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32 Cards in this Set
- Front
- Back
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what is parkinsons disease
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degenerative disorder of basal ganglia involving the dopaminergic nigrostraiatal pathway.
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what does the basal ganglia include
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corpus stratum, globus pallidus, subthalamic nucleus and substantia nigra
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what is the patho of parkinsons
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cells in substantia nigra begin to malfunction and die which decreases dopamine producedand messages to direct and how and when to move and much slower. This causes the person with PD incapable of initating and controlling movement in a normal manner.
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what does dopamine do
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helps to contorl movement and coordination. produced by cells in substantia nigra
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what are the primary motor symptoms of parkinsons
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tremor, rigidity, bradykinesia and postural instability
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what are the secondary motor symptoms of parkinsons
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stooped posture, fatigue, poverty of movement, sppech problems, difficulty swallowing, masking, micrographia
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what are the non motor symptoms of parkinsons
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demenia, confusion, fear, anxiety, memory difficulty, slowed thinking, aching, loss of energy
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how do you diagnose parkinsons
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medical history, physical exam, trial of medication
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what are the treatments of parkinsons
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carbidopa/levodopa, dopamine agents, anticholinergics, MAO-B inhibitors, COMT inhibitors, antioxidants, vitamins E and C.
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what foods would you eat with parkinsons
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feremnted papaya and blueberries
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what is the surgery for parkinsons
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deep brain stimulation- decreases tremors
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if you survive 1 stroke how much more likely are you to have another
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9 times
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what are the risk factors for stroke
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male, age, black, family history, pervious stoke of TIA, sickle cell anemia, Carotid Artery Disease, smoking, ETOH, obesity, high cholesterol, hypertension, diabetes, atrial fibrillation, drug abuse
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what are the types of stroke
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ischemic and hemorrhagic
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what is an ischemic stroke
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clot blocks blood flow to an area of the brain
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what are the types of ischemic stroke
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thrombotic and embolic
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what is a hemorrhagic stroke
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bleeding occurs inside or around brain tissue
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what are the types of hemorrhagic stroke
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intracerebral or subarachnoid
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what artery is usually clogged in an ischemic stroke
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cerebral artery
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what are the warning sings of stroke
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blurry vision, dizziness, trouble speaking, weakness, headache, numbness
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what are the manifestations of a stroke
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headache, dependent on area affected, weakness, paralysis, speech, sensation, visual, decrease LOC, cognitive, global aphasia
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what perceptual disturbances will a person with a stroke have
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homonymous or hemianopsia
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what happens in a right sided stroke
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left paralysis, left neglect, short attention, impulsive, impaired judgement, impaired time concepts
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what happens in a left sided stroke
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irght paralysis, impaired speech, impaired right/left discrimination, depression, impaired comprehension of language and math
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what should you do on the initial evaluation
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note time of onset of symptoms, rapid transport, assess ABCs and glucose, use of stroke scale, monitor neuro status, EKG, patient history
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what diagnostic studies can be done for a stroke
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CT, MRI/MRA, carotid dopplers, TTE,TEE, C-spine if any trauma suspected, labs
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what is the treatment of an ischemic stroke
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antiplatelet therapy-ASA, plavix, aggrenox (ASA and persantine)
Decrease dose or stop anithypertensives, continue any statins, utilize insulin sliding scale, stool softener/laxative, tylenol, heparin, tPA |
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when do you use a tPA
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if onset of symptoms was less than 3 hours ago. Baseline CT scan with no hemorrhage, NIH stroke scale of greater than 5.
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what is the exclusion criteria for an ischemic stroke
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evidence of hemorrhage, minor or rapidly improving symptoms, active internal bleeding, known bleeding tendencies (INR greater than 1.5), heparin in last 48 hours, SBP greater than 185 or DBP greater than 110, recent surgery, seizure at time of stroke
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4. Osmotic Diuretics"
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mannitol,
glycerin, urea |
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what are the surgical treatments for a stroke
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endarerectomy or stent
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what are the nursing interventions for a stroke
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monitor neuro status, monitor BP, monitor respirations to prevent aspiration, mobilize to prevent DVT and contractions, skin care, nutrition, and assist communication
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