NURS 213 Parkinson's Disease

parkinson's disease

a chronic, progressive, neurodegenerative disorder (1)

-low dopamine

-high acetylcholine

causes of parkinson's disease (2)

-tremors (1st sign)

-rigidity (2nd sign)

-bradykinesia

-mood changes

-swallowing difficulties and speech difficulties

manifestations of parkinson's (5)

-hand, diaphragm, tongue, lip, jaw

-pill rolling tremors

what areas of the body do tremors affect and an example (2)

rigidity

increase resistance to passive range of motion (1)

cogwheel rigifity

stiff jerking motions (1)

bradykinesia

impairment in voluntary motor control and slow movements (1)

-loss of blinking eyelids

-loss of swinging arms

-loss of hand movements

-loss of ability to swallow saliva

-loss of facial expressions (masked face)

-loss of gait movements (frozen gait)

-postural instability

signs of bradykinesia (7)

sialorrhea

excessive drooling

akinesia

absence of movement (frozen gait)

bradykinesias

slowness and impairment of movements

-stooped posture

-shuffling gait

signs of postural instability (2)

risk for falls due to impaired balance and gait disturbances

what are people at risk for with postural instability (1)

-depression

-anxiety

-fatigue

-pain

-sleep problems

mood changes in parkinsons (5)

-dopamine decreases

-communication between brain cells becomes more difficulty resulting in variable movements and cognitive deficits

why does swallowing and speech difficulties occur (1)

-speech

-language

-cognition

-swallowing

what do lower levels of dopamine cause (4)

vision

what does parkinsons usually not affect (1)

-maximize neuro function

-promote independence of ADL

-promote healthy mental health

-safety concerns (gait, mobility, immobile)

nursing management of parkinsons (4)

-antiparkinsons drugs

-dopamine agonists

-anticholinergic drugs

medications for parkinsons (3)

carbidopa/levodopa (sinemet)

examples of antiparkinsons meds (1)

-levodopa leaves dopamine in brain

-carbidopa allows body to use it more

what does levodopa and carbidopa do for the body (2)

-orthostatic hypotension

-dark urine, sweat, and saliva

-nausea and vomiting

-ataxia

-constipation

-weakness

-hallucinations

-long terms of dyskinesia

-confusion

side effects of levodopa carbidopa (9)

low dose

what do you need to start with when taking levodopa carbidopa (1)

-dyskinesia

-tics

-involuntary movements

-face and tongue movements

-body jerking (arms and legs)

signs of toxicity for levodopa carbidopa (5)

-take 2-6 weeks to work

-up to 6 months for full effect

-can take with MAOI antidepressant

-no high protein (interferes with absorption)

-does not eliminate tremors or rigidity (decreases)

-life long drugs (does not cure)

-taken 3-4 times a day

considerations for levodopa carbidopa (7)

-pramipexole (mirapex)

-rotigotine (neupro)

-ropinirole (requip)

examples of dopamine agonists (3)

can be taken with levodopa carbidopa

what can dopamine agonists be taken with (1)

-sleepiness

-confusion

-hallucinations

-low BP

-dizziness

-leg swelling

-dyskinesia (involuntary movements)

side effects of dopamine agonists (7)

decrease activity of acetylcholine

what do anticholinergic drugs do for parkinsons (1)

-trihexyphenodyl (artane)

-benztropine (cogentin)

examples of anticholinergic meds (2)

-muscle spasms

-stiffness

-tremors

-poor muscle control

what symptoms of parkinsons do anticholinergics affect (4)

-dry mouth

-dry eyes

-blurred vision

-constipation

-urinary retention

-tachycardia

-confusion

side effects of anticholinergic side effects (7)