ATI Ch 7 Parkinson's Flashcards Preview

Nursing 281 > ATI Ch 7 Parkinson's > Flashcards

Flashcards in ATI Ch 7 Parkinson's Deck (28):
1

4 primary sx of parkinson's

tremor, muscle rigidity, bradykinesia and postural instability

2

How to tx parkinson's

increase dopamine or decrease Ach

3

Parkinson's stage 1

unilateral shaking or tremor of one limb, it can be very minimal, just a couple fingers to begin with

4

Parkinson's stage 2

bilateral limb involvement, making walking and balance very difficult

5

Parkinson's stage 3

the physical movement slow down significantly making walking more and more difficult

6

Parkinson's stage 4

the tremors may slow down, but the akinesia and rigidity may make it difficult to achieve ADLs

7

Parkinson's stage 5

the client is usually able to difficulty standing and walking and are dependent for all their care, they may also show signs of dementia

8

Parkinson's statistics

usually males between 40-70 yo
genetic predisposition
possible risk from environmental toxins

9

Parkinson's s/sx

tremors-pill rolling
mask like expression
bradykinesia/akinesia
orthostatic hypotension

10

Parkins diagnosis

no lab tests to confirm, done by s/sx

11

Medication time frame

can take weeks to see any result
PTs can have a weaning off phenomenon and may need a medication holiday

12

Dopaminergics

given PO, increase dopamine, used w/ other meds like carbadopa to decrease levodopa metabolism

13

Dopamine agonists ex

bromocriptine (Parlodel), ropinirole (Requip), and pramipexole (Mirapex),

14

Dopamine agonists function

activate the release of dopamine, can be used in conjunction w/ dopaminergic

15

Dopamine agonists nursing consideratios

Monitor for orthostatic hypotension, dyskinesias, and hallucinations

16

Anticholinergics ex

benztropine (Cogentin) and trihexyphenidyl (Artane)

17

Anticholinergics function

control tremors and rigidity

18

Anticholinergics nursing considerations

Monitor for anticholinergic effects (dry mouth, constipation, urinary retention, acute confusion)

19

Catechol O-methyltransferase (COMT) inhibitors ex

entacapone (Comtan)

20

Catechol O-methyltransferase (COMT) inhibitors function

decrease the breakdown of levodopa making more available to the brain as dopamine
combined w/ dopaminergic and dopamine agonist for better results

21

Catechol O-methyltransferase (COMT) inhibitors nursing considerations

Monitor for dyskinesia/hyperkinesia when used with levodopa. Assess for diarrhea. Dark urine is a normal finding

22

Antivirals ex

amantadine (Symmetrel)

23

Antivirals function

stimulate release of dopamine and prevent its reuptake

24

Antivirals nursing considerations

Monitor for swollen ankles and discoloration of skin. PT may also have atropine-like effects.

25

Parkinson's surgical interventions

Stereotactic pallidotomy
Deep brain stimulation

26

Stereotactic pallidotomy

destroy a small portion of the brain to reduce tremors and rigidity

27

Deep brain stimulation

electrode is place into the thalamus, turned on w/ a magnet

28

Parkinson's surgical interventions nursing considerations

look for any signs of hemorrhage/stroke like syndromes