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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 Update...

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  • September 29, 2024
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  • Nurs 234
  • Nurs 234
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Nurs 234 Exam 3 Questions And Answers Latest Update



four 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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