Parkinsons

Question 1

4 cardinal sxs of parkinsons

Answer 1

1. Tremor
   
   2. Muscle rigidity
   3. Bradykinesia/ akinesia
   4. Postural instability

Question 2

parkinsons causes

Answer 2

idiopathic or secondary to brain tumor/injury

Question 3

another name for parkinsons

Answer 3

Paralysis agitans

Question 4

Parkinsons patho

what NT are @ play?

Answer 4

• • Degeneration of substantia nigra **
• ->Results in decreased amounts of dopamine in brain

-Loss of ability to refine voluntary movement
Normal acetylcholine (excitatory neurotransmitter)
Not enough dopamine (inhibitory neurotransmitter)
-Reduced influence of SNS on heart and vessels
–>Widespread damage to ANS

Question 5

stages of parkinsons

Answer 5

Stage I Initial Stage
Stage II Mild Stage
Stage III Moderate Disease
Stage IV Severe Disability
Stage V Complete Loss of Independence

Question 6

parkinsons risk factors

Answer 6

• Cause unknown
• May be associated with environmental exposures (Pesticides, Herbicides, Drinking well water)
• May have a genetic component
• Age (>40)

Question 7

first thing when assessing parkinsons

Answer 7

history: rule out of other causes

Question 8

Parkinsons s/s

Answer 8

-Resting Tremor
-Handwriting changes
-Freezing: bradykinesia
-Rigidity (present in early disease) (cogwheel,plastic,leadpipe)
-masklike face
-changes in personality
-Dementia
-Sleep issues- awake at night, sleep during day
-Nutritional deficits- difficulty chewing/swallowing
-Speech changes
-Excessive drooling
-Autonomic Nervous System Symptoms
Orthostatic hypotension
Excessive perspiration
Bowel and Bladder problems

Question 9

spastic rigidity- if pull someones arm down it is not fluid =

Answer 9

cogwheel

Question 10

fluid movement with increased resistance- no spastic =

Answer 10

plastic

Question 11

fluid resistance with extreme rigidity - hard time pulling arm down at all =

Answer 11

lead pipe

Question 12

Changes in facial expression w/ parkinson

Answer 12

• Impaired chewing and swallowing

- Masklike face

Question 13

ANS changes in parkinsons

Answer 13

Orthostatic hypotension
Excessive perspiration
Bowel and Bladder problems

Question 14

Parkinson Disease Diagnostics

Answer 14

• No definitive tests
• Eliminate other Neurological diseases
• Based on Clinical Findings
• Cerebrospinal fluid (decrease in dopamine levels)
• MRI, SPECT, PET

Question 15

parkinson disease interventions interdisciplinary

Answer 15

• Multi-disciplinary team approach
• PT/OT
• Speech pathologist
• Dietician
• Palliative Care
• Case management
• Family & Patient

+Drug therapy

Question 16

concerns with parkinsons pharmacology

Answer 16

“Wearing off”
Drug toxicity
Drug Holiday-hospitalized to stop “wearing off”

Question 17

fall precautions for parkinsons

Answer 17

-Shoes: light tread, velcro

Question 18

nursing interventions for parkinsons

Answer 18

-Exercise
-Fall precautions
-Shoes: light tread, velcro
-Optimize independence
Clothing
Shoes
Assistive devices
-Small, frequent meals/ Individualized / supplements
Risk for aspiration
Nutritional deficits
-Communication