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Nursing 161 Unit 4 > Cognition > Flashcards

Cognition Flashcards

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1
Q

What is meant by “intellectual capacity”?

A

Perception
Cognitive Ability
Memory
Learning

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2
Q
  • awareness and interpretation of stimuli
  • the ability of the individual to interpret the environment
  • dependent on the acuteness of senses
  • affected by impairment of senses
A

Perception

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3
Q
  • intellectual skills or thought processes that include problem solving, decision making, critical thinking and creativity
  • with aging this may not be as fast
A

Cognitive Ability or Skills

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4
Q
  • the power or process of remembering what has been learned

- involves several steps

A

Memory

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5
Q
  • the activity or process of gaining knowledge or skill by studying, practicing, being taught, or experiencing something : the activity of someone who learns
  • additional time required as we age
  • motivation is important
A

Learning

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6
Q

-momentary perception of stimuli from the environment

A

Sensory Memory

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7
Q

-information held in the brain for immediate use or what one has in mind at a given moment

A

Immediate or Short Term Memory

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8
Q

-memory that deals with the recent past few minutes or hours

A

Short Term Memory or Recent Memory

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9
Q
  • repository for information that is stored for periods longer than 72 hours (and usually for weeks or years)
  • has left short term and is encoded
A

Long Term Memory

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10
Q

What are some normal age-related changes that may occur with regard to cognition?

A
  • information processing speeds decline with age (results in slower learning rate, more repetition needed etc)
  • ability to divide attention between two tasks declines
  • ability to switch between auditory inputs declines
  • ability to maintain attention declines
  • ability to perform vigilance tasks declines
  • ability to filter out irrelevant information declines
  • accessing long term memory takes longer
  • word finding, naming ability, generating word lists decline
  • drawing and construction ability declines
  • abstraction and mental flexibility decline
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11
Q

What are some methods for coping with age related cognitive changes?

A
  • lists
  • notes to self
  • memory training
  • memory enhancement techniques
  • computer games that emphasize eye-hand coordination or memory
  • keeping mentally active by challenging mind (reading, crossword puzzles, playing bridge etc)
  • using assistive devices (pill boxes, preprogrammed phones etc)
  • cultivate habits (park in same place every day etc)
  • seek support and encouragement
  • stay positive and hopeful for future
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12
Q

What are some pediatric learning disabilities?

A

Dyslexia (writing, reading, spelling)
Dyscalculia (math and computation)
Dysgraphia (writing, spelling, composition)
Dyspraxia (manual dexterity and coordination)

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13
Q
  • significant limitation in intellectual functioning and adaptive behaviour
  • manifested in differences in conceptual, social and practical life skills
  • begins before the age of 18
  • has deficits in adaptive functioning in at least 2 areas
A

Mental Retardation

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14
Q

-ability of an individual to meet the standards expected for his or her cultural group

A

Adaptive Functioning

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15
Q

-any of a variety of chronic conditions that are characterized by mental and/or physical impairment

A

Developmental Disability

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16
Q

What are the three general categories for mental retardation?

A

1) Prenatal errors in development of CNS
2) Prenatal or Postnatal changes in the biological environment of the person
3) external forces leading to CNS damage

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17
Q

What are the three most common conditions related to Prenatal causes of mental retardation?

A

1) Down Syndrome
2) Fragile X Syndrome
3) Fetal Alcohol Syndrome

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18
Q
  • condition caused by an extra chromosome (47 rather than 46)
  • at higher risk for developing cardiac defects, hearing loss, strabismus, GI problems, orthodontic conditions, thyroid disease, dermatologic conditions, and leukemia
  • physical characteristics associated
A

Down Syndrome

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19
Q
  • condition caused by a single recessive gene abnormality on the X chromosome
  • often associated with ADHD, anxiety and autism
A

Fragile X Syndrome

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20
Q
  • condition caused by the effects of ethyl alcohol on the developing fetus
  • wide range of effects from the disorder
  • higher rate in Alaskan Natives and Native Americans
A

Fetal Alcohol Syndrome (or Fetal Alcohol Spectrum Disorder)

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21
Q

What are some of the different types of dementia?

A

Alzheimer’s Disease (60%)
Multi-Infarct Dementia (5-20%)
Mixed Alzheimer’s & Multi-Infarct Dementia
Non-Alzheimer’s Dementia: Parkinson’s Disease, AIDS related, Pick’s Disease (<15%)

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22
Q

What conditions may mimic dementia?

A

Age Related Cognitive Decline
Mild Cognitive Impairment
Delirium
Depression

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23
Q

What differentiates Delirium from Dementia?

A
  • dementia sets on gradually while delirium has a sudden or acute onset
  • dementia is irreversible, while delirium is reversible
  • dementia has consistent deterioration while delirium fluctuates
  • with dementia hallucinations are not prominent, but with delirium auditory, visual or tactile hallucinations occur
  • dementia patients are more often disinterested/disinhibited, while delirious patients are anxious and fearful, angry, irritable, depressed
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24
Q

What differentiates Alzheimer’s Disease from Normal Aging?

A

AD = inability normal aging = difficulty

  • AD affects recent and remote memory, while normal aging affects recent memory
  • with AD there is an inability to recall people/names/places, while with normal aging it is just difficult
  • AD has inability to concentrate, normal aging shows a decreased ability
  • AD lacks ability to write, nothing stimulates memory, while with normal aging notes to self helps to stimulate memories
  • AD inability to function at work/socially/home, while with normal aging changes do not interfere with daily functioning
  • with AD the individual has no idea changes have occurred, with normal aging there is an awareness that forgetful behaviour is present
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25
Q

What differentiates Depression from Alzheimer’s Disease?

A
  • AD has insidious onset, depression is rapid onset
  • AD has slow progression, depression has fast progression
  • AD has difficulty with recall, depression has memory intact
  • AD uses confabulation, someone with depression often answers “don’t know”
  • AD has impaired attn span, depression pt has normal attn span
  • AD cannot recognize people/places, depression pt is oriented to person/time/place
  • AD pt struggles with ADLs and gets frustrated, depression pt is apathetic about ADLs
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26
Q

-the process of learning, storing, retrieving and using information

A

Cognition

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27
Q
  • believed cognition was an orderly process
  • 4 major phases (sensorimotor, preoperational, concrete operational, formal operational)
  • theory has limitations
A

Piaget

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28
Q

Piaget is one of the main cognitive theorists, what are the other two we have looked at?

A

Vygotsky

Information processing theory

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29
Q

What was the difference between Vygotsky’s theory and Piaget’s theory?

A

Vygotsky agreed with Piaget’s theory of a child’s cognition, but believed that children are embedded with social context which influences learning (children need guidance from parents and others to learn tasks that they could not master on their own)

30
Q

What is Information Processing Theory?

A
  • views attention and memory as the most important parts of learning, rather than as structures as described by Piaget
  • infants grown bored with the same stimuli so are drawn to new stimuli
  • older children actively engage in strategies for memorization (play active part in learning)
31
Q

Why do learning disabilities occur in children?

A

-usually due to some neurological condition

32
Q

What does IEP stand for?

A

Individualized Education Plan

33
Q

In assessing a child for developmental delay, when should a child be able to phrase sentences?

A

-by 2.5 years

34
Q

In assessing a child for developmental delay, when should a child be able to use speech that is understandable 50% of the time?

A

-by 3 years

35
Q

In assessing a child for developmental delay, when should a child be able to tie shoes, hop, or cut with scissors?

A

-by kindergarten (age 5)

36
Q

In assessing a child for developmental delay, when should a child be able to sit still for a short story?

A

-by 3-5 years

37
Q

Mild mental retardation is rated at what IQ range?

A

IQ 50-75

38
Q

Moderate mental retardation is rated at what IQ range?

A

IQ 35-50

39
Q

Severe mental retardation is rated at what IQ range?

A

IQ 20-35

40
Q

Profound mental retardation is rated at what IQ range?

A

IQ <20

41
Q

What is the approach to mental retardation in terms of clinical therapy?

A
  • assembly of a multidisciplinary team
  • communication with parents
  • plans for intervention which change as child grows and as family situation evolves
  • IEP
42
Q
  • syndrome characterized by unpleasant sensations of inner restlessness that manifests itself with an inability to sit still or remain motionless
  • deficit associated with AD
A

Akathisia

43
Q
  • a neurological condition that impairs one’s ability to name persons and objects
  • deficit associated with AD
A

Anomia

44
Q
  • condition that causes the inability to speak

- deficit associated with AD

A

Aphasia

45
Q
  • condition characterized by the production of unintended syllables, words, or phrases during the effort to speak
  • deficit associated with AD
A

Paraphasia

46
Q
  • condition consisting of lack of voluntary coordination of muscle movements
  • deficit associated with AD
A

Ataxia

47
Q
  • a lint-picking behavior that is often a symptom of a delirious state
  • deficit associated with AD
A

Carphologia

48
Q
  • condition characterized by an inability or difficulty to build, assemble, or draw objects
  • deficit associated with AD
A

Constructional Difficulty

49
Q
  • condition characterized by a difficulty in swallowing

- deficit associated with AD

A

Dysphagia

50
Q
  • the automatic repetition of vocalizations made by another person
  • deficit associated with AD
A

Echolalia

51
Q

What is the treatment for Alzheimer’s Disease?

A
  • tx focuses on reducing effects of the disease
  • drugs rx’d: Donepezil & Memantine
  • agitation treated with antipsychotics
  • anxiety & depression treated with anxiolytics
52
Q

-an alteration in cognition that makes it difficult to think clearly, focus attention, or make decisions.

A

Confusion

53
Q

What are some Nursing Implementations to consider when dealing with a client who is confused?

A
  • orient to time and place often (ask “where are you?”)
  • calendar and clock in client’s room
  • speak clearly and calmly
  • allow time for client to process words
  • encourage family to visit if appropriate
  • provide clear and concise explanations
  • eliminate unnecessary noise
  • reinforce reality
  • schedule activities consistently
  • assign same caregivers if possible
  • provide adequate sleep
  • ensure adequate pain management
  • keep familiar items near client
54
Q
  • progressive degenerative changes
  • results in gross atrophy of cerebral cortex
  • neurofibrillary tangles (loss of communication between neurons - leads to death of neurons - follows specific pattern)
  • amyloid plaques in space between neurons
  • galanin inhibits access to memory
  • blood flow to affected areas decreases
  • atrophy of cortical areas of brain
  • structural and chemical changes
A

Alzheimer’s Disease

55
Q

What is the specific pattern that the death of neurons follows in AD?

A
  • Limbic System
  • Hippocampus
  • Frontal Lobe
  • Parietal Lobe
  • Temporal Lobe
  • Occipital Lobe
56
Q

What are the two types of AD?

A

Familial & Sporadic

57
Q

What are some of the warning signs for AD?

A
  • memory loss that affects job skills
  • difficulty performing familiar tasks
  • problems with language
  • disorientation to time and place
  • poor or decreased judgment
  • problems with abstract thinking
  • likelihood of misplacing things
  • changes in mood or behaviour
  • changes in personality
  • loss of inititative
58
Q

Stage of AD:

  • typically 2-4 yrs
  • forgetfulness begins to interfere with ADLs
  • may seem restless, forgetful, uncoordinated
  • short term memory loss
  • subtle changes in personality
  • difficulty doing simple calculations
A

Stage 1 (mild)

59
Q

Stage of AD:

  • lasts 2-12 yrs
  • memory deficits have become more apparent
  • may still have periods of mental lucidity
  • becomes more confused
  • sundowning
  • language deficits common
  • diagnosis usually occurs in this stage
  • sensorimotor deficits (apraxia, astereognosis, angraphia)
  • malnutrition, decreased fluid intake
  • safety becomes a major issue
  • deterioration of intellect, logic, behaviour, deaily function
A

Stage 2 (moderate)

60
Q

-inability to identify an object by active touch without other sensory input

A

Astereognosis

61
Q

-the inability to execute learned purposeful movements,[2] despite having the desire and the physical capacity to perform the movements

A

Apraxia

62
Q

-loss in the ability to communicate through writing, or an inability to spell

A

Angraphia

63
Q

Stage of AD:

  • lasts 1-2 yrs
  • increasing dependence
  • inability to communicate
  • loss of continence
  • progressive loss of cognitive abilities
  • usually requires 24 hr care (most institutionalized at this stage)
  • complications: pneumonia, dehydration, malnutrition, falls, depression, seizures, paranoid reactions
A

Stage 3 (severe)

64
Q

DEMENTIA diagnostic tool:

D stands for…

A

Drugs and Alcohol - older adults often purchase OTC meds, have many meds prescribed, and sometimes borrow meds from friends

65
Q

DEMENTIA diagnostic tool:

E stands for…

A

Eyes and Ears - people who cannot hear or see well often appear confused
OR
Emotional Disorders - mood and schizophrenic disorders may be mistaken for AD

66
Q

DEMENTIA diagnostic tool:

M stands for…

A

Metabolic and Endocrine disorders - disruptions such as electrolyte imbalance, hypothyroidism and uncontrolled diabetes may mimic dementia

67
Q

DEMENTIA diagnostic tool:

N stands for..

A

Nutritional Deficiencies - may mimic dementia

68
Q

DEMENTIA diagnostic tool:

T stands for..

A

Tumors and Trauma - disorders of the CNS may be confused with dementia

69
Q

DEMENTIA diagnostic tool:

I stands for…

A

Infection - infections of the urinary tract and pneumonia in older adults may lead to confusion. Clients may not have an elevated temperature

70
Q

DEMENTIA diagnostic tool:

A stands for..

A

Arteriosclerosis - a decreased blood flow to the brain, brain attacks, and multi-infarct dementia often mimic AD

71
Q

What is the method of action of Donepezil?

A

Cholinesterase inhibitor (allows Ach to remain in synaptic gap longer, increasing synaptic functions)

72
Q

What are some alternative therapies available for AD?

A
  • antioxidants
  • omega-3 fatty acids
  • phophatidyl serine
  • melatonin
  • DHEA
  • SAMe
  • Lecithin
  • Music Therapy
  • Touch Therapy
  • Animal-assisted therapy

Nursing 161 Unit 4 (4 decks)

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