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Parkinson's and huntington's
Debbie's lecture
36
Nursing
Graduate
03/11/2011

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Cards

Term
A patient with this disease has slow, uncoordinated movements. Beginning movement is very difficult.
Definition
Parkinson's
Term
Which part of the brain deteriorates in Parkinson's disease?
Definition
The substantia nigra, part of the basal ganglia in the midbrain
Term
How does Parkinson's impact dopamine and ACh levels?
Definition
Decreased dopamine results in an imbalance between dopamine and ACh
Term
What are dopamine and ACh needed for?
Definition
these are needed to initiate and refine voluntary movement
Term
What is the FIRST sign of Parkinson's disease?
Definition
Slight tremor of the hand
Term
What is the general age of onset of Parkinson's?
Definition
50-60
Term
Chronic use of which drugs are a risk factor for Parkinson's?
Definition
Antipsychotic drugs: respitol, halidol, thorazine.
Term
Which non specific symptoms may be present early in the disease ("warning signs")?
Definition
Depression, anxiety, shoulder bursitis and muscle aches
Term
What is festiantion?
Definition
Speeding up with difficulty stopping, unsteady brief halts with difficulty resuming
Term
An involuntary, tottering walk is present in which disease?
Definition
Parkinson's
Term
A mask-like face with a slow, shuffling gait is present at which stage of Parkinson's?
Definition
Stage 2: Mild stage
Term
At which stage of Parkinson's is the patient completely dependent in all ADLs?
Definition
Stage 5
Term
What is the cause of death in most patients with Parkinson's?
Definition
Aspiration
Term
In this disease, the patient will eventually start repeating what other people say ("echolia")
Definition
Parkinson's
Term
What is considered the best way to positively diagnose someone with Parkinson's disease?
Definition
There is no definitive diagnostic test, but positive response to anti-Parkinson's drugs is considered pretty reliable.
Term
What is the goal of treatment for Parkinson's disease?
Definition
Since there is no cure for Parkinson's, the goal is to improve and maintain patient's ability to perform ADL's
Term
What is the most effective treatment for Parkinson's?
Definition
Medication
Term
What is the goal of anti-Parkinson's medications (what biochemical things are we trying to balance)? What are the two groups of drugs used to do this?
Definition
The goal is to restore balance between dopamine and acetylcholine. Dopaminergic drugs do this by increasing activation of dopamine receptors, and anticholinergic drugs block acetylcholine receptors.
Term
What is the most common dopaminergic drug used for Parkinson's? For how long is it most effective?
Definition
Levodopa

The first 1-5 years of its use.
Term
At what time of day is it best to administer Levodopa? Why?
Definition
First thing in the morning (before breakfast) or long afterward, after gastric emptying has occurred. Foods that are high in protein or vitamin B6 interfere with its absorption.
Term
Anticholinergics are given with this type of drug:
Definition
Dopaminergic. Anticholinergics are used to increase effectiveness of dopaminergics. They are not used alone.
Term
A patient with Parkinson's is receiving benztropine. The nurse should expect to see that the patient is also receiving this drug:
a) trihexyphenidyl
b) levodopa
c) Requip
d) Parlodel
Definition
b) Levodopa.

benztropine is an anticholonergic, which is used in conjunction with a dopaminergic.
Term
What would be the reason a patient would begin receiving parlodel (a dopamine antagonist) for Parkinson's?
Definition
Dopamine antagonists are used when the combination of dopaminergics and anticholoniergics are no longer effective.

They activate the release of dopamine.
Term
The family of a patient being treated for Parkinson's tells the nurse that the patient recently began binge eating. The nurse knows this behavior may be a result of what?
Definition
Dopamine antagonists can cause impulse control disorders in 10% of patients. These manifest as binge eating, gambling, or hyper sexuality.
Term
This is an autosomal dominant genetic disorder
Definition
Huntington's disease
Term
The daughter of a patient recently diagnosed with Huntington's disease tells the nurse that she is concerned about inheriting the disease, and asks, "What are the odds that I have inherited this from my mother?"

What is the correct answer to this question?
Definition
50% chance
Term
What is the life expectancy of a patient with HD?
Definition
15 years after onset of symptoms
Term
What are the dopamine and ACh levels like in a patient with Huntington's disease
Definition
Dopamine levels are increased and ACh is decreased
Term
The body movements of a patient with huntington's are describe like this:
Definition
Increased and exaggerated
Term
Which disorder involves a mental status change that leads to dementia?
Definition
Huntington's disease
Term
Slurred speech, clumsiness, depression and balance and coordination problems are early symptoms of which disease?
Definition
Huntington's
Term
What are choreiform movements? What disease presents with choreiform movements?
Definition
Rapid, jerky, involuntary movements are present in Huntinton's disease.
Term
Facial grimacing is a motor symptom present in what disease?
Definition
Huntington's
Term
Two hallmark symptoms of Huntington's disease
Definition
Choreothetosis (the exaggerated movements) and dementia
Term
What usually causes death in patients with Huntington's disease?
Definition
Complications from immobility: pneumonia, sepsis
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