Final Exam Review
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.
Signs and symptoms
o Prodromal phase: Food cravings or mood changes
o Aura phase: Visual changes, flashint lights, diplopia
o Headache phase: Lasts hours – days.
o Termination phase: Intensity decreases
Treatment
o Preventitive medications are taken every day despite prescense of signs or symptoms.
Beta blockers
Calcium channel blockers
Prevent vascular changes associated with migraine headaches.
Educate patient to take EVERY DAY
o Abortive medications are taken at the onset of signs or symptoms.
Tylenol or ibuprofen
Caffeine
Triptans
Sumatriptan
Eletriptan
Naratriptan
Seizures
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.
Signs and symptoms
o Prodromal phase: Food cravings or mood changes
o Aura phase: Visual changes, flashint lights, diplopia
o Headache phase: Lasts hours – days.
o Termination phase: Intensity decreases
Treatment
o Preventitive medications are taken every day despite prescense of signs or symptoms.
Beta blockers
Calcium channel blockers
Prevent vascular changes associated with migraine headaches.
Educate patient to take EVERY DAY
o Abortive medications are taken at the onset of signs or symptoms.
Tylenol or ibuprofen
Caffeine
Triptans
Sumatriptan
Eletriptan
Naratriptan
Seizures
