Alzheimer Disease Flashcards
What is Alzheimer’s disease?
Chronic progressive irreducible neurodegenerative brain disease
Alzheimer’s is __ to __ of all dementias
60-80%
Alzheimer’s is a progressive diseases which means it has 3 levels?
Mild
Moderate
Severe
Alzheimer disease is also known a as the ??
Long goodbye or death in slow motion
Most common in gender?
And has a late ??
What are biological factors?(2)
Risk factors
- age and family
- cardiovascular disease
- social engagement and diet
- head injury & tramua brain I just
Female
Onset
Neuronal degeneration
Genetics
It’s important to know that the brain and heart/circulatory health are closely linked
So many factors that increase the risk of cardiovascular disease
- name them (5)
Will increase the risk of Alzheimer’s disease
Diabetes
Hypertension
Obesity
Hypercholesterolemia ( high cholesterol )
Smoking
Diabetes has a significant increase risk of developing Alzheimer’s disease or any form of disease why? (2)
Because of
Chronic high levels of insulin and glucose may be toxic to the brain
Insulin resistance may interfere with ability to break down amyloid
( amyloid, a protein that forms brain plague in AD )
Another huge risk for developing AD is head trauma why?
Don’t over think it
Because anything hitting the head will cause huge damage
Application of nursing processs
Assessment
Defense mechanism of a AD patients is? (4)
Denial
Confabulation
( creation of stores in place of missing Memories to maintain self esteem )
Perseveration
( repetition of phrases or behavior )
Avoidance of questions
What are the 5 main symptoms of AD?
Memory impairment
Disturbances in executive functioning
Aphasia ( loss of language ability )
Apraxia ( loss of coordination )
Agnosia ( loss of sensory ability to recognized objects )
What are the 10 early warning signs of AD?
- Memory loss that effects job skills
- Difficulty performing familiar tasks
- Problems with language
- Disorientation to time & place
- Poor judgment
- Problems with abstract thinking
- Misplacing things
- Change in mood/behavior
- Change in personality
- Loss of initiative
Does normal memory decline interfere with ADLS?
No!!
What does recent memory loss mean?
What does remote memory loss mean?
These two recent and remote memory loss ; will they interfere with a patients ADLS? And this will ultimately lead to the patient being unable to?
Early
Lost as disease progresses
Yes ; take care of themselves
As alzheimer disease progression
The patients personal hygiene and concentration and attention will ??
They will have unpredictable behavior and hallucinations; in which the patient has what??
Decrease
No control over
Alzheimer patients will under reterogenesis, what does that mean?
Process where degenerative changes occur in reverse order in which they were required
( they start turning into a kid again, from speaking like an adult, to not even being able to hold up there head like an newborn )
What is the second stage in the spectrum of AD?
Mild cognitive impairment
What is mild cognitive impairment?
Are these problems severe to be noticed by others?
Can it show up on tests??
Does this help meet the criteria for dementia?
Cognitive function in which persons have problems with memory, language, or other cognitive functions
Yea
Yes
No
Acute care
Diagnosis is very traumatic for patients, so it’s important that the nurse assess the patients for?
Not only is the patient at risk, but we also want to help out family caregivers because they could be in?
Patients will often respond with
- depression
- denial
- anxiety
- withdrawal
- feelings of loss
Depression or suicidal ideation
Denial or delaying critical care
Acute care
It’s important to work and collaboration with the patients caregiver in order to?
Help manage clinical manifestations and engagement with client and caregiver
It’s important to note that patients with AD are subject to hospitalizations for other problems!!
It’s important that the care giver and nurse focus there attention on the patient to____otherwise it’s there responsibility
It’s also not that fun for ad patients to be hospitalized since it increases ?(2)
Communicate!!
Delirium & dementia
Ambulatory care
It’s important to know that AD is a progressive disease and will get worse over time so it’s important for care givers and friends to ?? (2)
Don’t over think it
Choose a right location & care giver
Ambulatory care for Alzheimer’s disease
In early stages it’s important to use memory aids ; what is it and why?
We can also developers depression
, in which advance directives should be set why?
Memory aids is like a calendar
To help Tract and report status of a patient
Because it has a massive impact on a patient ADLS
Not only can we use family care and calendars, we have adult care, which can help as patients how?
Live
ADLS
safety
Stimulation
Just remmeber, as a patient with alzheimer reaches a full on patient needed care, you as a nurse are responsible for?
Safety!!!!!!!! And performing ADLS
Behavior problems in AD patients are? (9)
Repetitiveness
Delusions
Hallucinations
Agitation
Aggression
Altered sleep patterns
Wandering
Hoarding
Resisting care
Problems as mentioned before can be ____ and ____ ?
Which often leads patients to go to?
Remember, patients aren’t doing this on purpose and are difficult to control
unpredictable and challenging
Institutional care settings
What are the ways we see a patient respond to the problems mentioned before ? (4)
Pain
Frustration
Temperature extremes
Anxiety
When an AD patient is experience those problems and performing those behaviors
It’s important that we as nurses will make a plan to protect the patient
But we also want to assess (2)
Maybe we might want to remove any triggers and reassure the patient that it’s safe
However, patients also can’t speak sometimes, so what’s the most important thing to look out for?
You should never ask a patient what thing?
Vital signs
Environment
There mood!! The way they responded to problems
Why!!
What are diagnostic test we can do for AD? (6)
CT
PET
mini mental stat examination
Physical/neuro exam
Medical history
Medications/nutrition/symptoms
Notes
Nursing process
Family assessment
- realistic understanding of the disease
- stress mangamenr
- support & educate
- realistic outcomes
- maintain good self care
Alzheimer disease disrupts all aspects of a person life
It is very stressful for the patient and the caregivers
So it’s important to note that we as nurses should also watch out for caregivers because?
It can lead to conflict and Strain
Not to mention, loss of employment and a toll on emotional and physical health
Did you know that caregiving increases the risk for development of dementia??
How does this work?
Chronic and severe stress can effect the hippocampus
( this is a place where it’s responsible for memory )
Notes
Outcomes identification
Planning
- connect caregivers to support services
Intervention
- person centered care approach
- health teaching and health promotion
- referral to community supports
- pharmacological intervention
- integrative therapy
Evaluation
Alzheimer disease
Safety risk for injury / wandering
We want to ? (3)
Minimize risk in home environment
- implement all possible safety strategies
Supervision
Wandering is a major concern
- observe factors or events
- medical alert + safe return
- GPS
Alzheimer disease
Pain management
Impaired communication
Pain should be recognized and treated promptly
But how? (3)
Monitor patient response
Patient difficulty communicating complaints
May exhibit change in behavior
Alzheimer disease
Eating and swallowing difficulties
We want to? (2)
What are two short term possibilities
But we want to be careful because of?
Offer liquids
Finger foods which allow self feeding
NG PEG tubes
Aspiration
Undernutrition is a problem in modereate and severe stages of Alzheimer’s
Because patients loose internet in foods and that decreases their ability to self feed ( apraxia )
So it’s important to have foods like?
To encourage eating
What type of environment do we want for these patients when eating ?
We also want what type of utensils?
Puréed, thicken liquids and nutritional supplements
Quiet and unhurried
Easy grip
In late stages of Alzheimer disease, it’s important to always assess a patient oral care because when they stop having those functions, it can lead to?
Tooth decay and dental problems !
What are two most common infections AD patients get?
And any signs of these two manifestations need prompt evaluation and treatment !
UTI and pneumonia ( most common death )
In late stages of AD, patients are unable to take care of there skin, and that leads to skin breakdown.
We often see ?
So it’s important to keep the skin __ and __
And to avoid skin breakdown we want to do what with the patient?
Rashes and redness
Dry and clean
Change position regularly
Urinary and fecal Incontience during middle to late stages will lead the patient to get what?
UTI
Constipation may relate to immobility and dietary intake
So it’s important to increase patients what?
Fluids !!
What are the expected outcomes of AD? (4)
Functions at the highest
ADLS!
No injuries
Remains in a restricted area ( no wandering )
