Term
| A patient with this disease has slow, uncoordinated movements. Beginning movement is very difficult. |
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Definition
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Term
| Which part of the brain deteriorates in Parkinson's disease? |
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Definition
| The substantia nigra, part of the basal ganglia in the midbrain |
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Term
| How does Parkinson's impact dopamine and ACh levels? |
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Definition
| Decreased dopamine results in an imbalance between dopamine and ACh |
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Term
| What are dopamine and ACh needed for? |
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Definition
| these are needed to initiate and refine voluntary movement |
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Term
| What is the FIRST sign of Parkinson's disease? |
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Definition
| Slight tremor of the hand |
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Term
| What is the general age of onset of Parkinson's? |
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Definition
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Term
| Chronic use of which drugs are a risk factor for Parkinson's? |
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Definition
| Antipsychotic drugs: respitol, halidol, thorazine. |
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Term
| Which non specific symptoms may be present early in the disease ("warning signs")? |
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Definition
| Depression, anxiety, shoulder bursitis and muscle aches |
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Term
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Definition
| Speeding up with difficulty stopping, unsteady brief halts with difficulty resuming |
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Term
| An involuntary, tottering walk is present in which disease? |
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Definition
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Term
| A mask-like face with a slow, shuffling gait is present at which stage of Parkinson's? |
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Definition
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Term
| At which stage of Parkinson's is the patient completely dependent in all ADLs? |
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Definition
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Term
| What is the cause of death in most patients with Parkinson's? |
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Definition
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Term
| In this disease, the patient will eventually start repeating what other people say ("echolia") |
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Definition
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Term
| What is considered the best way to positively diagnose someone with Parkinson's disease? |
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Definition
| There is no definitive diagnostic test, but positive response to anti-Parkinson's drugs is considered pretty reliable. |
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Term
| What is the goal of treatment for Parkinson's disease? |
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Definition
| Since there is no cure for Parkinson's, the goal is to improve and maintain patient's ability to perform ADL's |
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Term
| What is the most effective treatment for Parkinson's? |
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Definition
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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? |
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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. |
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Term
| What is the most common dopaminergic drug used for Parkinson's? For how long is it most effective? |
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Definition
Levodopa
The first 1-5 years of its use. |
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Term
| At what time of day is it best to administer Levodopa? Why? |
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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. |
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Term
| Anticholinergics are given with this type of drug: |
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Definition
| Dopaminergic. Anticholinergics are used to increase effectiveness of dopaminergics. They are not used alone. |
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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 |
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Definition
b) Levodopa.
benztropine is an anticholonergic, which is used in conjunction with a dopaminergic. |
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Term
| What would be the reason a patient would begin receiving parlodel (a dopamine antagonist) for Parkinson's? |
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Definition
Dopamine antagonists are used when the combination of dopaminergics and anticholoniergics are no longer effective.
They activate the release of dopamine. |
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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? |
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Definition
| Dopamine antagonists can cause impulse control disorders in 10% of patients. These manifest as binge eating, gambling, or hyper sexuality. |
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Term
| This is an autosomal dominant genetic disorder |
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Definition
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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? |
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Definition
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Term
| What is the life expectancy of a patient with HD? |
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Definition
| 15 years after onset of symptoms |
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Term
| What are the dopamine and ACh levels like in a patient with Huntington's disease |
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Definition
| Dopamine levels are increased and ACh is decreased |
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Term
| The body movements of a patient with huntington's are describe like this: |
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Definition
| Increased and exaggerated |
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Term
| Which disorder involves a mental status change that leads to dementia? |
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Definition
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Term
| Slurred speech, clumsiness, depression and balance and coordination problems are early symptoms of which disease? |
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Definition
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Term
| What are choreiform movements? What disease presents with choreiform movements? |
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Definition
| Rapid, jerky, involuntary movements are present in Huntinton's disease. |
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Term
| Facial grimacing is a motor symptom present in what disease? |
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Definition
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Term
| Two hallmark symptoms of Huntington's disease |
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Definition
| Choreothetosis (the exaggerated movements) and dementia |
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Term
| What usually causes death in patients with Huntington's disease? |
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Definition
| Complications from immobility: pneumonia, sepsis |
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