic

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5
Q

What secondary issues can cause Parkinson’s?-6

A
  • atherosclerosis
  • excess free radicals
  • viral infections
  • head trauma
  • chronic antipsychotic meds
  • environmental exposures
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6
Q

Parkinson’s disease is associated with decreased levels of ___

A

dopamine

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7
Q

cardinal symptoms of Parkinson’s disease (must have ___ of these symptoms)

A
  • tremor
  • rigidity
  • bardykinesia
  • postural instability
  • must have 2
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8
Q

tremor characteristics -5

A
  • slow
  • unilateral
  • resting (disappears with purposeful movement, not present during sleep)
  • pronation/supination forearm and hand
  • motion of thumb against fingers (pill rolling)
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9
Q

rigidity characteristics- 4

A
  • muscle rigidity
  • passive movement of extremities happens in jerky increments
  • cog wheel movements
  • stiffness in neck/shoulders
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10
Q

bradykinesia characteristics-4

A
  • slowing of active movements
  • takes longer to complete activities
  • difficulty in initiating movement
  • give these patients extra time to do activities
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11
Q

postural instability characteristics- 4

A
  • shuffling gait
  • stooped posture, head bent forward
  • loss of balance
  • difficulty pivoting
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12
Q

Autonomic symptoms of PD-17

A

-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

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13
Q

PD assessment and dx-3

A

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

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14
Q

Medical goal for PD

A

manage symptoms and maintain functional independence

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15
Q

PD meds

A

levodopa and carbidopa (taken together)

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16
Q

What does levodopa do

A

it is converted to dopamine in basal ganglia

17
Q

What does carbidopa do

A

added to tx to prevent metabolism of levodopa before it reaches the brain

18
Q

SE carbidopa-7

A

N/V, hypotension, loss of appetite, confusion, dystonia, dyskinesia

19
Q

other classes of meds used for PD-4

A
  • anticholinergics
  • antivirals
  • dopamine agonists
  • monoamine oxidase-inhibitors
20
Q

What do anticholinergics do in PD

A

counteract acetylcholine, control tremors

21
Q

ex anticholinergics

A

apo-trihex

congentin

22
Q

SE apo-trihex -6

A
  • blurred vision
  • flushing
  • rash
  • constipation
  • urinary retention
  • acute confusional state
23
Q

When is congentin contraindicated

A

in patients with narrow-angle glaucoma

24
Q

what do antivirals do in PD

A

reduce tremor, rigidity, bradykinesia, postural changes

25
Q

ex antiviral

A

symmetrel

26
Q

SE symmetrel-5

A
  • psychiatric disturbances
  • lower extremity edema
  • nausea
  • epigastric pain
  • urinary retention
27
Q

what are dopamine agonists used for in PD

A

used in early PD or when levodopa/carbidopa don’t work anymore

28
Q

ex dopamine agonist

A

parlodel, premix

29
Q

se parlodel-5

A
  • N/V/D
  • lightheadedness
  • hypotension
  • impotence
  • psychiatric effects
30
Q

What do monoamine oxidase-inhibitors do in PD

A

inhibits dopamine breakdown (antidepressant)

31
Q

ex monoamine oxidase-inhibitors

A

Emma, axilect

32
Q

SE emsam-2

A

-stomatitis, postural hypotension

33
Q

What does a deep nerve stimulator do?

A

blocks nerve pathways associated with tremors

34
Q

candidate for deep nerve stimulator-3

A
  • med not working
  • debillitating muscle spasms
  • severe SE of levodopa/carbidopa
35
Q

Nursing interventions PD-7

A
  • improve mobility
  • promote self-care activities
  • maintain adequate nutrition
  • enhance swallowing
  • maintain bowel/bladder function
  • improve communication
  • promote effective coping mechanisms
36
Q

promoting self care activities-2

A
  • Encourage to do ADLs within their abilities

* Environmental modifications may be necessary

37
Q

enhance swallowing-3

A
  • Have pt sit in upright position
  • Semisolid diet with thick liquids are easier to swallow than solids
  • Thin liquids should be avoided

G240 Exam #4 (7 decks)

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