Ch13 Neurocognitive Disorders

Question 0

Predisposing factors of delirium

Answer 0

Systemic infections
febrile illness (fever)
Stroke
Postoperative states
Electrolyte imbalance
Brain abscess (bacterial infection of brain)
Migraine headaches
Seizures
Head trauma
Hepatic encephalopathy (loss of brain function when liver is unable to remove toxins)
Metabolic disorders: hypoxia (low levels of oxygen), hypercarbia (high levels of CO2), or hypoglycemia

Question 1

Delirium

Answer 1

A mental state characterized by a disturbance of cognition, which is manifested by confusion, excitement, disorientation, and a clouding of consciousness that can develop rapidly over a short period. Hallucinations and delusions are common.

Question 2

Other etiological implications of delirium

Answer 2

Substance intoxication delirium
Substance withdrawal delirium
Medication-induced delirium
Medical conditions or multiple Etiologies

Question 3

Primary NCD

Answer 3

Diseases like Alzheimer’s, in which the NCD itself is the major sign of some organic brain disease not directly related to any other organic illness

Question 4

Secondary NCD

Answer 4

Caused by or related to another disease or condition such as HIV disease or a cerebral trauma

Question 5

Most common NCD

Answer 5

Alzheimer’s

Question 6

Aphasia

Answer 6

inability to communicate through speech, writing, or signs, caused by dysfunction of brain centers. –The client may know his or her needs, but may not know how to communicate those needs to a caregiver

Question 7

Personality ____ is common in NCD

Answer 7

Personality change. An individual who was previously very socially active may become apathetic and socially isolated.

Question 8

Reversibility of NCD

Answer 8

Occurs in only small percentage of cases and is most often temporary. In most clients, NCD runs a progressive, irreversible course.

Question 9

Apraxia

Answer 9

Inability to carry out motor activities despite intact motor functions

Question 10

Stages of AD

Answer 10

Stage 1: no apparent symptoms
Stage 2: forgetfulness:: the individual may forget things/names. The individual is aware of intellectual decline and may become ashamed. Making lists/structured routines may help. NOT OBSERVABLE BY OTHERS Stage 3: Mild cognitive decline:: person may become lost when driving difficulty planning/organizing. DECLINE BECOMES NOTICEABLE TO OTHERS
Stage 4: mild-to-moderate cognitive decline:: May forget their own birthday, decline in being able to perform tasks (shopping, personal finances) may deny a problem by covering up memory loss w/ confabulation. Depression/social withdrawal.
Stage 5: moderate cognitive decline:: cannot perform ADLs, forgets names of relatives and disoriented to place/time. Frustration/withdrawal/self-absorption
Stage 6: moderate to severe cognitive decline:: sundowning; disorientation to year doesn’t remember spouse name
Stage 7: severe cognitive decline:: the person is unable to recognize family members. Bedfast and problems with immobility lead to muscle rigidity

Question 11

Example of major NCD

Answer 11

Dementia

Question 12

Confabulation

Answer 12

Creating imaginary events to fill in memory gaps

Question 13

Sundowning

Answer 13

Symptoms seem to worsen in the late afternoon and evening (phenomenon)