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NURS 212 > CH 14 > Flashcards

CH 14 Flashcards

1
Q

Delirium

A

a syndrome
that develops over hours or days, fluctuates over the course
of the day and can persist for months. Changes in mental
status involve problems with attention and consciousness
and several or many additional changes, including altered
sleep—wake patterns.

ACUTE CONFUSION CHARACTERIZED
BY SUDDEN AND TEMPORARY CHANGES IN
COGNITION, ATTENTION, MEMORY AND
PERCEPTION

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2
Q

Common precipitating factors for delirium

A

surgery, infections, serious illness and physical restraints.

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3
Q

most widely used screening tool in LTC and acute care

A

Confusion Assessment method

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4
Q

Features of deliriuj according to CAM

A

Acute onset or fluctuating course: change in mental status
from baseline or onset of abnormal behaviours that tend
to come and go or increase and decrease in severity.
Inattention:
Disorganized thinking:
Altered LOC

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5
Q

3 Subtypes of delirium

A

Hyperactive
Hypoactive
Mixed (fluctuates bwhyper and hypo)

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6
Q

Examples of nursinginterventions to delirium

A

Provisions of aids to orientation i.e. clock
Environmental modification (noise reduction)
Psychological support
Protomooion of normal sleeping pattern

etc
\

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7
Q

Dementia medical term

A

medical term
that includes a group of brain disorders characterized by a
gradual decline in cognitive abilities (e.g., memory, understanding,
judgment, decision-making, communication) and
changes in personality and behaviour.

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8
Q

How many cases of dementia are alzheimers disease

A

60-80%

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9
Q

Lewey body ementia

A

part of a group of disorders called
Lewy body diseases, which also includes Parkinson disease
and Parkinson disease with dementia.

Account for 15-20% of dementia diagnoses

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10
Q

How many Stages of AD

A

7

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11
Q

Anosognosia,

A

Anosognosia,
which is the diagnostic term for lack of awareness, is assessed
by having the person who is being evaluated and a
family member or caregiver independently answer questions
related to the person’s behaviours and daily activities

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12
Q

behavioural
and psychological symptoms of dementia (BPSD)

A

Agitation
Psychiatric symptoms: delusions, hallucinations
e Personality changes,
Mood disturbance

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13
Q

Causes of delirium

A

UNKNOWN, THOUGHT TO BE
DISTURBANCES IN THE NEUROTRANSMITTERS
WITH MULTIFACTORIAL CAUSES

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14
Q

Predisposing

A

Things that exist that increase risk for something (age)

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15
Q

Precipitating

A

More spontaneous risk factors (pain, surgery, contitpation, urinary retention etc.)

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16
Q

3 types of delirium

A

Hyperactive, hypoactive, mixed

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17
Q

How important is delirium

A

A medical emergency

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18
Q

Consequences of delirium

A

Longer hospital stays
Higher rate of LTC residency
Short and long term functional impairment
Development of or worsening of dementia

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19
Q

What can delirium do to dementia

A

exacerbate it

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20
Q

Nursing assessment for delirium

A

Assess and treat predisposing factors

Keep individual safe until delirium is resolved

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21
Q

CAM

A

Confusion assessment method
- Diagnosis tool for delirium

1 Acute onset/fluctuating course
2 Inattention
3 Disorganized thinking
4 Altered LOC

22
Q

Pharmacological intervention for delirium

A

Not recommended BC medication can cause it in the first place

Limit the use of psychoactive meds

Discontinue Non-essential medications

23
Q

Non-pharm interventions for delirium

A

Physiological stability/reversible cause
Environmental (Create a stress free environment)
Education (teaching them what they need to do)
Get them to work with you
Communication

24
Q

Treatment of delirium focused on

A

Possible contributing factors
Safety to address function and behaviour changes
Managing aggravating factors that might worsen the delirium

25
Q

Key parts of deleirum

A

Sudden
Acute
Predisposing factors

26
Q

Key features of dementia

A

Aphasia, apraxia (Cant do the action with their body that they intend), agnosia (recognition problems), disturbances in executive functioning (act do cycle)

27
Q

Types of dementia

A

Alzheimer
Vascular
Lewy Body
Frontotemporal

28
Q

Cause of demntiia

A

Damage TO OR LOSS OF NERVE CELLS AND THEIR
CONNECTIONS IN THE BRAin

29
Q

Most dementia is

A

Alzheimers

30
Q

Alzheimers

A

Requires a genetic component

60-80% of dementia

Insidious disease (happens and progresses quickly)

Cannot be officially diagnosed until post Morten autopsy

31
Q

Vascular dementia

A

Dying blood vessels leading to brain death

11-18%
stroke (CVA)
heart disease

32
Q

Lewy body dementia

A

15-20% (grouped with parkinsons)

similar symptoms to alzheimers

Very insidious

33
Q

Functional consequences of dementia

A

Various
Loss of personhood/self-worth
Feel isolated and depressed
Difficult to recognize and/or acknoledge

34
Q

Initial and ongoing assessment

A

MMSE
Behaviour and psych symptoms of dementia

35
Q

Important treatment for people with dementia

A

Routine
Regular faces
Regular location

36
Q

Nursing assessment for dementia

A

MMSE
Behaviour and pscyh symptoms of dementia
Nursing diagnosis to individualize interventions

37
Q

Dementia interventions

A

Pharmacological intervention
Non pharm interventions

38
Q

Pharmacological interventions for dementia

A

Most meds can stabilize disease etiology and progression and mange symptoms

Alzheimer’s disease does have specific meds

Undrrelying cardiac factors for vascular dementia can be treated

39
Q

Non pharm interventions for dementia

A
  • EDUCATION
  • ENVIRONMENTAL MODIFICATION
  • COMMUNICATION SKILLS
  • ALTERNATIVE THERAPIES FOR DEMENTIA (mobilize)
40
Q

KNOW SUMMAR OF IMPAIRED condition delirium and dementia

A
40
Q
A
40
Q

Primary characteristics

A
  • RAPID CHANGE IN MENTAL STATUS
  • DEVELOPS IN HOURS TO DAYS
  • SYMPTOMS FLUCTUATE
  • PREVENTABLE AND TREATABLE
  • NURSING CARE FOCUSED ON RISK
    FACTORS AND SYMPTOMS
41
Q

Primary intervention for management of delirium

A

Reducing noise and placing familiar objects in the client’s environment

42
Q

Open ended questions for people with dementia?

A

No, maintain good eye contact and relaxed and smiling is more important

43
Q

A brain with vessel occlusions is suffering from what kind of dementia

A

Vascular

44
Q

How to best tell someone to react to alzheimers

A

Yes, progression is usually fairly fast, you might want to start making plans.

???

45
Q

Sudden onset of delirium should first be investigated in what

A

Medications or infections

46
Q

Lewy body dementia characterized by

A

The presence of abnormal proteins in the brain (lewy bodies) that eventually damage the neurons in the brain

people are highly sensitive to anticholergenic medications even in low doses

Can progress quickly if environment is changed or if infection or condition occurs as well

47
Q

Frontotemporal degeneration (dementia)

A

Major cause of young onset dementia

48
Q

Stage 2 of dementia

A

Age associated memory impairment (normal)

49
Q
A

NURS 212 (15 decks)

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