question

Pt's w/Parkinsons disease exhibit-------- marked for difficulties in performing intentional movement and extreme sluggishness

answer

Bradykinesia

question

In Parkinson's disease, nerve cells begin to which degenerated in the dopamine rich area of the brain is called--------

answer

Substania Nigra

question

Dopaminergics Agents

answer

amantadine levedopa ropinirole

question

Anticholinergics

answer

benztropine biperden diphenhydramine

question

Adjunctive Agents

answer

entacapone selegiline

question

When describing the action of levodopa, which of the following would the nurse include? a. acts like replacement therapy b. increases the release of dopamine c. binds directly w/postsynatic dopamine receptors d. stimulates dopamine receptors

answer

a. acts like replacement therapy

question

A Pt asks nurse why he must take his levodopa in combination with carbidopa. Which response by nurse would be appropriate? a. "the carbidopa helps the levodopa get in to the brain" b. "the carbidopa allows a lower dose of levodopa to be used." c. "it boosts the action of levodopa to prevent the nerve cells from degenerating" d. "the carbidopa prevents too much levodopa from being excreted"

answer

b. "the carbidopa allows a lower dose of levodopa to be used."

question

A Pt is to receive apomorphine as treatment for Parkinson's disease. The nurse would expect to administer this drug by which route? a. oral b. topical c. subcutaneous d. intramuscular

answer

c. subcutaneous

question

When reviewing a Pt's history, which of the following would the nurse identify as a contraindication to the use of levodopa? a. mycardial infarctions b. bronchial asthma c. peptic ulcer disease d. suspicious skin lesions

answer

d. suspicious skin lesions Because levodopa is associated with development of melanoma. Use with caution with the other conditions

question

Which of the following would a nurse expect to assess as potential adverse effect of dopaminergic therapy? a. sedation b. muscle flaccidity c. nervousness d. hypertension

answer

c. nervousness Because of stimulation of dopamine receptors also may include anxiety, confusion, mental changes, muscle twitching, ataxia and hypotension

question

Which of the following would a nurse identify as lease likely to contribute to a decrease in effectiveness of levodopa? a. pyridoxine b. phenytoin c. multivitamin supplement d. St. Johns wort

answer

d. St. Johns wort St Johns may lead to hypertensive crisis if given with rasagiline not levodopa.

question

A Pt is to receive trihexyphenidyl as adjunctive treatment for Parkinson's disease. The nurse would expect to administer this drug by which route? a. oral b. subcutaneous c. intramuscular d. intravenous

answer

a. oral

question

A nurse is reviewing a Pt's history for conditions that would contraindicate the use of anticholinergics for Parkinson's disease. Which of the following would cause the nurse to be concerned? a. hypertension b. myasthenia gravis c. hypatic dysfunction d. cardiac arrhythmia

answer

b. myasthenia gravis

question

Which of the following would lead the nurse to suspect that a Pt is experiencing an adverse effects to an anticholinergic agents? a. diarrhea b. diaphoresis c. excess salvation d. agitation

answer

d. agitation Would be noted due to blocking of central acetylcholine receptors

question

After reviewing the drugs used to treat Parkinson's disease, the students demonstrate understanding when they identify which of the following as dopaminergice agent? a. diphenhydramine b. biperiden c. bromocriptine d. tolapone

answer

c. bromocriptine biperiden is anticholinergic

question

A Pt who is receiving biperiden complains of light headedness, dizziness and blurred vision. Which nursing Dx would be most appropriate? a. risk for impaired thermoregulation b. disturbed thought process c. deficient knowledge d. risk for injury

answer

d. risk for injury

question

When administering entacapone, the nurse understands that this drug affects which enzyme? a. lactic dehyrogenase b. catecholamine- O - methyl transferase c. monoamine oxidase d. acetylcholinesterase

answer

b. catecholamine- O - methyl transferase

question

Which action would be a priority for a Pt receiving apomorphine? a. giving the drug w/food b. monitoring cardiac status c. checking for skin lesions d. palpating the bladder

answer

b. monitoring cardiac status

question

A Pt is experiencing parkinsonism as a result of drug therapy w/ a phenothiazine. The nurse would anticipate which agent as being prescribed? a. bromocriptine b. pramipexole c. biperiden d. selegiline

answer

c. biperiden Indicated for treatment of parkinsonism

question

Which of the following would be considered a peripheral anticholinergic effect of anticholinergic drug therapy? a. delirium b. blurred vision c. agitation d. memory loss

answer

b. blurred vision Is a sign of peripheral anticholinergic effects, the others are CNS effects

question

Parkinsons is progressive, chronic neurological disorder that is usually? a. associated w/severe head injury b. associated w/chronic diseases c. associated w/old age d. known to affect people of all ages w/no known cause

answer

d. known to affect people of all ages w/no known cause

question

Parkinsons disease reflects an imbalance between inhibitory and stimulating activity of nerves in the? a. reticular activating system b. cerebellum c. basal ganglia d. limbic system

answer

c. basal ganglia

question

The main underlying problem w/Parkinson's disease seems to be a decrease in the neurotransmitter? a. acetylcholine b. norepinephrine c. dopamine d. serotonin

answer

c. dopamine

question

Anticholinergic drugs are effective in early Parkinson disease. They act?

answer

to block stimulating effects of acetylcholine in the brain to bring activity back into balance.

question

Pt receiving an anticholinergic drug for Parkinson goes to Tahiti @70degrees warmer than at home. What precautions should Pt be urged to take?

answer

Reduce dose and take precessions to reduce risk of heat stroke

question

Replacing dopamine in the brain would seem to be the best treatment for Parkinson disease. This is difficult because dopamine? a. is broken down in gastric acid b. in not available in drug form c. cannot cross the blood brain barrier d. is used peripherally before reaching the brain

answer

c. cannot cross the blood brain barrier

question

A Pt taking levodopa and over the counter megavitamins might experience? a. cure from parkinson disease b. return of parkinson symptoms c. improved health and well being d. a resistance to viral infections

answer

b. return of parkinson symptoms

question

How can nurse best explain what causes parkinsonism to a Pt?

answer

adverse effects of drug therapy brain injury viral infections

question

No therapy is available that will stop the loss of neurons and eventual decline of function in clients w/parkinson. Nursing care should include?

answer

-Supportive education as drugs fail and new therapy is needed -Community and family support networking -Explanations of the adjective drug therapy that may be used

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