Alzheimers Flashcards
What is Alzheimer’s Disease
A non-reversible type of dementia that progressively develops over many years
What is dementia
multiple cognitive deficits that impair memory and can affect language, motor skills, and/or abstract thinking
What are risk factors of Alzheimer’s Disease (AD)
Age (generally occur in 60s/70s), sex (female), chemical imbalances, previous head injury, genetics (apolipoprotein E)/family history of AD, ethnicity (African American and Hispanics are at increase risk), environmental agents (herpes virus/metal/toxic waste)
Characteristics of AD
memory loss, problems with judgment, and changes in personality.
as disease progresses, severe physical decline accompanies deteriorating cognitive functions
What are the stages of AD
Early stage, middle stage, late stage
Characteristics of Mild Alzheimer’s (early stage)
memory lapses, losing or misplacing items, difficulty concentrating and organizing, unable to remember material just read, still able to perform ADLs, short-term memory loss noticeable to close relations, trouble remembering names when introduced to new people, greater difficulty performing tasks when in a worse setting, can get lost driving (basically short term memory problems and issues with new things)
Characteristics of Moderate Alzheimer’s (middle stage)
forgetting events of your own history, difficulty performing tasks that require planning and organizing (finances), difficulty with complex mental arithmetic, personality and behavioral changes (withdrawn/subdued/compulsive/repetitive actions), changes in sleep patterns, can wander and get lost, can be incontinent, clinical findings are noticeable to others (basically harder to do more complex things and starting to lose autonomy)
Characteristics of Severe Alzheimer’s (late stage)
Losing ability to converse with others, assistance required for ADLs, incontinence, losing awareness of one’s environment, progressing difficulty with physical abilities, progressing difficulty with physical abilities (ex: walking, sitting, eventually swallowing), eventually loses ability to move (can develop stupor and coma), death frequently related to choking or infection, vulnerable to infection (especially pneumonia) which may become lethal (basically, more life threatening symptoms)
What assessments can be used to detect/measure AD?
Mini Mental State Examination (MMSE), set test using FACT, Short Blessed Test, or Clock Drawing Test
Low levels of what protein precursor supports the diagnosis of AD?
Soluble beta protein precursor (sBPP) in the cerebral spinal fluid when taken from a puncture in the lumbar region
-Beta amyloid protein normally assists in growth and protection of nerve cells
What are nursing interventions for AD?
Assess cognitive status/memory judgment/personality changes; help with ADLs when necessary; encourage client and family to participate in a AD support group; provide a safe environment (monitor, keep client from stairs/elevators/exits, remove dangerous equipment); provide frequent walks; provide cognitive stimulation; provide memory training; use of routines
What is pharmacotherapeutics based on?
The theory that AD is a result of depleted levels of the enzyme acetyltransferase
What prevents the breakdown of acetylcholine (ACh) and what is the effect?
Donepezil, increased nerve impulses at the nerve sites
What blocks nerve cell damage caused by excess glutamate and therefore shows reduction of deterioration in clients?
Memantine
What drugs help slow the process of AD?
Cholinesterase inhibitors, memantine, and donepezil
What should nurses observe for when clients are on AD medication?
Observe for frequent stools or upset stomach, monitor for dizziness/headache/unsteady gait, use caution when administering medication tothose who have asthma or COPD (lung problems can worsen)
What are some alternative therapies for AD and their effects?
estrogen therapy for females (can prevent AD but not useful in treating effects of existing dementia) ginkgo biloba (an herbal product taken to increase memory and blood circulation) can cause a variety of adverse effects and medication interactions, if client is doing this it must be shared with provider
A charge nurse in a long term care facility is preparing a program for assistive personnel about caring for a client who has AD. What should be included in the program? Describe 3 nursing interventions for each of the following: providing cognitive stimulation, providing memory training
cognitive stimulation: offer varied environmental stimulations (walks, music, and craft activities); keep a structured environment/introduce change slowly; use a calendar ti assist with orientation; use short directions when explaining care; be consistent and repetitive; use therapeutic touch (ex: mas
memory training: reminisce about the past; help the client make lists and rehearse; repeat the client’s last statement to stimulate memory
A nurse is providing teaching to the partner of a client who as AD and has a new prescription for donepezil. Which of the following statements by the partner indicates the teaching is effective?
A. This medication should increase my husband’s appetite
B. This medication should help my husband sleep better
C. This medication should help my husband’s daily function
D. This medication should increase my husband’s energy level
C; Donepezil helps slow the progression of AD and can help improve behavior and daily functions
A nurse working in a long-term care facility is planning care for a client who has moderate AD. Which of the following interventions should be included in the plan of care?
A. Use a gait belt for ambulation
B. Thicken all liquids
C. Provide protective undergarments
D. Reorient the client to self and current events
D; A client who has moderate AD can require reorientation to self and current events as cognitive function declines
A nurse is making a home visit to a client who has AD. The client’s partner states that the client is often disoriented to time and place, is unsteady, and has a history of wandering. Which of the following safety measures should the nurse review with the partner? Select all that apply.
A. Remove floor rugs
B. Have door locks that can be easily opened
C. Provide increased lighting in stairwells
D. Install handrails in the bathroom
E. Place the mattress on the floor
A, C, D, E; all can reduce the risk of falling
A nurse is caring for a client who has AD and falls frequently. Which of the following actions should the nurse take first to keep the client safe?
A. Keep the call light near the client
B. Place the client in a room close to the nurses’ station
C. Encourage the client to ask for assistance
D. Remind the client to walk with someone for support
B; allows for close observation of the client for nurses
A nurse is caring for a client who has AD. A family member of the client asks the nurse about risk factors for the disease. Which of the following should be included in the nurse's response? Select all that apply. A. Exposure to metal waste products B. Long-term estrogen therapy C. Sustained use of vitamin E D. Previous head injury E. History of herpes infection
A, D, E
