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Med Surg 2 > 58 - Parkinson > Flashcards

58 - Parkinson Flashcards

(42 cards)

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1
Q

parkinson’s

A

chronic, progressive NEURODEGENERATIVE DISORDER

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2
Q

pakinson’s is characterized by

A
  • bradykinesia
  • rigidity
  • tremor at rest
  • gait changes
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3
Q

bradykinesia

A

slowness in intitiatn + executn of mvmt

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4
Q

rigidity

A

incr muscle tone

  • resistance to passive motin when limps are moved thru ROM
  • jerky quality
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5
Q

PD age + sex of onset

A
  • incr w age
  • only 4% diagnosed before 50 y.o
  • men>women
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6
Q

is PD heredetary?

A

NO but genetic + environmental factors could be a cause

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7
Q

exposure to ____ may incr risk

A
  • well water
  • pesticides
  • herbicides
  • industrl chemcl
  • wood pulp mills
  • rural residence
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8
Q

drug-inducing parkinsonism

A
  • haloperidol
  • chlorpromazine
  • metoclopramide
  • reserpine
  • methyldopa
  • lithium
  • illicit drugs like meth
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9
Q

pathological process of PD

A

low dopamine fr degeneratn of neurons that produce DA> imbalance bw DA + ACh> unusual clumps of lewy bodies in brain

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10
Q

Dopamine [DA] is important for…

A

normal functiong of extrapyramidal motor system

  • control of posture
  • support
  • voluntary motion
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11
Q

PD onset of sympt

A
  • gradual + ongoing progression

- 1 side of body may be involved at first

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12
Q

classic manifestation of PD

A 
TRAP
Tremor
Rigidity
Akinesia
Postural Instability
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13
Q

early manifestations

A
  • mild tremor
  • slight limp
  • decr arm swing
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14
Q

later signs

A
  • shuffling gait
  • arms flexed
  • postural reflex seem lost
  • speech problems
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15
Q

parkinsonian tremor is more prominent…

A

at rest

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16
Q

tremors can affect…

A
  • diaphragm
  • tongue
  • lips
  • jaw
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17
Q

essential termor

Study These Flashcards
A

occurs during voluntary mvmt + has more frequency than parkinsonian
-more familial

18
Q

akinesia

Study These Flashcards
A

absence/loss of coluntary muscle mvmt

-stoop posure, masked face, drooling, shiffling gate

19
Q

Pull Test

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A

assessment of postural stability

  • stand behind pt + tug backwards on their shoulder
  • pt will fall backward
20
Q

nonmotor symptoms

Study These Flashcards
A

-depression
-memory changes
-sleep problems
fatigue
-pain
-urinary retentn

21
Q

PD complications

Study These Flashcards
A
  • dyskinesia
  • weakness
  • neurologic (dementia)
  • dysphagia
  • malnutrition
  • aspiration
  • PNA
  • UTI
  • skin breakdown
  • ortho hypotension
22
Q

dyskinesia

Study These Flashcards
A

spontaneous INVOLUNTARY mvmt

23
Q

dysphagia

Study These Flashcards
A

difficulty swallowing

24
Q

diagnosis

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A

based on history + clinical features (TRAP_

25
confirmation of PD is....
a positive response to ANTIparkinsonian drugs like levadopa or DA agonsit
26
MRI + CT for PD
- not helpful | - mostly used to rule out stroke or tumors
27
PD treatment
no cure | -aimed at correcting imbalance of neurotransmitters
28
antiparkinsonian drugs either _____ or ______
- enhance release/supply of DA (dopaminergic) | - block effects of overactive cholinergic neurons (anticholinergic)
29
primary tx of PD are...
levadopa + carbidopa
30
levadopa + carbidopa | nursing alert
- monitor for signs of dyskinesia - monitor short term a/e (n/v, light headed) - onset may take months - report signs of EPS - DO NOT give w food
31
dont give levadopa + carbidopa w food bc...
protein reduces absorption
32
DA agonist drug name
pramipexole | -directly stim DA receptors
33
pramipexole | drug alert
- take w food to decr nausea | - notify HCP if uncontrollable urses, confusn, rigidity, excess urinatn, SOB, vision changes
34
anticholinergic drug names + action
trihexyphenidyl + benztropine + diphenhydramine | -decr activity of ACh to balance bw cholinergic + dopanergic actions
35
anticholinergic drugs may be used to manage...
tremors
36
MAO inhibitors drug name + action
selegiline | -inhibits the enzyme that degrades DA
37
list of antiparkinsonian drug types
- DA agonist - anticholinergic - mao inhibitor - DA precursor
38
w/in 3-5 yrs, pt have episodes of...
hypomobility | -inability to raise fr chair, speak, or walk
39
PD mgmt
- antiparkinsonian drugs - surgical therapy - deep brain stim - ablation - phys therapy - occptnl therapy
40
3 categories of surgical therapy
1 deep brain stim 2 ablation 3 transplantation
41
DBS is preferred over ablation bs...
reversible + programable
42
to prevent "freezes" while walking
imagine walking over an imaginary object on floor - rock fr side to side before stepping - walk to beat - swing both arms - 1 step back 2 forward

Med Surg 2 (13 decks)

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