Week 4: Intracranial Regulation, Alzheimer's, and Parkinson's

Question 1

What is intracranial regulation?

Answer 1

The compensatory mechanisms in the brain that maintain pressure within the cranial cavity.

Question 2

What is the safe range for intracranial pressure?

Answer 2

0-15 mm Hg

Question 3

Describe in simple terms what Alzheimer’s Disease is.

Answer 3

It’s a progressive disease that involves memory loss, changes in personality, and confusion. It is not curable.

Question 4

Alzheimer’s disease is characterized by an accumulation of which two abnormal findings?

Answer 4

• Neuritic plaques
• Neurofibrillary tangles

Question 5

Although exact causes of Alzheimer’s disease aren’t fully understood. At the basic level, what has happened to the brain?

Answer 5

Brain proteins fail to function as they should.

Question 6

Describe what occurs in AD stage 1. This includes the initial changes and moderate stage.

Answer 6

Initial Changes:
- short-term memory loss
- mild personality changes
- randomly forgets details

Moderate Stage:
- global impairment of cognitive functioning
- changes in the higher cortical functioning needed for language, relationships, problem solving, disorientation, not able to carry out ADLs, really confused.

Question 7

Describe AD stage 2. This is the severe stage of AD.

Answer 7

• Can’t respond to the environment
• Needs total care
• Bedridden
• Death

Question 8

What are the 4 risk factors for AD?

Answer 8

• Age
• Head injuries
• Down’s Syndrome
• Family History
• CVD

Question 9

What types of tests may be ordered to diagnose AD? What other things may the provider look at?

Answer 9

• memory tests
• health history
• brain scans, CT, MRI, PET scans
• talk with family members about symptoms

Question 10

How do you prevent AD?

Answer 10

Active lifestyle, healthy diet, brain games.

Question 11

Describe Parkinson’s Disease in simple terms.

Answer 11

It’s a slow, progressive neurologic movement disorder associated with decreased levels of dopamine.

Question 12

What are the manifestations of PD?

Answer 12

1. Cardinal: tremor, rigidity, bradykinesia/akinesia, postural instability
2. Autonomic: sweating, drooling, flushing, orthostatic hypotension, urinary retention
3. Dysphagia
4. Psychiatric changes: depression, anxiety, dementia, delirium, hallucinations

Question 13

Explain the pathophysiology of PD.

Answer 13

Destruction of dopaminergic neuronal cells occurs in the basal ganglia.

Degeneration happens in the nigrostriatal pathway.

There’s an imbalance of excitatory (acetylcholine) and inhibiting (dopamine) neurotransmitters in the corpus striatum resulting in the manifestations.

Question 14

List other manifestations seen in PD.

Answer 14

• tremor in hands, arms, legs, jaw, or head
• muscle stiffness, where muscle remains contracted for a long time
• slowness of movement
• impaired balance and coordination, sometimes leading to falls

Question 15

What are 2 things that can prevent PD?

Answer 15

1. Aerobic exercise
2. Caffeine (tea, coffee, cola).

Question 16

What tests or labs may be ordered to investigate PD? How may the doctor diagnose the disease?

Answer 16

• MRI
• DaT scan
• blood work
• medical history
• neuro examination

Question 17

What is treatment directed towards in PD?

Answer 17

Controlling symptoms and maintaining functional dependence.

Question 18

What are pharmacologic treatments?

Answer 18

• Levadopa
• Surgical Procedures
• Thalamotomy
• Pallidotomy
• Neural transplantation (ongoing research)

Question 19

What are the assessments the nurse will focus on in PD?

Answer 19

• Response to medications
• Quality of speech
• Swallowing deficits
• Tremors, movement, confusion
• Falls risk assessment

Question 20

What are the 6 major goals in PD?

Answer 20

• improve functional mobility
• maintain independence in ADLs
• achieving adequate bowel elimination
• acceptable nutritional status
• effective communication
• positive coping skills