17 Neurocognitive Disorders Flashcards
3 types of neurocognitive disorders
- delirium
- mild neurocognitive disorder
- major cognitive disorder aka dementia
onset
DLRM: short term, hours days, fast, reversible
MAJOR NCD: progressive, months yrs, irreversible
Major + Mild NCD classification
Alzheimer’s
Parkinson’s
Huntington’s
____ in older adults can mimic early Alzheimer’s
depression
delirium RF
physio + neuro changes (parknsn, huntngtns)
- metabolic (hepatic/renal failure, electrlt imbalance)
- cardiovasc disease
- resp disease
- infection
- withdrawal
NCD RF
- old age
- head trauma
- cardiovasc
- lifestyle
- fam hx
- strong genetic*
common defense mechanisms in NCD
- denial
- confabulation
- preservation
diagnostic procedures to diagnose NCD
diagnosis CANNOT be made until autopsy
-testing is done to rule out other pathologies that could be mistaken for NCD
delirium vs NCD manifestations
DLRM: impairments fluctuate throughout the day
- disorientatn/confusn worse at night
- rapid personality change
- perceptual disturbances (hallucntn, delusn)
- UNSTABLE VS
NCD: impairments, LOC do NOT change
- sundowning
- gradual personality change
- stable VS
nursing care to provide safe/therapeutic environment
- assign pt to room close to nurs statn
- low level visual + auditory stim
- well lit to minimize contrast + shadows
- room w windows to help w time orientatn
nursing care for cognitive support
- compensatory memory aids
- consistent daily routine
- consistent caregivers
- cover/remove mirrors to decr fear/agitatn
- phys activity during day
- adequate lighting at night
vital signs assoc w delirium
- tachycardia
- high BP
- sweating
- dilated pupils
communication
- calm reassuring tone
- positively worded phrases
- reinforce reality
- reorient to person, place, time
- introduce self w each new contact
- eye contact + short simple sentences
- break instructn + actvts in short time frames
- limit choices in dressing + eating
- minimize decision making + abstract thinking
- approach slowly fr front
what may be prescribed for delirium
antipsychotic + antianxiety
med to slow cognitive deterioration of of Alzheimers
cholinesterase inhibitor such as
- donezepil
- rivastigmine
- galantamine
