Chapter 23: Neurocognitive Disorders Flashcards
delirium onset
abrupt
delirium
- periods of ________
lucidity
is delirium a medical emergency
yes
- because it is from medical/physical cause
can a patient have delirium if it is a gradual onset
no, delirium is abrupt onset
four cardinal features of delirium
acute onset and fluctuating course
reduced ability to direct, focus, shift, and sustain attention
disorganized thinking
disturbance of consciousness
with delirium patients it is important to assess potential
injury
- safety
CAM
confusion assessment method
CAM categories
actue onset and fluctuating course
inattention
disorganized thinking
altered level of consiousness
some causes of delirium
infections
withdrawl
acute causes
toxins/drugs
CNS pathology
hypoxia
deficiencies (b12)
endocrone
acute vascular shock
trauma
heavy metals
some meds we can use for delirium agitation
haloperidol
olazapine
quetiapine
risperadone
lorazepam
what are some non pharm meds for agitation in delirium
washcloths
cards
distracting stuff
when dosing a older adult, how should we do this
low dose
what should we take into account when selecting a med for older adult
how sedating, EPS, hypotension, respiratory depression
older adult: paradoxical reaction
opposite reaction
for delirium is there a loss of consiousness
no
mild vs major neurocognitive disorders
mild: does not interfere with ADLs, does not necessarily progress
major: interferes with daily functioning and indepence
cognitive domains(6)
attention, executive function, learning/memory, language, motor, cognition
common major neurocognitive disorder
alzheimers disease
is all forgetfulness alzheimers
no, sometimes people can just have small forgetfullness
AD progression
mild
moderate
severe
AD has disturbances in executive function, what does that mean
set of mental skills than include working memory, flexible thinking, self control
trouble with flexible thinking
make it hard t focus
follow directions
handle emotions
aphasia
loss of language
apraxia
loss of purposeful movemt
agnosia
loss of sensory ability to recognize objects
who is most likely to develop AD
late onset females
common defense mechanisms seen in AD
denial
confabulaiton
perseveration
avoidance
confabulation
creation of stories in place of missing memories to maintain self esteem (because they cannot remember)
perseveration
repetition of phrases or behavior
apraphia
diminished ability to read or write
hyperorality
tendency to put everything in mouth
sundowning/sundown syndrome
tendency formed to drop and agitation to rise as light of day diminishes
these patients are at risk for
wandering
injury
PACE flint
program for all inclusive care of the elderly
are meds we can use for AD curative
no, just supportive
medications for cognitive symptoms
cholinesterase inhibitors
rivastigmine transdermal
n-methyl-D-aspart (NMDA) receptor antagonist
what meds can we use for behavioral symptoms
antipsych with EXTREME caution
donepezil which is used for what stages
all including severe
what is a preventative drug
omega 3 fatty acid
