Parkinson's Disease

Question 1

Parkinson’s disease

Answer 1

progressive disorder characterized by tremors, rigidity, bradykinesia and postural instability

Question 2

pathophysiology of parkinson’s disease

Answer 2

Destruction of dopaminergic neuronal cells in the substantia nigra in the basal ganglia

Depletion of dopamine stores

Degeneration of the dopaminergic nigrostriatal pathway

Imbalance of excitatory (acetylcholine) and inhibiting (dopamine) neurotransmitters in the corpus striatum

Impairment of extrapyramidal tracts controlling complex body movements

Tremors, rigidity, bradykinesia, postural changes

Question 3

dopamine

Answer 3

neurotransmitter responsible for movement)

Question 4

risk factors for parkinson’s disease

Answer 4

Age (greater than 50 years old) – increased risk in patients greater than 85 years old

Gender (males > females)

Genetics

Environmental exposures (oxidative stress, chemical exposure, meds such as anti-psychotics, anti-depressants)

Head injury (brain injury, repeated head trauma, cerebrovascular disease)

Question 5

clinical manifestations of parkinson’s disease

Answer 5

resting tremors
rigidity
bradykinesia
postural instability

Question 6

how is parkinson’s disease diagnosed?

Answer 6

2 of 4 cardinal manifestations; diagnosis of exclusion

Question 7

goal of pharmacologic treatment

Answer 7

to control signs and symptoms and maintain functional status

Question 8

levodopa

Answer 8

dopamine precursor, able to cross blood brain barrier

Question 9

carbidopa

Answer 9

slows breakdown of levodopa, ↑ uptake & ↓ side effects

Question 10

side effects of levodopa carbidopa

Answer 10

nausea, vomiting, orthostatic hypotension

avoid high protein meals ⇢ will decrease effect on motor function

Question 11

onset of levodopa carbidopa

Answer 11

2-3 weeks

Question 12

nursing assessment

Answer 12

Degree of disability, function of patient: ADLs, IADLS, cognitive function

Medications & response to medications

Emotional response & individual coping

Family processes & coping

Home care and education needs

Fall risk assessment

Potential complications

Question 13

maintaining functional ability

Answer 13

Daily program of exercise 
ROM exercises
Postural exercises 
Consultation with physical therapy 
Walking techniques for safety and balance
Frequent rest periods – avoid frustration and fatigue 
Proper shoes 
Use of assistive devices