NUR 145 Pharmacology - Ch. 15 (Parkinson's) Review Questions and Correct Answers
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Course
NUR 145
Institution
NUR 145
Parkinson's disease is a chronic progressive disorder of the central nervous system. It is the 2nd most common neurodegenerative disease after Alzheimer's disease
Parkinson's was named after James Parkinson, the English physician who described the "shaking palsy" in 1817.
Parkinson's disease - No...
NUR 145 Pharmacology - Ch. 15
(Parkinson's) Review Questions and
Correct Answers
Parkinson's disease ✅is a chronic progressive disorder of the central nervous system.
It is the 2nd most common neurodegenerative disease after Alzheimer's disease
Parkinson's was named ✅after James Parkinson, the English physician who described
the "shaking palsy" in 1817.
Parkinson's disease ✅- Normally there is balance between neurotransmitters
-Dopamine—inhibitory effect
-Acetylcholine—excitatory effect
- Symptoms caused by the deterioration of dopaminergic
Neurons with resulting deficiency in dopamine
Two types of parkinsonism
-Primary—idiopathic (unknown cause)
-Secondary—induced by head trauma, infection, tumors,
Drug exposure
Parkinson's disease: Key terms ✅- Tremors—occur at rest, start in hand, face
- Dyskinesia—loss of voluntary movement, slow and jerky
- Propulsive uncontrolled movement—occurs when
Mobility has deteriorated to cause patient to have
Quickened and shortened steps; leads to falls
- Akinesia—loss of movement
What is the physiologic cause of tremors in patients with Parkinson's disease?
A. Increase in the amount of acetylcholine in the brain
B. Increase in the amount of dopamine produced in the
Substantia nigra
C. Overgrowth of the substantia nigra in the brain
D. Lack of oxygen to the brain during respiratory distress ✅Answer: A
Rationale: The symptoms associated with parkinsonism are caused by a deterioration of
the dopaminergic neurons in the substantia nigra, resulting in a depletion of dopamine
in the autonomic ganglia, basal ganglia, and spinal cord causing progressive neurologic
deficits. These areas of the brain are responsible for maintaining posture and muscle
tone and regulating voluntary smooth muscle activity as well as other nonmotor
activities. Normally a balance exists between dopamine, an inhibitory neurotransmitter,
and acetylcholine, an excitatory neurotransmitter. With a deficiency of dopamine, a
, relative increase in acetylcholine activity occurs, causing the symptoms of
parkinsonism. About 80% of the dopamine in the neurons of the substantia nigra of the
brain must be depleted for symptoms to develop.
Drug Therapy
for Parkinson's Disease ✅- Goal is to minimize symptoms, not cure
-Restore dopaminergic activity
-Restore neurotransmitter function
-Slow deterioration of dopaminergic nerve cells
-Inhibit excess cholinergic activity (which causes
Tremors)
- All symptoms cannot be eliminated because of adverse
Drug effects
- Effectiveness of therapy may take several weeks
Parkinson's therapy ✅is individualized and uses a combination of agents because
symptoms and disease progression vary greatly among individuals. Therapy begins
when symptoms interfere with the ability to function in daily life.
Management of Parkinson's Disease ✅- Nonpharmacologic
-Education, nutrition, exercise, support services, patient
Safety
- Pharmacologic
-Start neuroprotection drugs (selegiline [Eldepryl,
Zelapar])
-When function is impaired, use dopamine agonists
-Add levodopa (Larodopa) and/or COMT inhibitor
-Surgery is last resort if symptoms do not improve
*Stem cell research is ongoing for treatment of Parkinson's
What is the therapeutic outcome of antiparkinson medication therapy?
A. To cure the disease
B. To prevent the symptoms of the disease
C. To decrease the symptoms of the disease
D. To stop the progression of the disease ✅Answer: C
Rationale: There is no known cure for Parkinson's disease. Medication therapy will
decrease but not prevent the symptoms of the disease. High doses of drugs may
increase the very symptoms that are being treated. The goal of treatment is to relieve
symptoms and restore dopaminergic activity and neurotransmitter function as close to
normal as possible.
Which nursing intervention is best for patients with Parkinson's disease?
A. Provide six small meals per day rather than three large
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