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Nurs 234 Exam 3 Questions And Answers Latest Update
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Nurs 234 Exam 3 Questions And Answers Latest Updatefour cardinal symptoms of Parkinson's
1. Tremor
2. Rigidity
3. Bradykinesia or akinesia
4. Postural instability
Parkinson's is more common in
men
Primary Parkinson's Disease
idiopathic
-male
-over 40
-family history
Secondary Parkinson's Disease
brain tumors and antipsychotic drugs
tBI
Peak onset of Parkinson's
seventh decade
Parkinson's disease
A neurodegenerative disorder of the central nervous system that affects movement,
often causing tremors.
manifestations of Parkinson's
-onset is gradual
-early stages: mild resting tremor, bradykinesia, fatigue, rigidity
-later stages include shuffling, loss of postural reflexes. speech changes, urinary
incontinence, difficulty beginning urination, constipation, emotional changes
,-includes 5 stages
-resting tremors (UE first, increases with stress)
-masklike faces
Stages of Parkinson's
´Stage 1(Initial Stage): Unilateral limb involvement, minimal weakness, hand and arm
trembling
´Stage 2 (Mild Stage): Bilateral limb involvement, mask-like facies, slow and shuffling
gait
´Stage 3 (Moderate Disease): Postural instability, increased gait disturbances
´Stage 4 (Severe Disability): Akinesia, rigidity
´Stage 5: Complete ADL dependence
Parkinson's Tremor
occurs at rest but not with activity
Parkinson's complications
´Nonmotor symptoms
´Depression
´Anxiety
´Apathy
´Fatigue
´Pain
´Constipation
´Impotence
´Short-term memory impairment
´As disease progresses, complications increase
´Dementia occurs in 40% of patients (Lewy Body)
´Dysphagia may result in malnutrition and aspiration
´General debilitation may lead to pneumonia, UTIs, and skin breakdown
´Orthostatic hypotension may occur
,´Falls and injuries
´Sleep disorders are common
Parkinson's Diagnosis
´No specific test
´Testing may be completed by prescription of medication and improvement of symptoms
Diagnosis based solely on history and clinical features: When at least 2 of the 3
characteristics of the classic triad are present
Mirapex, Requip, Neupro
Dopamine agonist; mimics dopamine effects not as affective as levodopa
Side effects: orthostatic hypotension, hallucinations, sleepiness, drowsiness
Levodopa
Long-term use may lead to dyskinesia; Improves motor function
Levadopa/Carbidopa (Sinemet)
Long term use leads to dyskinesia
Parkinson's interventions
PT/OT
Yoga
Dietary Support
Psychosocial support
Surgical Management
Stereotactic pallidotomy: Opening into the pallidum within corpus striatum to perform
electrical stimulation
´Thalamotomy: Opening in thalmus to improve brain function
´Deep brain stimulation: Electrodes placed in brain (pulse generator) for electrical
current to reduce involuntary movement
´Fetal tissue transplantation: Experimental fetal substantia nigra tissue transplanted in
candidates nucleus of the brain to slow movements
, If a Parkinson's patient gets "stuck"
-March in place (stepping over line)
-2 steps back, 1 step forward
-rocking back and forth
Huntington's disease
´Hereditary disease that is transmitted by an autosomal-dominant trait at conception (50
percent chance of passing to offspring)
´Gradual decline over 15 years of the cognitive and neuromuscular symptoms
´Characterized by dementia and choreiform movements (rapid, jerky movements)
´Chronic, terminal
´Alterations in amounts of dopamine, gamma-aminobutyric acid (GABA), and glutamate
from the basal ganglia
´30-50 years of age
´Equal in men and women
Juvenile Huntington's
under 20 years old
Huntington's diagnosis and treatment
´Made on basis of family history of disease and clinical assessment
´Safety Measures
´Supportive care
´Behavior management
´ADL assistance
´No known cure at this time
-PT/OT for balance
Multiple Sclerosis (MS)
destruction of the myelin sheath on neurons in the CNS and its replacement by plaques
of sclerotic (hard) tissue
´Diffuse, random or patchy plaques in white matter of the CNS = Definitive finding
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