Parkinson's Disease Flashcards

1
Q

What disease is classified as a chronic, progressive, insidious, neurodegenerative disease?

A

Parkinson’s Disease.

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2
Q

What is the pathology of Parkinson’s Disease?

A

Not enough dopamine.

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3
Q

What is the relation of dopamine to acetylcholine in PD?

A

Not enough Dopamine. Normal balance of Acetylcholine.

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4
Q

4 cardinal features of PD?

A
  1. Tremor
  2. Muscle rigidity
  3. Bradykinesia
  4. Postural Instability (later)
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5
Q

Difference between PD tremors and essential tremors.

A

PD tremors are “rest tremors” or, pill-rolling, when the pt. is not engaged in activity. Essential tremors occur w/ movement.

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6
Q

PD tremor initial presentation.

A

Unilateral

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7
Q

Define muscle rigidity.

A

Increased resistance to PROM (jerky quality).

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8
Q

Muscle rigidity initial presentation.

A

Unilateral

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9
Q

What is the major cause of disability in pts. w/ PD?

A

Bradykinesia

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10
Q

Define bradykinesia.

A

Generalized slowness in movement.

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11
Q

How do pts. describe bradykinesia?

A

“Weakness, incoordination, and tiredness”

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12
Q

Why are tremors the least debilitating of PD cardinal symptoms?

A

B/c they improve with purposeful activity.

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13
Q

What happens in patients w/ postural instability?

A

They lose their balance. FALL RISK.

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14
Q

Non-motor/ neuropsychiatric manifestations in PD?

A
Cognitive disfunction & dementia.
Psychoses & hallucinations
Mood disorders
Olfactory dysfunction
Sleep disturbances
Autonomic dysfunction
Pain/sensory disorders
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15
Q

What is the physical appearance of a patient with PD?

A
Flat affect
Tilting forward
Soft, slow, monotonous speech. Dysarthria (slurred speech)
Tremors
Shuffling gait
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16
Q

What is micrographia?

A

Progressive shrinking of hand-writing associated w/ PD

17
Q

What is the ultimate confirmation of PD?

A

Positive response to antiparkinsonian drugs.

18
Q

What is the goal of drug therapy in pts. w/ PD?

A

Relief of symptoms. No cure.

19
Q

What is the most effective drug at treating symptoms of PD?

A

Levodopa

20
Q

Nursing implications w/ Levodopa?

A

Only effective for a certain period of time. Wears off w/in several years. Monitor s/s on-off phenomenon.

21
Q

Difference between on and off in PD.

A

On=mobile

Off=immobile

22
Q

List 3 interventions for pts. experiencing on-off phenomenon?

A

Reduce inter-dose intervals.
Controlled-release meds.
Avoid high-protein meals.

23
Q

What is the most common surgical procedure for pts. w/ advance PD?

A

Deep brain stimulation (DBS)

24
Q

What happens in DBS?

A

Electrodes are surgically placed in the brain and connected to a neurostimulator (pacemaker device).

25
Q

Is DBS life-long?

A

No. It is reversible.

26
Q

What will cause a patient to freeze while walking?

A

Shuffled gate and bradykinesia associated with PD.

27
Q

List nursing interventions for a PD patient who freezes while walking.

A
  1. Consciously think about stepping over imaginary or real lines on the floor.
  2. Drop rice kernels and step over them.
  3. Rock from side to side.
  4. Lift toes when stepping.
  5. Take one step backward and two steps forward.
  6. Remove rugs and other tripping hazards in the home.