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NURS 2500 > Class 5 - Cognition > Flashcards

Class 5 - Cognition Flashcards

1
Q

Cognition

A
  • Human thought
  • How info is received, processed, stored, and then used
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2
Q

6 domains of cognitive function

A
  1. Perceptual motor function
  2. Language
  3. Learning and memory
  4. Social cognition
  5. Complex attention
  6. Executive function
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3
Q

Perception

A
  • Interpretation of the environment
  • Related to awareness
  • Depends on sensory input
  • Attention is focus on a particular area
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4
Q

Memory types

A
  1. Declarative episodic memory
  2. Declarative semantic memory
  3. Immediate memory-attention span
  4. Working memory
  5. Procedural memory
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5
Q

Declarative episodic memory

A

A clear memory of an entire scenario - think of an episode of a show that you remember
- Long term memory

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6
Q

Declarative semantic memory

A

Long term memory that is for knowledge. You’re working hard to remember this information

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7
Q

Immediate memory-attnetion span

A

forget right away when the information is done being used - the info you used during an exam and you forget it all immediately after you’re done

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8
Q

Working memory

A

Maintain for a short period of time

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9
Q

Procedural memory

A

This will take a long time - riding a bike or drive a car for the first time

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10
Q

Executive function

A
  • Higher order of thinking that is future oriented
  • Flexibility, adaptibility, goal directedness
  • Determines contents of consciousness
  • Supervises voluntary activity
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11
Q

Higher order cognitive function

A
  • Learning
  • Comprehension
  • Problem-solving
  • Reasoning
  • Decision making
  • Creativity
  • Metacognition
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12
Q

Basic order cognitive function

A
  • Perception
  • Pattern recognition
  • Attention
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13
Q

When does significant changes to cognitive developemnt occur?

A

Infancy to adolescence

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14
Q

Cerebral cortex

A
  • Ability to reason, function intellectually, express personality, and purposefully interact with the world
  • Neurons and neurotrandmitters deliver information
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15
Q

Age-related differences: Infants and children

A
  • Brain stem and spinal cord are fully developed
  • Limbic system and cerebral cortex are underdeveloped at birth
  • Myelination occurs throughout childhood and into young adulthood
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16
Q

Age-related differences: Older adults

A
  • Size and weight of the brain and number of neurons decrease
  • Cognitive impairment or intellectual loss is not part of normal aging, rather it is indicative of disease
  • Decline in memory is associated with aging, but the extent and degree varies
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17
Q

What is delirium?

A

A state of disturbed consciousness and altered congition with a rapid onset of a few hours or days

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18
Q

Delirium: Individuals experience

A
  • Dulled awareness
  • Reduced ability to focus, sustain and shift attention
  • Memory and judgement impaired
  • Disorientation
  • Change in speech
  • Emotional swings
  • Restlessness
19
Q

Delirium: Caused by

A
  • Undelrying condiitons
  • Dehydration
  • Electrolyte imbalances
  • Infection
  • Pain
  • Fever
  • Hypoxia
  • Sleep deprivation
  • Adverse effects of medications
  • Most frequent complication of hospitalization
20
Q

Delirium: Symptoms

A
  • Varibale over 24 hours
  • Mood swings
  • Disturbed sleep
  • Reduced attention span
  • Decreased memory
  • Hallucinations
  • Tremors
21
Q

Dementia

A
  • Gradual and progressive decline in mental functioning
  • Some are associated with changes in mood and behaviour
22
Q

Dementia effects to short term

A

Short term memory, language, judgement, reasoning, and abstract thinking

23
Q

Dementia effects to long term

A

Long term memory and the ability to perform familiar tasks

24
Q

Dementia may have

A

Paranoia, depression, delusions of theft

25
Q

Dementia: Difficulty with

A
  • Executive functioning (speaking and walking)
  • Sleep disturbances
  • Agitation
  • Wandering
26
Q

Depression

A

Cluster of depressive symptoms is present on most days, most of the time, for at least 2 weeks, and when the intnsity of hte symptoms is out of the ordinary for that person

27
Q

Depression: Biologically

A

Biologically based illness that affects a person’s thoughts, feelings, behaviour, and even their physical health

28
Q

9 Risk factors for inadequate cognition

A
  1. Advanced age
  2. Brain trauma
  3. Disease or disorder (tumour, hypoxia, stroke)
  4. Environmental exposure (lead)
  5. Substance use disorder
  6. Genetic diseases
  7. Depression
  8. Medications
  9. Fluid and electrolyte imbalance
29
Q

6 Consequences of cognitive impairment

A
  • Loss of short- and/or long-term memory
  • Disorientation to person, place, time, and context
  • Impaired reasoning and decision-making ability
  • Imapired language skills
  • Uncontrollable or inappropriate emotions such as severe agitation and aggression
  • Delusions and hallucinations
30
Q

6 General management tools

A
  1. Primary prevention
  2. Secondary prevention (screening)
  3. Collaborative interventions
  4. General management
  5. Pharmacologic agents (medications)
  6. Family and caregiver support
31
Q

What is primary prevention?

A
  • Promote a healthy lifestyle
  • Gentic counselling
  • Educating healthcare providers about latest evidence
32
Q

Screening/Assessment for Cognitive Impairment

A
  • Detect early
  • General survey
  • Glasgow Coma Scale
  • Mini Mental State Examination (MMSE)
  • Confusion Assessment Method (CAM)
33
Q

General survey: Physical

A
  • Age, gender
  • LOC
  • Skin colour
  • Facial features
34
Q

General survey: Behaviour

A
  • Facial expressions
  • Mood and affect
  • Speech
  • Dress
  • Personal hygiene
35
Q

General survey: Body structure

A
  • Stature
  • Nutrition
  • Symmetry
  • Posture
  • Position
  • Body build and contour
36
Q

General survey: Mobility

A
  • Gait
  • Range of motion
37
Q

Assessing LOC

A
  • General survey
  • A and O x4? (person, place, time, and context)
  • Hand grasps
38
Q

Glasgow coma scale

A

Eye opening response
Verbal response
Motor response

39
Q

Response to painful stimuli

A
  • Localizes
  • Withdraws
  • Grimaces
  • Abnormal posturing (decerebrate [more serious]/decorticate)
  • No response, flaccid
40
Q

Confusion assessment method

A

1 and 2 and either 3 or 4

41
Q

CAM: Feature 1

A
  • Acute onset and fluctuating course
  • This feature is usually obtained from a family member or nurse and is shown by positive responses to the following questions:
  • Is there evidence of an acute change in mental status from the patient’s baseline?
  • Did the (abnormal) behaviour fluctuate during the day, that is, tend to come and go, or increase and decrease in severity
42
Q

CAM: Feature 2

A
  • Inattention
  • This feature is shown by a positive response to the following question:
  • Did the patient have difficulty focusing attention, for example, being easily
    distracted, or having difficulty keeping track of what was being said
43
Q

CAM: Feature 3

A
  • Disorganized thinking
  • This feature is shown by a positive response to the following
    question:
  • Was the patient’s thinking disorganized or incoherent, such as rambling or irrelevant conversation, unclear or illogical flow of ideas, or unpredictable switching from subject to subject?
44
Q

CAM: Feature 4

A
  • Altered level of consciousness
    • This feature is shown by any answer other than “alert” to the following question:
  • Overall, how would you rate this patient’s level of consciousness? Alert (normal), vigilant (hyper-alert), lethargic (drowsy, easily aroused), stupor (difficult to arouse), or coma (unarousable)

NURS 2500 (8 decks)

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