NUR 2571 FINAL EXAM STUDY GUIDE
Rasmussen College
Winter ‘19
Alzheimer’s Disease
Etiology
o Unknown but r/t genetics, age and head injuries.
o Neuronal degeneration results in memory loss and loss of speech,
reasoning and higher functioning.
Stages (Review Chart 42-1, know how to identify stages)
o Early/Mild
Poor memory, poor judgment and mild cognitive changes.
o Middle/Moderate
Impairment of all cognitive functions, unable to handle
finances, disorientation to place/time/events, depression or
agitation, aphasia, wandering.
o Late/severe
Weight loss, severe cognitive loss, total dependence, bedridden,
agnosia, incontinence.
Educate patients family on signs and symptoms of stages and what to
expect, there is little point in educating the patient because they will forget.
Review chart 42-1 Iggy, pg. 860
Treatment
o Cholinesterase inhibitors help slow cognitive degeneration
o Antidepressants
o Review Hogan 595 (Know side effects and nursing considerations for
medications)
o Goal is to slow the progression of the disease, Alzheimer’s cannot be
cured.
Recognize that these patients are at high risk for harm in relation to self-care
deficit. They may not be able to feed themselves or clean themselves, so it is
the nurses responsibility to be sure they are fed and cleaned.
Parkinson’s Disease
Etiology
, o Degenerative neurological disease
o 4 cardinal signs
Tremor
Muscle rigidity
Bradykinesia
Postural instability
o Dopamine is produced in the substantia nigra and is responsible for
controlling posture and voluntary motions.
Parkinson’s is a result of atrophied substantia nigra causing a
decrease in dopamine production.
Signs and symptoms
o Begin with fatigue and slight tremor
o Progress to bradykinesia, muscle rigidity, slight gaze, uncoordinated
movements and postural disturbance, short shuffled steps. (Think
sloth from Zootopia)
o Heat intolerance, excessive head sweating, constipation, anxiety,
depression, sleep disturbance.
Treatment
o Dopamine agonists, dopamine receptor antagonists, antivirals,
antichonlinergices, MAOIs, COMT inhibitors
Carbidopa/levodopa
Review pg 870 for medications and why they work
Stereotactic palliodotomy is a surgical intervention that may
relieve symptoms.
Review pg. 872
o Exercise and ROM BID can maximize function
Nutrition
o Monitor for dysphagia.
o Inability to feed self r/t tremors
Migraine Headaches
Etiology
o Vasodilation of the Dural blood vessels.
Stimulates trigeminal nerve pain pathways.
Neuropeptides increase vasodilation
Vicious positive feedback loop results in migraine.
Rasmussen College
Winter ‘19
Alzheimer’s Disease
Etiology
o Unknown but r/t genetics, age and head injuries.
o Neuronal degeneration results in memory loss and loss of speech,
reasoning and higher functioning.
Stages (Review Chart 42-1, know how to identify stages)
o Early/Mild
Poor memory, poor judgment and mild cognitive changes.
o Middle/Moderate
Impairment of all cognitive functions, unable to handle
finances, disorientation to place/time/events, depression or
agitation, aphasia, wandering.
o Late/severe
Weight loss, severe cognitive loss, total dependence, bedridden,
agnosia, incontinence.
Educate patients family on signs and symptoms of stages and what to
expect, there is little point in educating the patient because they will forget.
Review chart 42-1 Iggy, pg. 860
Treatment
o Cholinesterase inhibitors help slow cognitive degeneration
o Antidepressants
o Review Hogan 595 (Know side effects and nursing considerations for
medications)
o Goal is to slow the progression of the disease, Alzheimer’s cannot be
cured.
Recognize that these patients are at high risk for harm in relation to self-care
deficit. They may not be able to feed themselves or clean themselves, so it is
the nurses responsibility to be sure they are fed and cleaned.
Parkinson’s Disease
Etiology
, o Degenerative neurological disease
o 4 cardinal signs
Tremor
Muscle rigidity
Bradykinesia
Postural instability
o Dopamine is produced in the substantia nigra and is responsible for
controlling posture and voluntary motions.
Parkinson’s is a result of atrophied substantia nigra causing a
decrease in dopamine production.
Signs and symptoms
o Begin with fatigue and slight tremor
o Progress to bradykinesia, muscle rigidity, slight gaze, uncoordinated
movements and postural disturbance, short shuffled steps. (Think
sloth from Zootopia)
o Heat intolerance, excessive head sweating, constipation, anxiety,
depression, sleep disturbance.
Treatment
o Dopamine agonists, dopamine receptor antagonists, antivirals,
antichonlinergices, MAOIs, COMT inhibitors
Carbidopa/levodopa
Review pg 870 for medications and why they work
Stereotactic palliodotomy is a surgical intervention that may
relieve symptoms.
Review pg. 872
o Exercise and ROM BID can maximize function
Nutrition
o Monitor for dysphagia.
o Inability to feed self r/t tremors
Migraine Headaches
Etiology
o Vasodilation of the Dural blood vessels.
Stimulates trigeminal nerve pain pathways.
Neuropeptides increase vasodilation
Vicious positive feedback loop results in migraine.
