Adult Health Nursing II (2025/2026 New Update) Complete Study
Guide with Practice Questions & Key Concepts|Already Graded
A+
Parkinson's Disease
Progressively debilitating disease affecting motor function
Dopamine neurotransmitter → essential for functioning of the
extrapyramidal system (posture, motor control, writing) Dopamine
creates an inhibitory response/action while acetylcholine creates an
excitatory response/action so when there's an imbalance between
those NTs that’s when we see the symptoms/CMs of PD because the
dopaminergic cells degrade over time
Affects attention/emotion and fine motor skills
Dec production from loss of basal ganglia in brain
Parkinson's recognizing cues
TRAP
Tremors → resting, involuntary, “Pill-rolling”
Rigidity Difficulty with coordination Freezing in place Stiffness
Muscle soreness Masked face
Akinesia Slow movements Shuffling gait Reduced arm swing
Posture → stooped, loss of balance
Drooling, sweating
Orthostatic hypotension
Difficulty chewing/swallowing
Urinary retention, constipation
Psychiatric changes → depression, mood changes
Parkinson's risk factors and Dx
pg. 1
,Risk factors/Causes: Genetic/hereditary Environmental exposure:
heavy metal, pesticides, chemical toxins Traumatic head injury
Higher incidence in men, typical onset ~60+
Clinical dx → hx, symptoms, physical exam
MRI brain
DaT scan (dopamine transporter scan)
TRAP findings → bradykinesia + tremor, rigidity or balance/falls
Parkinson's management
Treatment directed toward controlling symptoms and maintaining
functional independence
Carbidopa-levodopa
Deep Brain stimulator (electrodes in brain)
Carbidopa/Levodopa
May take wks or months to see improvement
Monitor for adverse effects (grimacing, involuntary movements of
trunk/limbs, orthostatic hypotension and dark urine)
On/off syndrome
Give on an empty stomach
Parkinson's disease Role of the Nurse
Safety:
Risk for falls → home environment, proper footwear, assistive
devices, PT
Aspiration → speech therapy, appropriate diet
Altered cognition
Mobility
Exercise/ROM
Assistive devices
pg. 2
,Pace activities
Education around orthostatic hypotension
Medication education
Bowel/bladder training
Mood/emotional changes
Social support
Support groups/resources
Multiple sclerosis
A progressive immune-mediated demyelination disease of the CNS
Cause unknown; affects women 3x > men, 20s-50s onset of age
MS risk factors
Family hx
Viruses/infectious agents
Genetic mutations
Physical injury
Pregnancy
African-American, caucasian
Higher latitudes
Vitamin D deficiency
MS recognizing cues
Fatigue
Neuropathic pain
Cognition → memory loss, slower processing, word finding, impaired
judgment
Vision → diplopia, scotomas, blindness, loss of visual acuity,
nystagmus
Mobility → balance, spasticity, muscle tightness, ataxia
Bowel dysfunction → constipation, incontinence
pg. 3
, Bladder dysfunction → incontinence, urgency, nocturia
Sexual dysfunction
MS Dx studies
No definitive diagnostic test for MS
Diagnosis based on clinical, imaging, and laboratory findings
Plaques in the CNS & spine on MRI exams
McDonald criteria for Diagnosis Based on number of clinical attacks
and number of lesions w/ objective clinical evidence
CSF findings → oligoclonal banding
MS - Immune modulators
- Reduce frequency and durations of relapse
> Interferon beta 1a and 1b
> Glatiramer acetate
MS- Corticosteriods
> Prednisone
- Reduces inflammation in MS exacerbation
MS Antispasmodics
- Baclofen
MS Anticholinergics
> treats bladder dysfunction
- Propantheline
MS Docusate Sodium
- Prevents and treats constipation by softening the stool
MS Assessment
Neurologic deficits Vision/hearing Fatigue/weakness Cognitive
changes
Mobility and balance → risk for falls
Incontinence (fecal/urinary)
Swallowing and speech Communication barriers Aspiration
pg. 4
Guide with Practice Questions & Key Concepts|Already Graded
A+
Parkinson's Disease
Progressively debilitating disease affecting motor function
Dopamine neurotransmitter → essential for functioning of the
extrapyramidal system (posture, motor control, writing) Dopamine
creates an inhibitory response/action while acetylcholine creates an
excitatory response/action so when there's an imbalance between
those NTs that’s when we see the symptoms/CMs of PD because the
dopaminergic cells degrade over time
Affects attention/emotion and fine motor skills
Dec production from loss of basal ganglia in brain
Parkinson's recognizing cues
TRAP
Tremors → resting, involuntary, “Pill-rolling”
Rigidity Difficulty with coordination Freezing in place Stiffness
Muscle soreness Masked face
Akinesia Slow movements Shuffling gait Reduced arm swing
Posture → stooped, loss of balance
Drooling, sweating
Orthostatic hypotension
Difficulty chewing/swallowing
Urinary retention, constipation
Psychiatric changes → depression, mood changes
Parkinson's risk factors and Dx
pg. 1
,Risk factors/Causes: Genetic/hereditary Environmental exposure:
heavy metal, pesticides, chemical toxins Traumatic head injury
Higher incidence in men, typical onset ~60+
Clinical dx → hx, symptoms, physical exam
MRI brain
DaT scan (dopamine transporter scan)
TRAP findings → bradykinesia + tremor, rigidity or balance/falls
Parkinson's management
Treatment directed toward controlling symptoms and maintaining
functional independence
Carbidopa-levodopa
Deep Brain stimulator (electrodes in brain)
Carbidopa/Levodopa
May take wks or months to see improvement
Monitor for adverse effects (grimacing, involuntary movements of
trunk/limbs, orthostatic hypotension and dark urine)
On/off syndrome
Give on an empty stomach
Parkinson's disease Role of the Nurse
Safety:
Risk for falls → home environment, proper footwear, assistive
devices, PT
Aspiration → speech therapy, appropriate diet
Altered cognition
Mobility
Exercise/ROM
Assistive devices
pg. 2
,Pace activities
Education around orthostatic hypotension
Medication education
Bowel/bladder training
Mood/emotional changes
Social support
Support groups/resources
Multiple sclerosis
A progressive immune-mediated demyelination disease of the CNS
Cause unknown; affects women 3x > men, 20s-50s onset of age
MS risk factors
Family hx
Viruses/infectious agents
Genetic mutations
Physical injury
Pregnancy
African-American, caucasian
Higher latitudes
Vitamin D deficiency
MS recognizing cues
Fatigue
Neuropathic pain
Cognition → memory loss, slower processing, word finding, impaired
judgment
Vision → diplopia, scotomas, blindness, loss of visual acuity,
nystagmus
Mobility → balance, spasticity, muscle tightness, ataxia
Bowel dysfunction → constipation, incontinence
pg. 3
, Bladder dysfunction → incontinence, urgency, nocturia
Sexual dysfunction
MS Dx studies
No definitive diagnostic test for MS
Diagnosis based on clinical, imaging, and laboratory findings
Plaques in the CNS & spine on MRI exams
McDonald criteria for Diagnosis Based on number of clinical attacks
and number of lesions w/ objective clinical evidence
CSF findings → oligoclonal banding
MS - Immune modulators
- Reduce frequency and durations of relapse
> Interferon beta 1a and 1b
> Glatiramer acetate
MS- Corticosteriods
> Prednisone
- Reduces inflammation in MS exacerbation
MS Antispasmodics
- Baclofen
MS Anticholinergics
> treats bladder dysfunction
- Propantheline
MS Docusate Sodium
- Prevents and treats constipation by softening the stool
MS Assessment
Neurologic deficits Vision/hearing Fatigue/weakness Cognitive
changes
Mobility and balance → risk for falls
Incontinence (fecal/urinary)
Swallowing and speech Communication barriers Aspiration
pg. 4
