NCM 116 LEC o shoes with no lace and low heeled

NEUROLOGIC DISTURBANCES o high seated chair

o thick food
PARKINSON’S DISEASE o care that promotes independence
 ↓ Dopamine: inhibitory
 ↑ Acetylcholine: exhibitory ALZHEIMER’S DISEASE
 Cause: IDIOPATHIC  Emotions
o Viral  Progressive disease beginning with mild memory loss
o Aluminum theory and possibly leading to loss of the ability to carry on a
o Boxers pugilistica conversation and respond to the environment.
 Men: common  Cause: IDIOPATHIC
 Symptoms: 5th decade of life (50’s) o Family history
 Degenerative disease
 Diagnose: 30 years old Symptoms
 Forgetfulness (important memories)
Pathophysiology  Irreversible
Destruction of dopaminergic neuronal cells in substancia nigra in  Degenerative
basal ganglia
↓ Diagnosis
↓ Dopamine  Cerebral biopsy: dead (DEFINITIVE) confirmatory
↓ o See if plaques are present in brain (memory:
Imbalance ↓ Dopamine ↑ Acetylcholine parietal and temporal)
↓  CT Scan
Impaired body movements
 PET Scan
Tremors Rigidity Bradykinesia
↓
 MRI
Cardinal signs of Parkinson’s Disease  Family history

Symptoms Manifestations
STAGE I
 Initial tremors
o Intentional  Healthy and alert
o Resting (pinrolling)  Subtle personality changes
 Bradykinesia  Memory lapses and forgetfulness
o Micrographia  Restless
o Dyphonia (soft, slurred, ↓ pitched, less audible  Uncoordinated
speech)
 Shuffling gait (stooped forward; penguin walk) STAGE II
 Mask like face (blank facial expression)  Memory deficits (get lost)
 Impaired language
Diagnosis  Problem:
 PET Scan: Levodopa -> ↓ Dopamine o motor and object recognition
o ADLs (grooming, toileting, bathing)
Medication  Impaired judgement
 Dopaminergic: levodopa (MOST COMMON AND  Sun downing (↑agitated ↓sun: afternoon-night)
EFFECTIVE)  Inability to voluntarily urinate
 Antiparkinsonian or anticholinergics: artane, cogentin,
akineton STAGE III
 Completely dependent
Adverse Effect of LEVODOPA  Incontinence
 Nausea and vomiting
 Orthostatic hypotension Nursing Management
 Insomnia 1. Safety
 Mental confusion 2. Calm environment
 Agitation 3. Quiet manner of speaking
4. Present reality
 Renal damage
5. Restraints (if necessary: not near the patient)
 Complications (overdosed) 6. Familiar food for patient
7. Cut foods in small pieces
Foods to avoid with LEVODOPA
HUNTINGTON’S DISEASE
 ↑ CHON: ↓ effect of levodopa (not effective)  ↓ Acetylcholine
 ↓ GABA Gamma-aminobutyric acid (calming effect)
 Corpus luteum and nucleus
Nursing Management  Age: 25-55 years old
1. Safety  Rate: 1:10,000
Provide:  Cause: Autosomal Dominant Hereditary Disorder (50%
o clothes with no buttons chance)
Symptoms
 Twisting
 Abnormal involuntary movement (chorea)
 Intellectual decline
 Emotional disturbances
Face
 Twitching
 Tics
 Grimaces
Speech
 Slurred
 Explosive
 Resistant
 Difficulty swallowing and chewing (airway)

Diagnosis
 Genetic testing
 Family history
 Imaging studies
o MRI
o CT Scan
o PET Scan

Medication
 Haloperidol (Haldol)
 Thiothixene Hydrochloride (Navane)
o akathesia (restless fidgeting)
 Psychotherapy
o ↓ anxiety and stress

Nursing Management
1. Safety
2. Airway