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Parkinson's Disease

Medical-Surgical Nursing

What is Parkinson's disease? A chronic, progressive neurodegenerative disorder characterized by slowness in the initiation and execution of movement, increased muscle tone, tremor at rest, and gait disturbance.
True or False: The exact cause of Parkinson's disease is known. False; the cause is unknown.
What medications are related to drug-induced parkinsonism? Reglan, reserpine, methyldopa, lithium, Haldol, and chlorpromazine, and illicit drugs.
In drug-induced parkinsonism, do symptoms generally disappear after stopping the drug therapy? Yes
What are other causes that have been linked with parkinsonism?
What neurotransmitter is lacking in the brain of a Parkinson's patient? Dopamine
What part of the brain is most affected by Parkinson's disease? Substantia nigra
True or False: Lewy bodies are found in the brains of Parkinson's patients. True
What are Lewy bodies? Unusual clumps of protein
What is the most common gene linked to PD? LRRK2 gene
Describe the onset of PD. Gradual and insidious, with an ongoing progression
What are the clinical manifestations of PD? TRAP (tremor, rigidity, akinesia, postural instability)
True or False: In PD, only one side of the body may be affected initially. True
What is the speech abnormality associated with PD? Hypokinetic dysarthria
What is often the first sign of PD? Tremor
When is parkinsonism tremor more prominent: At rest or during movement? At rest
How is the hand tremor of PD described? "Pill rolling"
What can aggravate the tremor associated with PD? Emotional stress and increased concentration
What is rigidity? The increased resistance to passive motion when the limbs are moved through their ROM
Describe the rigidity associated with PD. Jerky quality; "cogwheel rigidity"
What is akinesia? The absence of or loss of control of voluntary muscle movements
How can you assess postural instability with PD? The pull test
What are nonmotor S/S of PD? Depression, anxiety, apathy, fatigue, pain, urinary retention, constipation, erectile dysfunction, memory changes, and sleep problems (e.g., difficulty staying asleep, restless sleep, nightmares, or sudden drowsiness)
What are progressive complications of PD? Dysphagia, increased motor and neurologic symptoms, and orthostatic hypotension
How is PD diagnosed? There is no specific test, so diagnosis is based on patient history and clinical features
What is necessary to clinically diagnose PD? The presence of TRAP and asymmetric onset
What is nursing care directed toward in PD? Maintenance of good health, encouragement of independence, and avoidance of complications (i.e., contractures and falls)
Created by: shrewsburysd