Parkinson's Disease


by Kimberly Kwasniewski



dopamine.jpg

Parkinson's disease is a chronic, progressive, degenerative brain disease in which nerve cells (neurons) in the substantia nigra, which produce dopamine, begin to die. Dopamine serves an important bodily function and helps with muscle control. When 80 percent of the nerve cells that produce dopamine die, the Parkinson's symptoms begin to present.



Antiparkinsonian Agents

Answers at bottom of page

1. Cogentin's generic name is ? and is an ? agent used to treat muscle tremors and rigidity, as well as drug-induced extrapyramidal reactions.

2. Antihistamines, such as ? work similary to anticholinergics.

3. ? and ? are considered the "gold standard" medications used to replace dopamine.

4. ? is able to cross the blood-brain barrier, where it is converted to dopamine.

5. ? in doses greater than 10 mg will reverse the effects of levodopa.

6. Taking Levodopa with ? may result in a hypertensive crisis.

7. ? and ? are dopamine-receptor agonists, that stimulate the production of dopamine.

8. ? may delay the development of serious debilitating PD for 9 to 18 years.

9. ? and ? inhibit enzymes that break down levodopa, and are used when other agents fail.

10. ? releases dopamine drom storage sites and should not be discontinued abruptly.


NCLEX Practice Questions





Nursing Diagnosis for Parkinson's Disease

Nursing Diagnosis
Expected Outcomes
Nursing Interventions
Impaired physical mobility related to rigidity, bradykinesia, and/or postural instability.
Patient will demonstrate maximal independence with performing activities of daily living.
Consult with physical therapy for exercises and assistive devices to maximize independence with self-care activities.

Plan for patient to participate in care when medications are at peak levels.
Impaired verbal communication related to softening of voice.
Patient will communicate effectively with others.
Facilitate consultation with speech therapy.

Provide opportunities for patient to practice speech exercises.
Altered self-esteem related to dependency on spouse/significant other.
Patient will actively participate in decisions related to care prior to discharge.
Incorporate patient into decision-making process about taking medications and participating in diversional activities.

Offer suggestions for patient to have opportunities to socialize in the community.
Altered thought processes related to hallucination and confusion.
Patient will state that hallucinations are not real prior to discharge.
Provide reality orientation to patient as needed.

Be calm and offer reassurance if patient becomes fearful.

Limit environmental stimuli.

Promote restful sleep-wake cycle.




Reference for Nursing diagnosis
Parkinson's Disease
Quality of Life Issues
Barbara Fitzsimmons, RN, MS
Lisette K. Bunting, RN, MScN
http://www.cnsonline.org/www/archive/parkins/park-07.txt





QUIZ ANSWERS

1. Benztropine Mesylate; anticholinergic.
2. Benadryl (Diphenhydramine)
3. Levodopa; Sinemet.
4. Levodopa
5. Pyridoxine (vitamin B6)
6. MAOIs
7. Parlodel; Permax
8. Deprenyl (Selegiline)
9. Comtan (Entacapone); Tasmar (Tolcapone)
10. Symmetrel ( Amantadine)