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NURS 347 EXAM 6 > Parkison Disease > Flashcards

Parkison Disease Flashcards

1
Q

What is parkison disease?

A

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

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2
Q

From the PowerPoint what does Parkinson’s disease mean?

A

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

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3
Q

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

A

First sign
Large & trails off

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4
Q

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

A

Bradykinesia

Arms swinging
Decreasing swallowing saliva
Decrease everything

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5
Q

Why do patient have an increase muscular tone ?

A

Because they have jerking quality
( cog wheel rigidity )

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6
Q

Parkison is more common in who?

A

Men

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7
Q

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

A

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

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8
Q

Parkison effects how many people
And increases with?

A

160/10000
Age

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9
Q

Clinical manifestations
Pd is what and how does it occur?

A

Gradual with ongoing progrsssion

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

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10
Q

What are the 4 common manifestations?

A

Tremors
Rigidity
Bradykinesia
Postural instability

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11
Q

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?

A

Sign
Rest
Stress
Pill rolling

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

Makes it large and trails off

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12
Q

What is rigidity?

What is the jerky quality called?

A

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

Cogwheel Ridgity

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13
Q

Does rigidity make the patient feel tired ? Why?

A

Because the constant uncontrolled movement

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14
Q

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

A

Slowness if movement
Decreased impulses from the basal ganglia

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

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15
Q

What are the physical attributes of PD (6)

A

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

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16
Q

What is festination mean?

A

Shuffling gait

17
Q

What is postural instability? (2)

What test do we do for this?

A

Propulsion ( going forward )
Retropulsion ( going backward)

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

18
Q

What are the complications of PD? (10)

A

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

19
Q

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

A

Danny
Mails
Annie
Ice
Over
Favorite
Dyes
Water
Neurons
Dimes

20
Q

Does PD have a cure? So we focus on?

A

No
Symptom management

21
Q

Why do PD patients have an aspiration risk?

A

Slurred speech
Drooling

22
Q

What do PD patients have a fall risk?

A

Tremors & postural

23
Q

How to reduce risk of aspiration? (5)

A

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

24
Q

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

A

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

25
Q

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?

A

Correct imbalance of dopamine

On medication = patients can initiate movement

Off medication = patient decrease movements

Dyskinesia
Uncontrolled movements
Face hands, arms

26
Q

Anti parkison drugs will either do what two things?

A

Release or supply dopamine

Black the effect of the overactive cholinergic neurons in the striatum

27
Q

You must be very careful when giving PD drugs why?

A

Because it can cause paradoxical intoxication

28
Q

What are the 4 PD drugs ?

A

Hytrin
Sinemet
Lexapro
Celebrex

29
Q

What does Hytrin & sinemet cause?

Function of Hytrin ?
Function of sinemet?

A

Orthostatic hypotension

Control hypertension & decrease BPH

Control PD symptoms

30
Q

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

Function?

A

Decrease effectiveness of Hytrin
( hypertension )

Decrease inflammation & pain of degenerative joint disease

31
Q

What does lexapro do?

A

Help with depression

32
Q

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

A

Speech therapy

33
Q

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

A

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

34
Q

What has a negative impact on levodopa ( sinemet ) drugs?
How so?

Patients want to have more during when
And less during when?

A

Proteins

It impairs levadopa absorption

More during bed time
Less during day time

35
Q

Patients should be on what diet?
To prevent?

A

High fiber
Constipation

36
Q

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

A

Small
Yes
Orthostatic hypotension/constipation

37
Q

Why can’t we give coffee?

A

Aggravate symptoms
But may help with apathy/drowsiness

38
Q

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

A

NURS 347 EXAM 6 (17 decks)

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