Parkison Disease Flashcards
What is parkison disease?
Chronic progressive neurodegenerative disorder characterized by slowness in the initiation and execution of movement ( bradykinesia ), increase muscle tone ( rigidity ), tremor at rest and gait changes
From the PowerPoint what does Parkinson’s disease mean?
Generalized slowness- loss of dopamine
( a neurotransmitter in the brain needed to initiate movement )
Tremor at rest usually is the ___
What happens to the hand writing?
First sign
Large & trails off
Slowness in initiation of movement is called?
What happens to the arm?
What happens to swallowing?
What happens to blinking, facial expression, posture?
Bradykinesia
Arms swinging
Decreasing swallowing saliva
Decrease everything
Why do patient have an increase muscular tone ?
Because they have jerking quality
( cog wheel rigidity )
Parkison is more common in who?
Men
Is there a specific test to Parkinson’s disease? And if yes/ nowhat is it?
No
Only based on a history and physical assessment
And positive response to anti parkison medication
Parkison effects how many people
And increases with?
160/10000
Age
Clinical manifestations
Pd is what and how does it occur?
Gradual with ongoing progrsssion
1 limb or 1 side of the body may be effect first
What are the 4 common manifestations?
Tremors
Rigidity
Bradykinesia
Postural instability
Tremor is often the first __
It’s more prominent at ___
It worsen by ___
Hand tremor is called as ___
Why is it called that ^
How does this effect hand writing?
Sign
Rest
Stress
Pill rolling
Because of the thumb and forefinger appear to move in a Dorsey fashion
Makes it large and trails off
What is rigidity?
What is the jerky quality called?
Increased resistance to passive motion when limbs are moved through their range of motion
Cogwheel Ridgity
Does rigidity make the patient feel tired ? Why?
Because the constant uncontrolled movement
What is bradykinesia?
What is this due from?
What will a normal patient have vs PD
Slowness if movement
Decreased impulses from the basal ganglia
Involuntary movement
( blinking normally )
Vs PD won’t
Swinging arms, blank facial expression
What are the physical attributes of PD (6)
Blank facial expression
Slow monotonous slurred speech
Forward tilt to posture
Tremor
Short,shuffling gait
Drooling
What is festination mean?
Shuffling gait
What is postural instability? (2)
What test do we do for this?
Propulsion ( going forward )
Retropulsion ( going backward)
Pull Test
- examiner stands back and gives a tug and patient falls back
What are the complications of PD? (10)
Dysphagia ( swallowing )
Malnutrition
Aspiration
Immobility problems
Orthostatic hypotension
Falls
Dyskinesias( spontaneous involuntary movement )
Weakness
Neuropsychiatric proeblems
Dementia
What’s an anagram to help me remember the 10 complications of PD?
Danny
Mails
Annie
Ice
Over
Favorite
Dyes
Water
Neurons
Dimes
Does PD have a cure? So we focus on?
No
Symptom management
Why do PD patients have an aspiration risk?
Slurred speech
Drooling
What do PD patients have a fall risk?
Tremors & postural
How to reduce risk of aspiration? (5)
Assess for gag reflex
OOB to chair for meals
Full fowlers position
Speech consult
Medications
How do you reduce falls for PD patients? (7)
Out of bed with assistance
Position change slowly
Walker
Call bell
Soled shoes
Physical therapy
Medications
Staff must be educated on parkison diseases when giving medications
What is the point of medications?
What is “on and off time”
What can medications cause?
What is it ^ Examples?
Correct imbalance of dopamine
On medication = patients can initiate movement
Off medication = patient decrease movements
Dyskinesia
Uncontrolled movements
Face hands, arms
Anti parkison drugs will either do what two things?
Release or supply dopamine
Black the effect of the overactive cholinergic neurons in the striatum
You must be very careful when giving PD drugs why?
Because it can cause paradoxical intoxication
What are the 4 PD drugs ?
Hytrin
Sinemet
Lexapro
Celebrex
What does Hytrin & sinemet cause?
Function of Hytrin ?
Function of sinemet?
Orthostatic hypotension
Control hypertension & decrease BPH
Control PD symptoms
What does Celebrex (NSAID) may cause? (Negative effect )
Function?
Decrease effectiveness of Hytrin
( hypertension )
Decrease inflammation & pain of degenerative joint disease
What does lexapro do?
Help with depression
The patient with PD will have slurred and speech problems so we will give them which therapy?
Speech therapy
How can we help improve communication with PD patients? (4)
Be patient
Do not finish sentences
Assist family
Don’t be loud
What has a negative impact on levodopa ( sinemet ) drugs?
How so?
Patients want to have more during when
And less during when?
Proteins
It impairs levadopa absorption
More during bed time
Less during day time
Patients should be on what diet?
To prevent?
High fiber
Constipation
Pd patients should what types of bites ?
Should they have adequate hydration?
To prevent ^
Small
Yes
Orthostatic hypotension/constipation
Why can’t we give coffee?
Aggravate symptoms
But may help with apathy/drowsiness
Home care notes
Promote exercise
Encourage loud speaking
Big movements
Chairs with arms
Raise back legs
Know side effects
