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Module 4 > Parkinsons > Flashcards

Parkinsons Flashcards

1
Q

what is Parkinsons?

A

chronic progressive neurodegenerative dz od CNS

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2
Q

primary manifestation is in

A

motor dysfunction

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3
Q

more common in which gender

A

males

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4
Q

cause?
might be related to

A

unknown
environmental factors/genetics

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5
Q

secondary/atypical parkinsons

A

-exposed to chemicals
-drug induced (prescribed, illicit)

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6
Q

lack of dopamine

A

-essential for normal functioning
-disrupts dopamine-acetylcholine balance in basal ganglia
-symptoms appear with 60% neuron loss and 80% dopamine decrease

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7
Q

clinical manifestations

A

TRAP
tremor
rigidity
akinesia / bradykinesia
postural instability

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8
Q

beginning stages symptoms

A

mild tremor, slight limp, decreased arm swing

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9
Q

what kind of tremor?

A

resting tremor

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10
Q

later stages symptoms

A

shuffling, propulsive gait w arms flexed, loss of postural reflexes

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11
Q

tremor

A

-often 1st sign
-initially minimal
-more prominent at rest
-aggravated by : emotional stress, increased concentration

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12
Q

tremor is also called

A

pill rolling hand tremor

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13
Q

tremor will eventually effect

A

diaphragm, tongue, lips, jaw

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14
Q

rigidity is

A

increased resistance to passive motion when limbs are moved through ROM

cogwheel rigidity

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15
Q

akinesia

A

absence or loss of control of voluntary muscle movements

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16
Q

bradykinesia

A

slowness of movement
particularly evident in loss of automatic movements

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17
Q

loss of automatic movements

A

-stooped posture
-masked face
-drooling
-festination (shuffling gait)

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18
Q

nonmotor symptoms

A

-depression/anxiety
-apathy
-fatigue
-pain
-urinary retention and constipation
-ED
-memory changes

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19
Q

________ problems are common

A

sleep

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20
Q

T or F ; pt can get “parkinsons dementia”

A

true

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21
Q

complications ________ as dz ________

A

progress
progress

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22
Q

dysphagia may result in

A

malnutrition/aspiration

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22
Q

debilitation may lead to

A

pneumonia, UTI, skin breakdown

23
Q

is pt at risk for falls and injuries? why?

A

yes, orthostatic hypotension is a complication

24
Q

is there a definitive diagnostic procedure?

A

NO

25
Q

how do we diagnose?

A

-pt history, clinical features
-2+ TRAP
-medical hx, symptoms, neuro exam
-postive response to antiparkinsonian drug

26
Q

drug therapy is aimed at

A

correcting imbalances of neurotransmitters within CNS

27
Q

antiparkinsonian drugs either

A

-enhance or release dopamine
-antagonize or block effects of overactive cholinergic neurons

28
Q

most commonly used drugs for PD are

A

dopaminergic agents

29
Q

dopaminergic agent- most common

A

levodopa

30
Q

anticholinergic agent

A

benztropine

31
Q

levodopa is _____________, but benefits ______ over time

A

highly effective
diminish

32
Q

what form is levodopa

A

PO - absorbed in intestine

33
Q

does food delay absorption of levodopa? which food reduce therapeutic effects?

A

yes - high protein

34
Q

levodopa/carbidopa what does carbidopa do?

A

help levodopa cross BBB

35
Q

dopamine agonists are first choice for

A

mild or moderate symptoms

36
Q

dopamine agonists do not compete with

A

dietary protein

37
Q

pramipexole is used alone in _________ and with ______ in advance PD

A

early PD
levodopa

38
Q

pramipexole alone can cause

A

sleep attacks

39
Q

anticholinergic meds

A

trihexiphenidyl and benztropine

40
Q

MOA of trihexiphenidyl and benztropine

A

decreases activity of ACh

41
Q

never stop med abruptly, why?

A

can have rebound effect

42
Q

COMT inhibitors inhibit

A

metabolism of levodopa in periphery (cross BBB)

43
Q

COMT inhibitors

A

entacapone
tolcapone

44
Q

entacapone is used with
because?

A

levodopa - inhibits breakdown of levodopa in periphery

45
Q

tolcapone use with

helps

A

levodopa

extend effects of levodopa up to 3 hrs a day

46
Q

MAO-B inhibitors are considered

can be given with

A

first line drugs for PD

levodopa - reduces wearing off effect

47
Q

MAO-B inhibitors

A

-selegiline
-rasagiline

48
Q

selegiline can be given early on as ________ or later with ________

A

mono therapy

levodopa

49
Q

parkinsons pt will have multiple

A

changes or adds of medicines

50
Q

rasagiline is used for _______ therapy and for combined use with ______

A

initial

levodopa

51
Q

other things used to manage PD

A

-antihistamines : tremors
-antiviral agent amantadine
-amorphine : hypo mobility

52
Q

surgery (last resort)

A

-deep brain stimulation : most common
-ablation
-tranplantation (stem cell - not approved)

53
Q

care for PD

A

nutrition
(malnutrition, constipation)
(dysphagia, bradykinesia)
(adequate fiber)
(more numerous small meals)

54
Q

nursing diagnoses

A

-self care deficity
-chronic confusion
-impaired physical mobility
-impaired verbal communication
-impaired swallowing
-risk for imbalanced nutrition

55
Q

nursing management

A

-maximize neuro function
-maintain ADL
-optimize psychosocial well being
-administer meds
-nutrition
-PT, OT, SpeechT

Module 4 (23 decks)

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