Ch. 22 Neurocognitive Disorders Flashcards
A ______ is characterized by disturbance in attention and awareness and a change in cognition that develop rapidly over a short period of time.
delirium
includes delirium, dementia and amnestic disorders
common defense mechanism used by people with neurocognitive disorders (delirium)?
- Denial
- confabulation
- Perseveration
Delirium or Dementia?
A. progressive
B. Acute rapid onset
A = dementia B = delerium
Dementia is caused by deterioration in the brain.
Delerium can be brought on by illness or intoxication/withdrawal which happens very quickly
Delirium or Dementia?
Profound loss and/or impairment in intelligence
Dementia
This is the hallmark sign!
Dementia patients can start out as phD scholars but eventually forget how to use utensils…how to talk…etc.
Delirium or Dementia?
Attention waxes and wanes (increase and decrease)
Delirium
Delirium or Dementia?
short lived, reversible
Delirium
dementia is IRREVERSIBLE
Delirium or Dementia?
sundowning
dementia
Delirium or Dementia?
wandering
dementia
Delirium or Dementia?
unstable vital signs
delerium - remember it comes on quick and is usually caused by illness, wd or intox which all change vital signs!
Delirium or Dementia?
Personality change is gradual
Dementia
gradual progression - gradual change
Delirium or Dementia?
A. LOC is unchanged
B. LOC fluctuates (wake–>sleep–>wake)
A. dementia
B. delirium
Delirium or Dementia?
stable attention
dementia
Delirium or Dementia?
A. Organic cause
B. Medical cause
A. Dementia
B. Delerium
what is aphasia?
loss of language
what is anomia?
decreased ability to remember words
A - means not
Nom - name
can’t name things, can’t find words
What is agraphia?
inability to express in writing (graphite pencil)
what is alexia?
inability to understand written language (dyslexia reads it scrambled, alexia can’t read it at all).
What is apraxia?
loss of motor ability
what is agnosia?
loss of ability to recognize objects
agNOsia - NO telling what they SIa
Which goes first short term or long term memory in alzheimers?
short term
Typically, where did I put that? Someone must’ve stolen it or is playing games with me!
But won’t forget family.
What is a good activity for demented client?
Reminiscing - look at old pictures of family, discuss them.
What happens in the first stage of alzheimer’s?
no apparent symptoms
What happens in the 2nd stage of alzheimer’s?
Forgetfulness
- Person is aware they are beginning to forget things.
- may feel embarrassed, anxious or ashamed
What happens in the 3rd stage of alzheimer’s?
Mild Cognitive Decline.
Executive functioning starts to go…interferes with work (can’t plan or organize). Gets lost.
What happens in the 4th stage of alzheimer’s?
Mild-Moderate Cognitive Decline-Confusion
- withdrawal
- confabulation
- Forget personal history
What happens in the 5th stage of alzheimer’s?
Moderate Cognitive Decline-Early Dementia
- cannot perform ADLs
- forgets phone #, address, relatives names
- Disorientation/Frustration
What happens in the 6th stage of alzheimer’s?
Moderate-Severe Cognitive Decline - Middle dementia
- wandering/elopement
- sundowning
- obesessiveness
- LOSS OF LANGUAGE
- forgets life and spouse
- incontinence
What happens in the 7th stage of alzheimer’s?
severe cognitive decline - late dementia
- immobility
- contractures
- aphasic
What is the cause of Alzheimer’s (a neurocognitive D/O)?
reduction in ACh (possibly due to destroyed neurons)
possibly genetic
What are the symptoms? (Alzheimer’s A’s)
Aphasia Anomia Agraphia Alexia Apraxia Agnosia
What causes Parkinson’s?
decreased DA
imbalance between DA and ACh
loss of nerve cells
What are the components of the MMSE?
- Orientation (date, day, month, year)
2.
Does pseudodementia gets worse or better as the day progresses?
better
see table 22-1 ch 22 page 345
for NCD vs Pseudodementia slide
Pseudodementia (depression) or dementia?
Patient complains about the memory loss
pseudo
Demented clients are usually brought in by family cuz they are not aware
