Chapter 22 Flashcards
What is the basic working unit of the nervous system?
The nervous system controls and coordinates all body functions, sends messages throughout the body, and senses and interprets information from outside the body.
What makes up the central nervous system?
The brain and spinal cord
What makes up the peripheral nervous system?
The nerves connected to the spinal cord
List three functions of the nervous system
Control and coordinate mental processes and voluntary movements
Provide reflex centers for heartbeat and respiration
Sense and respond to changes occurring both inside and outside the body
Normal age-related changes for the nervous system
Responses and reflexes slow
Some memory loss occurs, especially short term memory loss
Sensitivity of nerve endings in skin decreases, resulting in diminished sense of touch
Some hearing loss occurs
Senses of vision, smell, and taste weaken
Why is it important not to use rubbing alcohol to clean artificial eyes?
Using rubbing alcohol can cause infection and can permanently damage the eye.
What is the most common cause for dementia?
A series of strokes causing damage to the brain
Why is it important for nursing assistants to encourage independence for s long as possible for residents who have AD?
This helps to keep the resident’s mind and body as active as possible. It may even help slow the progression of the disease.
If a resident with Alzheimer’s disease loses interest in an activity, what should the nursing assistant do?
Should not try to push them to continue the activity. She should offer another activity.
Does a person usually overcome depression through sheer will?
It is typically treated with medication and psychotherapy
What should s nursing assistant do if s resident makes jokes about suicide?
Immediately report it to the nurse
When a cerebrovascular accident occurs on the left side of the brain, which side of the body will be affected?
The right side
When assisting a resident who has had a CVA with eating, in which side of the resident’s mouth should food be placed?
Stronger side
When a resident with Alzheimer’s disease repeats an action over and over, he is…
Perseverating
One morning a resident with Alzheimer’s disease says he does not like eating with others and wants to eat breakfast by himself in his room. The next morning he tells his nursing assistant that he does not like to eat alone and wants help going to the dining room. What would be the best response by the nursing assistant to this shift in the resident’s preferences?
The NA should take the resident to the dining room
What is a way for a nursing assistant to help a resident who head Alzheimer’s disease with his nutritional needs?
The NA should use a plain plate without a pattern and a single eating utensil for meals
When a resident with Alzheimer’s disease continues to ask the same question, the nursing assistant should…
Answer the question using the same words each time
A resident with Alzheimer’s disease tells his NA that he is not going to eat dinner today because he is meeting his wife for dinner at their favorite restaurant. The nursing assistant knows his wife has been dead for many years. What would be the best response by the nursing assistant?
TheNA should ask him what restaurant he is going to and what he will have
Which of the following puts a person at a higher risk for substance abuse?
Having a mental illness
Age-related macular degeneration
A condition in which the macula degenerates, gradually causing central vision loss
Agitated
The state of being excited, restless, or troubled
Alzheimer’s disease
A progressive, degenerative, and incurable disease that causes proteins to build up in and around nerve cells, which results in memory loss, cognitive impairment, and behavioral changes
Bipolar disorder
A type of depression that causes a person to have mood swings and changes in energy levels and the ability to function
Define: brain
The part of the nervous system housed in the skull that is responsible for motor activity, memory, thought, speech, and intelligence, along with regulation of vital functions, such as heart rate, blood pressure, and breathing
Burnout
Mental or physical exhaustion due to a prolonged period of stress and frustration
Cataract
A condition in which the lens of the eye becomes cloudy, causing vision loss
Catastrophic reaction
Reacting to something in an unreasonable, exaggerated way
Central nervous system
Part of the nervous system made up of the brain and spinal cord
Cerebrovascular accident
A condition causes when the blood supply to the brain is cut off suddenly y a clot or a ruptured blood vessel; also called a stroke
Cognition
The ability to think clearly and logically
Concussion
A head injury that occurs from banging movement of the brain against the skull
Cognitive behavioral therapy
A type of psychotherapy that is usually short-term and focuses on skills and solutions that s person can use to modify negative thinking and behavior patterns; often used to treat anxiety disorders and depression
Delusion
A belief in something that is not true or is out of touch with reality
Dementia
A serious, progressive loss of mental abilities such as thinking, remembering, reasoning, and communication
Disruptive behavior
Any behavior that disturbs others
Elopement
In medicine, when a person with Alzheimer’s disease wanders away from a protected area and does not return on his own
Epilepsy
A disorder that causes recurring seizures
Farsightedness
The ability to see distant objects more clearly than objects that are near; also called hyperopia
Generalized anxiety disorder
An anxiety disorder characterized by chronic anxiety, excessive worrying, and tension, even when there is no cause for these feelings
Glaucoma
A condition in which the pressure in the eye increases damaging the optic nerve and causing blindness
Hallucinations
Seeing, hearing, smelling, tasting, or feelings things that are not there
Hearing aid
A small device placed in the ear that amplifies sound
Hemianopsia
Loss of vision on one-half of the visual field, due to CVA, tumor, or trauma
Hoarding
Collecting and putting things away in a guarded way
Intervention
A way to change an action or developmental
Irreversible
Unable to be reversed or returned to the original state
Ménière’s disease
A disorder of the inner ear caused by a build-up of fluid, which causes vertigo, hearing loss, tinnitus, and pain or pressure
Mental health
Refers to the normal function of emotional and intellectual abilities
Mental illness
Disease that disrupts a person’s ability to function at a normal level in the family, home, or community
Multiple sclerosis
A progressive disease in which the protective covering of the nerves, spinal cord, and white matter of the brain breaks down over time; without this covering, nerves cannot send clear messages to and from the brain in a normal way
Nearsightedness
The ability to see objects that are near more clearly than distant objects; also called myopia
Neuron
The basic nerve cell of the nervous system
Obsessive- compulsive disorder
An anxiety disorder characterized by repetitive thoughts or behaviors
Otitis media
An infection in the middle ear that causes pain, pressure, fever, and reduced ability to hear
Pacing
Walking back and forth in the same area
Panic disorder
An anxiety disorder that causes a person to have repeated episodes of intense fear that something bad will occur
Paranoid schizophrenia
A form of mental illness characterized by hallucinations and delusions
Paraplegia
A loss of function of the lower body and legs
Parkinson’s disease
A progressive disease that causes a portion of the brain to degenerate; causes rigid muscles, shuffling gait, pill-rolling, mask-like face, and tremors
Peripheral nervous system
Part of the nervous system made up of the nerves that extend throughout the body connect to the spinal cord
Perseveration
The repetition of words, phrases, question, or actions
Pillaging
Taking things that belong to someone else
Post-traumatic stress disorder
A disorder caused by a traumatic experience
Progressive
Something that continually gets worse or deteriorates
Psychotherapy
A method of treating mental illness that involves talking about one’s problems with mental health professionals
Quadriplegia
Loss of function of legs, trunk, and arms
Reminiscence therapy
Type of therapy that encourages people with Alzheimer’s disease to remember and talk about the past
Remotivation therapy
Type of group therapy that promotes self-esteem, self-awareness, and socialization for people with Alzheimer’s disease
Rummaging
Going through items that belong to other people
Rummaging
Going through items at belong to other people
Schizophrenia
A form of mental illness that may involve acute episodes; affects a person’s ability to think, communication, make decision, and understand reality
Social anxiety disorder
A disorder in which a person has excessive anxiety about social situations; also called social phobia
Spinal cord
The part of the nervous system inside the vertebral canal that conducts messages between the brain and the body and controls spinal reflexes
Sundowning
A condition in which a person gets restless and agitated in the late afternoon, evening, or night
Trigger
A situation that leads to agitation
Validating
Giving value to or approving
Validation therapy
A type of therapy that lets people with Alzheimer’s disease believe they are living in the past or in imaginary circumstances
Violence
Forceful action that include attacking, hitting, or threatening someone
Wandering
Walking aimlessly around the facility or facility grounds
Neuron
The basic nerve cell of the nervous system
Central nervous
Part of the nervous system made up of the brain and spinal cord
Peripheral nervous system
Part of the nervous system made up of the nerves that extend throughout the body and connect to the spinal cord
Brain
The part of the nervous system housed in the skull that is responsible for motor activity, memory, thought, speech, and intelligence, along with regulation of vital functions, such as heart rate, blood pressure, and breathing
Spinal cord
The part of the nervous system inside the vertebral canal that conducts messages between the brain and the body and control spinal reflexes.
What does the brain control?
Speech, motor and sensory activity, intelligence, reasoning, coordination, reflexes, breathing, emotions, and heart rate
What does the spinal cord do?
Conducts messages between the brain and the body within its pathways
What are the parts of the eye?
Cornea, sclera, retina, pupil, iris
What is a sclera?
White of the eye
What is a cornea?
Transparent front part of the sclera
What is the iris?
Part of the eye that is genetically colored
What is the pupil?
Circular opening in the center of the iris, which dilates and constricts to adjust the amount of light coming into the eye
Retina
Located inside the back of the eye; contains cells that respond to light and send messages to the birth
What does the outer ear do?
Collects sound waves and directs them inward through the external auditory canal toward the middle ear
What does the middle ear do?
Amplifies and transfers sound waves to the inner ear
What is the function of the inner ear?
Contains tiny hair cells which send nerve impulses to the brain
What is the function of the eardrum?
Separates the outer ear from the middle ear; also known as the tympanic membrane
What are the ossicles?
Three tiny bones within the middle ear which pick up vibrations and send impulses to the brain
What is the cause of cerebrovascular accident
Obstruction inside a blood vessel or the rupture of a blood vessel
What is the most common type of stroke?
Ischemic stroke, the blood supply is blocked and brain cells begin to die
What is a Hemorrhagic stroke?
A stroke the occurs when there is leaking or s rupture of a blood vessel inside the brain
Care guidelines for residents recovering from CVA
Encourage independence and self-esteem
Be patient with self-care and communication
Encourage resting in between self-care tasks
Assist with ROM exercises
Reposition often, using proper alignment
Do not refer to resident’s affected side as bad
Other care guidelines for residents recovering from CVA
Assist with ambulation to prevent falls
For one-sided neglect, remind residents about weaker side of body
Always place food in the unaffected side of the mouth
Observe for swallowing problems
Encourage fluids and proper nutrition
Carefully assist with shaving, grooming, and bathing
Make sure a clock and calendar are visible
With emotional lability, redirect residents attention
Use praise often
Listen to resident if he or she wants to talk
Guidelines for communication with a resident post-CVA
Speak clearly and face the resident
Do not rush the resident
Use signals, such as nodding and pointing
Use yes or no questions
Keep question and directions simple. Use special methods, such as communication boards
What is the cause of Parkinson’s disease?
Neurons in the brain that produce dopamine begin to break down and die
What are the symptoms of Parkinson’s disease?
Tremors or shaking; mask-like face, pill-rolling, rigid muscles, shuffling gait, slurred speech, mood swings, gradual behavior changes
What is the treatment for Parkinson’s disease?
Drug therapy and surgery
Care guidelines for Parkinson’s disease
Encourage self-care Assist with ADLs Assist ROM exercises Assist with ambulation to prevent falls Encourage residents to stand as straight as possible for ambulation Encourage fluids and proper nutrition Listen to residents if they want to talk Report severe trembling, severe muscle rigidity/contractures, mood swings, sudden incontinence, constipation, dehydration, weight loss, or signs of depression
What is the cause of multiple sclerosis?
Loss of myelin
Symptoms multiple sclerosis
Numbness and tingling, muscle weakness, extreme fatigue, tremors, vertigo, reduced sensation, blurred or double vision, poor balance, difficulty walking, incontinence, paralysis
Treatment for multiple sclerosis
Medication
Care guidelines for multiple sclerosis
Be patient with self-care and movement
Offer rest periods as necessary
Assist with ROM exercises
Encourage residents to follow exercise programs
Assist with ambulation to prevent falls
Encourage proper nutrition and fluid intake
Do not rush communication
Try to provide a stress-free environment
Offer support and encouragement as symptoms change
Report red skin, pale skin, start of pressure ulcer, start of contracture, UTI symptoms, or signs of depression
Causes of head and spinal cord injuries
Accidents, sporting injuries, gunshot wounds, stab wounds,falls
Symptoms of head injuries
Confusion or disorientation, coma, death, headaches, drowsiness, loss of consciousness, seizures, fractures, drainage from the ears, nose and mouth, irritability, poor coordination, slurred speech, blurred vision, vomiting, stiff neck, decreased sense of smell
Symptoms of spinal cord injuries
Paralysis, loss of function, paraplegia, quadriplegia
Care guidelines for head or spinal cord injuries
Allow as much independence as possible with ADLs
Offer rest periods as necessary
Perform ROM exercises as ordered
Give frequent skin care
Be gentle she turning and repositioning
Protect residents from harm due to lack of sensation
Check water temperature carefully
Use special stockings to increase circulation as ordered
Encourage fluids and proper diet
Give careful catheter care and encourage fluids
Help with bladder and bowel training
Encourage deep breathing exercises
Provide privacy and be sensitive if involuntary erections occur
Listen to the resident
Report red skin, pale skin, start of pressure ulcer or contracture, UTI symptoms, shortness of breath, constipation, dehydration, weight loss, or depression
Causes of seizures
Tumors, head injuries, injuries to the brain during birth, high fever stoke, dementia, genetic factors, and alcohol and drug abuse
Causes of cataracts
Diabetes, eye injury, ,ay be inherited or result from normal aging
Symptoms of cataracts
Blurred vision, glare when driving at night, yellowing of vision
What is the leading cause of blindness in the US?
Glaucoma
Cause of glaucoma
Intraocular pressure increases, damaging the optic nerve
Symptoms of open- angle glaucoma
Not always apparent, but over time, there is a decrease in vision, especially in the peripheral vision
Symptoms of angle-closure glaucoma
Pain, nausea, vomiting, seeing a halo around lights, reddening of the eye, blurred vision
Treatment for glaucoma
Eye drops and other medications, surgery
Risk factors of age-related macular degeneration
Aging, smoking, sun exposure, heredity, gender, and race
Treatment for age-related macular degeneration
Laser surgery, injections, zinc, antioxidants
Care guidelines for vision impairment
Encourage use of eyeglasses or contact lenses if worn
Keep eyeglasses clean and safe
Change cases for contact lenses regularly
Keep doors completely open or closed
Leave furniture in place
Use the face of an imaginary clock to explain the position of objects in a room
Make sure there is enough lighting in every room
Walk a little ahead of the resident as she holds your arm
Walk at the resident’s pace
Assist residents to complete menus. Set up meal trays as needed
Use large-print books, audio books, and digital books
Read to residents of the desire it
Assist with vision screening
Things to remember about artificial eyes
Is a type of prosthetic and does not provide vision
Necessary for people who have lost an eye to cancer, other disease, or injury
Most are made from plastic
Held in place by suction
Carefully follow care instructions
Do not use alcohol or abrasives to clean the eye
Act professionally during care
Keep eye covered completely in solution when storied
Causes of Otis media
Infection in the middle ear
Symptoms of Otis media
Pain, pressure, fever, and reduced ability to hear
Treatment for Otis media
Antibiotics
Cause of Meniere’s disease
Build-up of fluid in the inner ear caused by infections, allergies, or a genetic link
Symptoms of Meniere’s disease
Vertigo, hearing loss, tinnitus, and pain or pressure
Treatment for Ménière’s disease
Medications, salt restriction and other dietary changes, cognitive therapy, antibiotic or corticosteroid injections, and in extreme cases surgery
Care guidelines for hearing aids
Be careful when handling a hearing aid
Turn volume down before inserting
Turn off when not in use
Replace batteries as needed
Do not submerge in water
Remove hearing aid before bathing, showering, or shampooing hair
Do not spray hair dare products near hearing aid
Check for hearing aids before removing bed linen and meal trays
Report any signs of sores or abrasions in the ear, as well as wax build-up
What increases the risk for certain nervous system diseases and disorders, including CVA, anxiety, and depression?
Obesity
Is dementia a normal part of aging?
No
Causes of dementia
Alzheimer’s disease Vascular dementia Lewy body dementia Parkinson’s disease AIDS Huntington’s disease Excessive alcohol or drug use Head injuries Thyroid disorders Nutritional deficiencies
Can dementia be treated?
Yes, but some forms of dementia are irreversible
Things to remember about Alzheimer’s disease
AD is progressive and irreversible
Occurs when tangled nerve fibers and protein deposits form in the brain
Cause is unknown
Older skills are usually kept longer
Describe Mild Alzheimer’s disease
Person may show some memory loss and forgetting some words and the location of familiar objects
Medial examination may show problems with memory and concentration
Person may still be independent and able to work, drive, and do other activities
Describe moderate Alzheimer’s disease
Generally has longest duration
Person may forget recent events. Some of her own past experiences and background
Person may demonstrate some changes in personality and may be moody or withdrawn
Person will need help with some ADLs
Sleep patterns may change
Confusion about time and place may occur
Describe Severe Alzheimer’s disease
Final stage
Person may be unable to communicate with others, control movement, or respond to his surroundings
Significant help must be provided for ADLs
Ability to walk, sit, and swallow may be affected
Guidelines for communication with people with AD
Always identify yourself and greet resident by name Look at resident while speaking to her Speak slowly and quietly Reduce background noise Use touch and gestures Only talk about one subject at a time Repeat directions and answers as many times as needed Use pictures Praise often
If a resident is frightened or anxious:
Move and speak slowly Speak in a quiet area with few distractions Try and see yourself as they might Use simple language and short sentences Check your body language
If a resident forgets or shows memory loss
Repeat yourself in the same words
Do not try to stop a resident who is perseverating
Keep messages simple
Break complex tasks into smaller, simpler steps
If a resident has trouble finding words or names:
Suggest a word that sounds correct
Use touch, if it is welcome
If the resident seems not to understand basic instructions or questions:
Ask resident to repeat your statements
Pay attention to communication methods that are usefulWatch for nonverbal cues
Use signs, pictures, gestures, or written messages
If the resident wants to say something but cannot:
Encourage resident to point, gesture, or act it out
Offer comfort or try to distract resident
If the resident is disoriented to time and place
Post reminders in early stages of disease
If the resident does not remember how to perform basic tasks
Break each activity into simple steps
If the resident insists on doing something that is unsafe or not allowed
Try to limit saying don’t
Redirect activities
If the resident hallucinates, is paranoid, or accusing
Do not take it personally
Try to redirect or ignore behavior
If the resident is depressed or lonely
Take time to ask how the resident feels, and listen closely
Try to involve resident in activities
Ic the resident repeatedly asks to go home
Ask the resident go tell you what home was like and how he felt being there
Redirect the conversation to something the resident enjoys
Expect that the resident may continue to ask to go home
If the resident is verbally abusive or uses bad language
Remember it is the dementia speaking and not the resident
Try to ignore the language and redirect attention
If the resident has lost most verbal skills
Use nonverbal communication
Assume that resident is aware of losses in abilities
Helpful attitudes when caring for people with AD
Do not take it personally
Be empathetic
Work with the symptoms and behaviors noted
Work as a team
Be aware of difficulties associated with caregiving
Work with family members
Remember the goals of the care plan
Guidelines for bathing
Schedule bathing when resident is least agitated. Be organized
Prepare resident before bathing
Walk with resident down the hall, stopping at tub room
Make sure bathroom is well-lit
Provide privacy
Be calm and quiet and keep the process simple
Offer the resident a washcloth to hold
Ensure safety
Do not try to force the resident to bathe
Allow resident to enjoy the bath. Be encouraging and positive
Observe the skin
Guidelines for dressing and grooming
Assist with grooming to help resident feel attractive and dignified
Avoid delays or interruptions
Show resident the clothing
Provide privacy
Encourage red side to pick out clothing. Lay out clothes in order to be put on
Do not rush the resident
Praise and encourage resident often
Guidelines for toileting
Encourage fluids Mark the restroom with a sign Check for episodes of incontinence Observe toilet patterns Take resident to the bathroom before meals and at bedtime Put lids on garbage cans or waste baskets Follow toileting schedule Support family and friends
Guidelines for nutrition
Encourage nutritious foods
Schedule meals at the same time each daily with familiar foods
Make sure there is proper lighting
Keep noise and distractions low
Keep task of eating simple
Avoid steaming or hot foods
Use plain plates without patterns or colors
Our only one item of food on plate at a time
Give simple, clear instructions
Guide resident through meal
Use assistive devices as needed
Make mealtimes simple and relaxed
Seat residents with others to encourage socializing
Observe and report changes or problems in eating habits
Promptly report changes in intake or output
Guidelines for physical health
Prevent infections and follow standard precautions Help residents wash hands Report potential problems Reduce risk of falls Provide excellent skincare Watch for and report signs of pain
