Chapter 23: Neurocognitive Disorders

Question 1

delirium onset

Answer 1

abrupt

Question 2

delirium
- periods of ________

Answer 2

lucidity

Question 3

is delirium a medical emergency

Answer 3

yes
- because it is from medical/physical cause

Question 4

can a patient have delirium if it is a gradual onset

Answer 4

no, delirium is abrupt onset

Question 5

four cardinal features of delirium

Answer 5

acute onset and fluctuating course
reduced ability to direct, focus, shift, and sustain attention
disorganized thinking
disturbance of consciousness

Question 6

with delirium patients it is important to assess potential

Answer 6

injury
- safety

Question 7

CAM

Answer 7

confusion assessment method

Question 8

CAM categories

Answer 8

actue onset and fluctuating course
inattention
disorganized thinking
altered level of consiousness

Question 9

some causes of delirium

Answer 9

infections
withdrawl
acute causes
toxins/drugs
CNS pathology
hypoxia
deficiencies (b12)
endocrone
acute vascular shock
trauma
heavy metals

Question 10

some meds we can use for delirium agitation

Answer 10

haloperidol
olazapine
quetiapine
risperadone
lorazepam

Question 11

what are some non pharm meds for agitation in delirium

Answer 11

washcloths
cards
distracting stuff

Question 12

when dosing a older adult, how should we do this

Answer 12

low dose

Question 13

what should we take into account when selecting a med for older adult

Answer 13

how sedating, EPS, hypotension, respiratory depression

Question 14

older adult: paradoxical reaction

Answer 14

opposite reaction

Question 15

for delirium is there a loss of consiousness

Answer 15

no

Question 16

mild vs major neurocognitive disorders

Answer 16

mild: does not interfere with ADLs, does not necessarily progress
major: interferes with daily functioning and indepence

Question 17

cognitive domains(6)

Answer 17

attention, executive function, learning/memory, language, motor, cognition

Question 18

common major neurocognitive disorder

Answer 18

alzheimers disease

Question 19

is all forgetfulness alzheimers

Answer 19

no, sometimes people can just have small forgetfullness

Question 20

AD progression

Answer 20

mild
moderate
severe

Question 21

AD has disturbances in executive function, what does that mean

Answer 21

set of mental skills than include working memory, flexible thinking, self control

Question 22

trouble with flexible thinking

Answer 22

make it hard t focus
follow directions
handle emotions

Question 23

aphasia

Answer 23

loss of language

Question 24

apraxia

Answer 24

loss of purposeful movemt

Question 25

agnosia

Answer 25

loss of sensory ability to recognize objects

Question 26

who is most likely to develop AD

Answer 26

late onset females

Question 27

common defense mechanisms seen in AD

Answer 27

denial confabulaiton perseveration avoidance

Question 28

confabulation

Answer 28

creation of stories in place of missing memories to maintain self esteem (because they cannot remember)

Question 29

perseveration

Answer 29

repetition of phrases or behavior

Question 30

apraphia

Answer 30

diminished ability to read or write

Question 31

hyperorality

Answer 31

tendency to put everything in mouth

Question 32

sundowning/sundown syndrome

Answer 32

tendency formed to drop and agitation to rise as light of day diminishes

Question 33

these patients are at risk for

Answer 33

wandering injury

Question 34

PACE flint

Answer 34

program for all inclusive care of the elderly

Question 35

are meds we can use for AD curative

Answer 35

no, just supportive

Question 36

medications for cognitive symptoms

Answer 36

cholinesterase inhibitors rivastigmine transdermal n-methyl-D-aspart (NMDA) receptor antagonist

Question 37

what meds can we use for behavioral symptoms

Answer 37

antipsych with EXTREME caution

Question 38

donepezil which is used for what stages

Answer 38

all including severe

Question 39

what is a preventative drug

Answer 39

omega 3 fatty acid