Parkison Disease

Question 1

What is parkison disease?

Answer 1

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

Question 2

From the PowerPoint what does Parkinson’s disease mean?

Answer 2

Generalized slowness- loss of dopamine
( a neurotransmitter in the brain needed to initiate movement )

Question 3

Tremor at rest usually is the ___
What happens to the hand writing?

Answer 3

First sign
Large & trails off

Question 4

Slowness in initiation of movement is called?
What happens to the arm?
What happens to swallowing?
What happens to blinking, facial expression, posture?

Answer 4

Bradykinesia

Arms swinging
Decreasing swallowing saliva
Decrease everything

Question 5

Why do patient have an increase muscular tone ?

Answer 5

Because they have jerking quality
( cog wheel rigidity )

Question 6

Parkison is more common in who?

Answer 6

Men

Question 7

Is there a specific test to Parkinson’s disease? And if yes/ nowhat is it?

Answer 7

No
Only based on a history and physical assessment
And positive response to anti parkison medication

Question 8

Parkison effects how many people
And increases with?

Answer 8

160/10000
Age

Question 9

Clinical manifestations
Pd is what and how does it occur?

Answer 9

Gradual with ongoing progrsssion

1 limb or 1 side of the body may be effect first

Question 10

What are the 4 common manifestations?

Answer 10

Tremors
Rigidity
Bradykinesia
Postural instability

Question 11

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?

Answer 11

Sign
Rest
Stress
Pill rolling

Because of the thumb and forefinger appear to move in a Dorsey fashion

Makes it large and trails off

Question 12

What is rigidity?

What is the jerky quality called?

Answer 12

Increased resistance to passive motion when limbs are moved through their range of motion

Cogwheel Ridgity

Question 13

Does rigidity make the patient feel tired ? Why?

Answer 13

Because the constant uncontrolled movement

Question 14

What is bradykinesia?
What is this due from?
What will a normal patient have vs PD

Answer 14

Slowness if movement
Decreased impulses from the basal ganglia

Involuntary movement
( blinking normally )
Vs PD won’t
Swinging arms, blank facial expression

Question 15

What are the physical attributes of PD (6)

Answer 15

Blank facial expression
Slow monotonous slurred speech
Forward tilt to posture
Tremor
Short,shuffling gait
Drooling

Question 16

What is festination mean?

Answer 16

Shuffling gait

Question 17

What is postural instability? (2)

What test do we do for this?

Answer 17

Propulsion ( going forward )
Retropulsion ( going backward)

Pull Test
- examiner stands back and gives a tug and patient falls back

Question 18

What are the complications of PD? (10)

Answer 18

Dysphagia ( swallowing )
Malnutrition
Aspiration
Immobility problems
Orthostatic hypotension
Falls
Dyskinesias( spontaneous involuntary movement )
Weakness
Neuropsychiatric proeblems
Dementia

Question 19

What’s an anagram to help me remember the 10 complications of PD?

Answer 19

Danny
Mails
Annie
Ice
Over
Favorite
Dyes
Water
Neurons
Dimes

Question 20

Does PD have a cure? So we focus on?

Answer 20

No
Symptom management

Question 21

Why do PD patients have an aspiration risk?

Answer 21

Slurred speech
Drooling

Question 22

What do PD patients have a fall risk?

Answer 22

Tremors & postural

Question 23

How to reduce risk of aspiration? (5)

Answer 23

Assess for gag reflex
OOB to chair for meals
Full fowlers position
Speech consult
Medications

Question 24

How do you reduce falls for PD patients? (7)

Answer 24

Out of bed with assistance
Position change slowly
Walker
Call bell
Soled shoes
Physical therapy
Medications

Question 25

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?

Answer 25

Correct imbalance of dopamine On medication = patients can initiate movement Off medication = patient decrease movements Dyskinesia Uncontrolled movements Face hands, arms

Question 26

Anti parkison drugs will either do what two things?

Answer 26

Release or supply dopamine Black the effect of the overactive cholinergic neurons in the striatum

Question 27

You must be very careful when giving PD drugs why?

Answer 27

Because it can cause paradoxical intoxication

Question 28

What are the 4 PD drugs ?

Answer 28

Hytrin Sinemet Lexapro Celebrex

Question 29

What does Hytrin & sinemet cause? Function of Hytrin ? Function of sinemet?

Answer 29

Orthostatic hypotension Control hypertension & decrease BPH Control PD symptoms

Question 30

What does Celebrex (NSAID) may cause? (Negative effect ) Function?

Answer 30

Decrease effectiveness of Hytrin ( hypertension ) Decrease inflammation & pain of degenerative joint disease

Question 31

What does lexapro do?

Answer 31

Help with depression

Question 32

The patient with PD will have slurred and speech problems so we will give them which therapy?

Answer 32

Speech therapy

Question 33

How can we help improve communication with PD patients? (4)

Answer 33

Be patient Do not finish sentences Assist family Don’t be loud

Question 34

What has a negative impact on levodopa ( sinemet ) drugs? How so? Patients want to have more during when And less during when?

Answer 34

Proteins It impairs levadopa absorption More during bed time Less during day time

Question 35

Patients should be on what diet? To prevent?

Answer 35

High fiber Constipation

Question 36

Pd patients should what types of bites ? Should they have adequate hydration? To prevent ^

Answer 36

Small Yes Orthostatic hypotension/constipation

Question 37

Why can’t we give coffee?

Answer 37

Aggravate symptoms But may help with apathy/drowsiness

Question 38

Home care notes Promote exercise Encourage loud speaking Big movements Chairs with arms Raise back legs Know side effects