Parkinsons Disease Flashcards
Parkinsons disease
Chronic progressive neurodegenerativve disease of the CNS NO DISEASE
Causes of PD
Unknown could be enviromental or a persons-genetic
Increase risk well water, pesticides, herbicides, industrial chemicals, wood, pulp mills rural residence
Dopamine
Degeneration of dopamine
Clinical manifestions of PD
Onset is gradual and insidious with ongoing progression
Tremor(resting tremor)
Rigidity
Akinesia(absent of movement) / OR bradykinesia(slow/movement).
Postural instability
Beginnings stages
Mild tremor, slight limp, decrease arm swing
Later stages
shuffling propulsive gait with arms flexed, loss of postural reflexes
Diaphragm , tongue lips jaw may be involved
Tremor
Often first sign
Pill rolling hand tremor
Initially minimal
More prominent at rest
Aggravated by emostional stress
And increase concentration
PD drool so they are at risk for
Aspiration
What do 90% of PD pt experience
Hypokinetic dysarthria
Rigidity
Cogwheel rigidity (jerky quality,
Sustained muscle contraction
Complaints of soreness
Feeling tired and achy
Pain in the head upper body spine or legs
Slowness of movement
Characteristic is of a person with PD
Stooped posture
Masked face
Drooling
Destination (shuffling gait)
Nonmotor symptoms
Depression and anxiety
Apathy
Fatigue
Pain
Urinary retention andconstipation
Erectile dysfunction
Memory changes
Sleep inPD
Sleep problems common
Difficulty staying asleep
Restless sleep
Nightmares
Drowsiness during the day
REM behavir disorder
(Violent dreams potentially dangerous motor activity during sleep )
Complications as disease progresses
Motor symptoms
Weakness
Akinesia
Neuro problems
Neuropsychiatric problems
Dementia often results (increase mortality)
Dysphagia results from PD what can that cause
Malnutrition and aspiration
What PD complications of general debilitation (weakness) may lead
Pneumonia UTIs skin break down
Orthostatic BP results from PD what risk does this increase
Fall an injuries
Diagnostic test PD
No definite diagnostics ***
Pt history and clinical features
Presence of two or more cardinal manifestations TRAP
Medicalhistory presenting symptoms neuro exam
POSITIVE RESPONSE TO ANTIPARKINSONIAN DRUGS
What are we things that PD suffer from
Focusing on two things at once ( writing small- focusing on writing big)
Overactive bladder (if they have an urgency but walk slow)
What teaching can we do for rigidity ?
Passive range of motion so they dont develop atrophy
PD drug therapy
Aimed at correcting imbalances of neurotransmitters within the CNS
Antiparksinson drugs either enhance or release supply of dopamine
Antagonize or block the effects of overactive cholinergic neurons in the striatum
Deep brain stimulation
Most common surgical treatment
Reversible and programmable
Improves motor function
Reduces dyskinesia and medications
Pace maker for the brain
In clavicle but if they have enough fat but if not they put it in abdomen
Ablation therapy
Destroy tissue that produces abnormal chemical or electrical impulses leading to tremors or other symptoms
Transplantation
Research and clinical trials ongoing
Nutritional therapy
At risk for mal nurtirion or constiipation
Pt with Dysphagia and bradykinesia need food that is easily chewed and swallowed
Adequate fiber
Eating more numerous small meals
Provide ample time
Nursing diagnosis
Self care deficit
Chronic confusion
Impaired physical mobility
Impaired verbal communication
Impaired swallowing
Risk for imbalanced nutrition less than body requirements
Nursing management
Maximize neuro function
Maintain independence-ADLS
Optimize psychosocial well being
Administer medication as prescribed
Facilitate nutritional intake
Interdisciplinary collaboration -PT , OT speech
