Review I
A chronic, progressive, neurodegenerative disorder affecting the dopamine-producing neurons in the brain?
Parkinson's Disease (PD)
Lilley p. 231
Does PD have an exact cause?
No
Lewis p. 1372
First sign of PD, is noticeable at rest, increase of stress, and lack of sleep.
Tremor
Lewis p. 1373
This medication is started as soon as client become functionally impaired. This is the drug of choice and it is a dopamine replacement drug.
carbidopa-levodopa
Lilley p. 233
Lewis p.1374
What foods can you encourage your client to consume to avoid malnutrition and constipation?
Six small meals that are appetizing and easily to be chewed so they may need bite size pieces. Fruit because it has fiber to decrease constipation. Limit protein and B6 prior to taking levodopa.
Lewis p. 1375
The substantia nigra, basal ganglia, and globus pallidus make up the system in the brain. It involves motor function, including posture, muscle tone, and smooth muscles activity.
extrapyramidal system
Lilley p. 231Does PD have a cure?
No
Lewis p. 1374
Increase resistance with passive range of motion that may have a jerky quality (cogwheel rigidity)
Rigidity
Lewis p. 1373
What foods and vitamin should be limited or not consumed before the dose of the medication levodopa-carbidopa?
Protein and Vitamin B6.
Lewis p. 1375
Is physical exercise used to promote health and alleviate some of the problem that are as a result of bradykinesia?
Yes. A consult with physical therapy to avoid contractures, muscle atrophy, and constipation which are a result of immobility.
Lewis p. 1376
An inhibitory neurotransmitter.
Dopamine
Lilley p. 231What is the percent that there is positive link to having a familial history of PD?
15%
Lewis p. 1372
Absence or loss of control of voluntary muscle movements
Akinesia
Lewis p. 1373
This surgical therapy is used to decrease medication usage, or used when medications are no longer working. It consists of a probe and generator to deliver impulses to the brain.
Deep brain stimulation (DBS)
Lewis p. 1375
Which therapy would a nurse consult in order to evaluate a swallowing/speech issue or to promote muscle tone of muscles that are involved with speaking and swallowing?
Speech language pathologist
Lewis p. 1376
An excitatory neurotransmitter
Acetylcholine
Lilley p. 231Exposure to these chemicals may produce symptoms of Parkinson's disease?
carbon monoxide, manganese, products from meperidine analog synthesis (MPTP)
Lewis p. 1372
Unable to stop when going forward (propulsion) or backward (retropulsion)
Postural Instability
Lewis p. 1373
This procedure involves locating, targeting and destroying and area of the brain that is affected by PD.
Ablation surgery
Lewis p. 1375
What teaching can the nurse provide to ensure safety in the home.
Upright chair with arms, use of appropriate assistive devices, clutter free environments, remove scatter rugs, clothing or shoes that are slip on with Velcro or zippers. Improve sleep disturbances with satin sheets or nightwear.
Lewis p. 1376
This therapy is aimed at increasing the supply of dopamine and blocking or lowering acetylcholine levels to gain a normal balance of these neurotransmitters.
Medication therapy
Lilley p. 231
Exposure to legal and illegal drugs may also cause PD.
Legal: metoclopramide, resperidone, methyldopa, lithium, haloperidol, and chlorpromazine.
Illegal: amphetamine and methamphetamine
Lewis p. 1372
These are complications of PD.
dementia, hallucinations, depression, anxiety, difficulty swallowing, orthostatic hypotension, loss of postural reflexes contributing to falls.
Lewis p. 1373
This procedure is still in the research and clinical trial phase.
Transplanting of fetal neural tissue.
Lewis p. 1375
Clients may need to have a referral for problems relating to depression, anxiety, hallucinations, psychosis. The caregiver could also benefit from this referral due to caregiver burden or burnout.
Mental health professionals
Lewis p. 1377.