Alzheimer's Disease Flashcards
What is the definition of cognition?
Mental action or process of acquiring knowledge and understanding through thought, experience, and the senses.
What are the consequences of cognitive impairment?
- Increased risk for injury
- Complicates disease management
- Decreased functional ability including capacity for independent living and normal social interaction
- Increased need for assistive services
- Financial hardship
- Caregiver burden
What are the risk factors of cognitive impairment?
- Elderly people
- Environmental exposure
- Congenital factors
- Genetic conditions
- Health-related conditions: acute or chronic
What are the congenital factors for cognitive impairment?
Maternal substance abuse
Birth injuries
What personal behaviors are the risk factors for cognitive impairment?
Substance abuse
Participation in high-risk activities
Accidental injuries
The type and degree of impairment depend on the type of problem and its severity. What are the types of problems?
- Memory
- Language
- Visuospatial ability
- Calculation
- Abstract reasoning
- Thought process and content
What are laboratory tests used for when it comes to cognitive impairment?
To rule out other medical problems
What are the two types of diagnostic tests used for identifying cognitive impairment?
Neuropsychometric testing
Brain imaging techniques
What types of brain imaging techniques could be used for diagnosing cognitive impairment?
- Neuroimaging
- Magnetic resonance imaging (MRI)
- Positron emission tomography (PET)
What can the Brain Imaging Techniques detect?
Intracranial tumors
Infarcts (vascular dementia)
Frontotemporal lobe atrophy
Alzheimer’s disease is a common what?
Degenerative neurological disorder
When does Alzheimer’s usually manifest?
after age 65
Half of the population over the age of what has alzheimer’s
85
What do patients with Alzheimer’s die from?
Comorbidities
What types of demands associated with Alzheimer’s disease can be devastating?
Personal, economic, and societal demands.
What are the two basic types of Alzheimer’s Disease?
Familial and Sporadic
What progressive degenerative changes are associated with Alzheimer’s?
Gross atrophy of cerebral cortex
What is Alzheimer’s caused by?
- Neurofibrillary tangles
- Amyloid plaques
- Loss of communication between neurons
- Death of neurons
The death of neurons follows this specific pattern.
Limbic system to center for emotion and memory. Hippocampus to recent memory
Death of neurons causes what?
Motor changes
Loss of ability to think, remember, and reason.
Changes in behavior that interfere with life
Can exhibit delusions or hallucinations.
What is the gist of the etiology of Alzheimer’s?
- Blood flow to affected areas decreases
- Atrophy of cortical area of brain
- Structural, chemical changes
- Having the structural changes and showing symptoms of Alzheimer’s may differ
What are the risk factors of Alzheimer’s?
Over 65
Family history
Gender
Head Injury
The following as all associated with Alzheimer’s.
- Anoxia (after cardiac arrest)
- Infectious disease (HIV)
- Depression
- Poisoning
- Substance abuse
- Down Syndrome
- Diabetes
- Atherosclerosis
- Hypertension
- Smoking
- Inflammation
What are the ways to limit your risk for Alzheimer’s?
- Weight control
- Regular exercise
- Consume protective foods
- Use of drugs and alcohol
- Mentally and socially active
Why do you need to rule out other disease processes when you are diagnosing someone with Alzheimer’s?
Many manifestations of Alzheimer’s are similar to other conditions
The rate of progression of Alzheimer’s depends on what/
Overall health
Type of care after diagnosis
Cognitive decline in Alzheimer’s disease patients is accompanied by what else?
Physical decline
What is the mnemonic for conditions that mimic Alzheimer’s?
D= Drug or alcohol E= Emotional disorders M= Metabolic or endocrine disorders E= Eye and ear dysfunctions N= Nutritional deficiencies T=Tumors, trauma, or toxins I= Infections A= Atherosclerotic effects on heart and brain
What is stage 1 of Alzheimer’s?
No impairment
What is stage 2 of Alzheimer’s?
Normal aged forgetfulness
What happens in stage 2 of Alzheimer’s ?
Mild cognitive decline due to aging or Alzheimer’s.
Trouble recalling names, finding correct word
What is stage 3 of Alzheimer’s?
Mild Cognitive Impairment
What happens in stage 3 of Alzheimer’s ?
- Memory lapses, decreased concentration (Become evident to others)
- Decreased task performance
- Inability to recall recently learned information
- Trouble with planning and organizing
What is stage 4 of Alzheimer’s?
Mild or early stage Alzheimer’s
What happens during stage 4 Alzheimer’s?
Symptoms of impairment more obvious
- Allow for considerably accurate diagnosis
- Trouble recalling recent events, personal history, day, week, month
- Difficulty performing complex ADLs.
What is stage 5 of Alzheimer’s?
Moderate Alzheimer’s
What happens during stage 5 of Alzheimer’s?
- Lose ability to live independently
- Remote memory starts to fail, can’t remember name of high school or college
- Inability to perform less complex activities.
What is stage 6 of Alzheimer’s?
Moderately severe Alzheimer’s
What happens during stage 6 of Alzheimer’s?
- Inability to perform even basic ALDs
- Can remember own name but not that of spouse
- Steep cognitive declines
- Personality changes, sundowning
- Wander
What is stage 7 of Alzheimer’s?
Severe Alzheimer’s
What happens during stage 7 of Alzheimer’s?
- Complete loss of ability to respond to surroundings
- Require total care
- Loss of ability to speak and walk
- Physically rigid, abnormal reflexes
Who is part of the multidisciplinary team to treat patients with Alzheimer’s ?
- MD
- Nurse
- Social Worker
- Neurologist
- Psychiatrist
- PT
- OT
- Gerentology nurse specialist
- Case worker
- Pharmacists
What is the most definitive way of diagnosing Alzheimer’s?
Brain autopsy
What other diagnostics can help diagnose Alzheimer’s?
- History and physical including psychiatric and neurological
- Ongoing interviews
- Brain scans (CT and MRI)
- PET imaging
- Lab work up
What are the local treatment centers for Alzheimer’s?
Memory Disorder Clinic and Roschamp Clinic
What type of drugs may slow the progression of Alzheimer’s?
Acetylcholinesterase inhibitors and MNDA receptor antagonists
What two types of behavior management drugs may help Alzheimer’s?
Antidepressants and antipsychotics
What nonpharmacologic therapies can help with Alzheimer’s?
- Speech therapy
- Physical therapy
- Occupational therapy
- Disability benefits
- Advocacy groups such as the Alzheimer’s Association
What complementary and alternative therapies are used for patients with Alzheimer’s?
- Antioxidants
- Resveratrol
- Ginko biloba
- Omega-3 fatty acids
- Music therapy
- Therapeutic touch
- Aromatherapy
- Therapy pets
What should you focus your nursing process on in patients with Alzheimer’s?
- Providing a safe and supportive environment that meets changing abilities and needs
- Collaborate with clients family members as they cope with physical and emotional demands
What physical assessment should be done on patients with Alzheimer’s?
- Possible signs of abuse, neglect, depression, and malnutrition
- Medications and supplements
What mental status examination can be done as an assessment for Alzheimer’s?
Mini-Mental Status Exam (MMSE)
What are the diagnoses for stage one and two of Alzheimer’s?
Impaired Memory and Chronic Confusion
What are the diagnoses for stage three of Alzheimer’s?
- Ineffective denial
- Risk for injury
- Anxiety
- Hopelessness
- Imbalanced Nutrition: Less than Body Requirements
As Alzheimer’s Progresses what are the nursing diagnoses?
- Risk for Caregiver Role strain
- Risk for Aspiration
- Self-Care Deficit
- Impaired Social Interaction
- Impaired Verbal Communication
- Functional Urinary Incontinence
- Impaired Physical Mobility
- Wandering
What should you implement with patients who have Alzheimer’s?
- Promote effective coping strategies
- Prevent injuries
- Promote balance between rest and activity
- Promote psychological wellness
- Facilitate stress management for the caregivers
- Community based care
What things can effect the emotional environment of a patient with Alzheimer’s?
- Agitation due to caregivers emotions
- Coach caregivers to create a calm environment
- Logic and orientation responses do not work
- Enter into the patients world and time
- Tell them what they need to hear to be calm
- Play music/movies or show pictures from this time period
- Temperature
What are the ethical concerns associated with stage one and two Alzheimer’s?
- Plan to put end of life issues in order
- Power of attorney
- Will
- Surrogate decision maker
- End of life decisions
- Checking accounts
What are the ethical concerns associated with stage three Alzheimer’s?
- Driving
- Living arrangements
- Contracts
- Major decisions
- Advanced directives
What are the ethical concerns associated with stage four to seven of Alzheimer’s?
- Treatment options
- Aggressive diagnosis or treatment
What should be included in the evaluation a client with Alzheimer’s?
- Asses client on regular basis
- Regularly readjust treatment for optimal outcomes
- Client remains free from injury
- Client’s nutritional intake meets needs
- Client maintains medication regimen
- Client effectively uses memory aids
- Caregiver utilizes community resources