Cognitive Disorders

Question 1

2 cognitive disorders

Answer 1

delirium and dementia

Question 2

prototype of dementia is called

Answer 2

Alzheimer’s

Question 3

Alzheimer’s is classified as a

Answer 3

major neuro-cognitive disorder

Question 4

what is delirium

Answer 4

abrupt onset of mental confusion, comes and goes, chg in LOC (not aaox3)

Question 5

delirium is secondary to another condition, t or f

Answer 5

true - something else is happening (alcohol withdraw (delirium tremons))

Question 6

once you treat the underlying condition, delirium will go away, t or f

Answer 6

true

Question 7

population most likely affected by delirium

Answer 7

older adults (poly pharmacy)

Question 8

cause of delirium

Answer 8

unknown

Question 9

co-morbidities r/t delirium

Answer 9

UTI, drugs, CHF

Question 10

4 cardinal features of delirium

Answer 10

acute onset (within a couple hrs)
disorganized thinking
disturbance of conscious
inattention

Question 11

*difference between delirium and dementia

Answer 11

delirium = altered level of consciousness - reversible
dementia = they are awake and alert - may not know themselves - not reversible

Question 12

cognitive/perceptual disturbances of delirium

Answer 12

illusions - false perception of real stimuli - iv tubing a snake
hallucinations - false sensory stimuli - tactile

Question 13

physical manifestations of delirium

Answer 13

autonomic hyperactivity = increased everything (HR, sweating, BP)

Question 14

mood and behaviors r/t delirium

Answer 14

mood changes from happy to angry

Question 15

how to assess delirium

Answer 15

assess fluctuating LOC
rely on family for info (baseline fxn?)
risk for injury - acute
VS/Neuro signs

Question 16

if delirium is not reversed what can occur

Answer 16

brain damage

Question 17

what is dementia

Answer 17

deteriorated cognitive, social and occupational fxn, levels of alertness generally not disturbed

Question 18

dementia is progressive t or f

Answer 18

true

Question 19

Is Alzheimer’s reversible

Answer 19

no

Question 20

risk factors for alzheimers***

Answer 20

advanced age
family hx
women more common than men
genetics - apolipoprotein E gene (APO4 allele) w/late onset AD
early/late onset - early=as early as 30’s

Question 21

is there a genetic component for alzheimers

Answer 21

yes - apolipoprotein E gene (APO4 allele)

Question 22

what causes alzheimers

Answer 22

cell death (cerebral atrophy)
neurofibrillary tangles inside cell
neuritic plaques are outside cell

Question 23

those with alzheimers have low levels of acetylcholine (neurotransmitter), t or f

Answer 23

true

Question 24

environmental fxrs r/t alzheimers

Answer 24

low socioeconomic status

inadequate medical care

Question 25

dx tests for alzheimers

Answer 25

assessment MMSE

brain weight

Question 26

what is the only verification of alzheimers

Answer 26

autopsy

Question 27

behaviors r/t alzheimers are the same across cultures, t or f

Answer 27

true - aggression (late stage)

Question 28

cultural groups most commonly affected by alzheimers

Answer 28

Native Americans

African Americans

Question 29

the way we perceive behaviors of alzheimers is different across cultures, t or f

Answer 29

true - we believe behaviors can be controlled, other cultures don’t believe that

Question 30

***4 A’s of cognitive impairment of alzheimers

Answer 30

amnesia - memory loss
aphasia - language/speech loss
apraxia - difficulty w/movement
agnosia - difficulty recognizing objects
loss of executive functioning

Question 31

during an assessment for alzheimers what might we see

Answer 31

denial - trying to cover it up - not purposeful lying
confabulation - making up stories - defense mechanism
perseveration - constant discussion about the same thing
sun-downers syndrome - symptoms worse in PM
problems w/organization and planning

Question 32

dementia primary vs secondary

Answer 32

primary - irreversible and progressive

secondary - result of some other process (AIDS relt’d dementia)

Question 33

***A nurse is assessing a client for dementia. What history
findings would the nurse expect to learn while talking
with the client and her family? Select all that apply.

Answer 33

1.The progression of symptoms has been slow.
4.The family can’t determine when the symptoms first
appeared
5.The client has been exhibiting basic personality changes.
6.The client has great difficulty paying attention to others