Podcast
Questions and Answers
Which of the following best describes the underlying cause of Parkinson's disease?
Which of the following best describes the underlying cause of Parkinson's disease?
- Excessive production of dopamine in the brain.
- Degeneration of neurons leading to dopamine deficiency and acetylcholine excess. (correct)
- An autoimmune reaction targeting acetylcholine receptors.
- Blockage of dopamine receptors in the basal ganglia.
A patient with Parkinson's disease is experiencing a 'pill-rolling' motion with their hands. How should the nurse document this finding?
A patient with Parkinson's disease is experiencing a 'pill-rolling' motion with their hands. How should the nurse document this finding?
- Action tremor
- Resting tremor (correct)
- Fine motor incoordination
- Essential tremor
Why is carbidopa administered in combination with levodopa for Parkinson's disease?
Why is carbidopa administered in combination with levodopa for Parkinson's disease?
- To prevent the peripheral breakdown of levodopa, allowing more to reach the brain. (correct)
- To reduce the side effects of levodopa such as psychosis
- To stimulate dopamine receptors directly in the brain.
- To inhibit the MAO-B enzyme, thus increasing dopamine levels.
A patient taking carbidopa/levodopa reports experiencing nausea and dizziness. What is the most appropriate initial nursing intervention?
A patient taking carbidopa/levodopa reports experiencing nausea and dizziness. What is the most appropriate initial nursing intervention?
Which of the following instructions is most important for a nurse to provide to a patient who is newly prescribed carbidopa/levodopa?
Which of the following instructions is most important for a nurse to provide to a patient who is newly prescribed carbidopa/levodopa?
A patient taking carbidopa/levodopa experiences sudden and uncontrolled movements (dyskinesias). Which intervention is the most appropriate initial action by the nurse?
A patient taking carbidopa/levodopa experiences sudden and uncontrolled movements (dyskinesias). Which intervention is the most appropriate initial action by the nurse?
When assessing a patient with Parkinson's disease, which finding would indicate a worsening of their condition?
When assessing a patient with Parkinson's disease, which finding would indicate a worsening of their condition?
A patient with Parkinson's disease is prescribed an anticholinergic medication. What is the primary mechanism of how this classification of drug helps alleviate Parkinson's symptoms?
A patient with Parkinson's disease is prescribed an anticholinergic medication. What is the primary mechanism of how this classification of drug helps alleviate Parkinson's symptoms?
Flashcards
Parkinson's Disease
Parkinson's Disease
A chronic neurological disorder with no cure, managed with medication to alleviate symptoms.
Parkinson's: Neurotransmitter Imbalance
Parkinson's: Neurotransmitter Imbalance
The result of not enough dopamine and too much acetylcholine.
Parkinson's: Key Symptoms
Parkinson's: Key Symptoms
Pill rolling, tremors, rigidity, postural changes, shuffling walk, bradykinesia, lack of facial expression.
Parkinson's: Drug Classes
Parkinson's: Drug Classes
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Carbidopa/Levodopa: Action
Carbidopa/Levodopa: Action
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Carbidopa/Levodopa: Use
Carbidopa/Levodopa: Use
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Carbidopa/Levodopa: Side Effects
Carbidopa/Levodopa: Side Effects
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Carbidopa/Levodopa: Interactions
Carbidopa/Levodopa: Interactions
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Study Notes
Parkinson's Disease Overview
- Parkinson's Disease is a chronic neurologic disorder with no cure where symptoms are managed with medication
- Is caused by degeneration of neurons of the extrapyramidal motor tract
- Symptoms of Parkinson's worsen as the disease progresses
- There is an imbalance of dopamine (not enough) and acetylcholine (too much)
Signs and Symptoms
- Pill rolling motion in hands
- Tremors of the head and neck
- Rigidity
- Postural changes
- Shuffling walk
- Bradykinesia (slow movement)
- Lack of facial expression
- No changes in cognitive level
Parkinson's Disease Treatments
- Drug classes include anticholinergic drugs, dopaminergics, dopamine agonists, MAO-B inhibitors, and COMT inhibitors.
- Anticholinergic drugs block cholinergic receptors
- Dopaminergics convert to dopamine
- Dopamine agonists stimulate dopamine receptors
- MAO-B inhibitors act by inhibiting MAO-B enzyme that interferes with dopamine
- COMT inhibitors act by inhibiting COMT enzyme that inactivates dopamine
Carbidopa and Levodopa
- Carbidopa and Levodopa are dopaminergic antiparkinson drugs
- Levodopa travels to brain cells to convert to dopamine
- Carbidopa prevents conversion peripherally so levodopa gains access to the brain
- Carbidopa and Levodopa treat the signs and symptoms, but do not cure Parkinson’s disease
Side Effects/Adverse Reactions
- GI distress, dry mouth
- Fatigue, insomnia, dizziness, headache, blurred vision
- Dark urine
- Orthostatic hypotension
- Palpitations
- Hypotension
- Urinary retention
- Psychosis, severe depression
Contraindications
- Antipsychotics
Interactions
- Many drug and food interactions
- High protein foods decrease absorption
Nursing Care Plan: Assessments
- Vital signs
- Signs and symptoms of Parkinson’s
- Medical/medication history
Nursing Care Plan: Interventions
- Monitor vital signs for orthostatic hypotension
- Administer on empty stomach, administer with low protein food if stomach upset occurs
- High protein foods delay absorption
- Monitor for signs and symptoms of Parkinson’s
- Monitor for suicidal ideation
Nursing Care Plan: Teaching
- Take on empty stomach
- Take at the same times each day
- Take with low protein foods if stomach upset occurs
- Do not abruptly discontinue drugs
- Levodopa may cause harmless discoloration of urine and sweat to brown
Nursing Care Plan: Evaluation
- Improved symptom control
- Client and family understanding of the medications
- Side effects/Adverse reactions minimized
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Description
Overview of Parkinson's Disease, a chronic neurological disorder characterized by the degeneration of neurons in the extrapyramidal motor tract, leading to a dopamine imbalance. Key signs and symptoms include tremors, rigidity, postural changes, and bradykinesia. Treatments focus on symptom management using various drug classes.
