Cognitive Disorders Flashcards
2 cognitive disorders
delirium and dementia
prototype of dementia is called
Alzheimer’s
Alzheimer’s is classified as a
major neuro-cognitive disorder
what is delirium
abrupt onset of mental confusion, comes and goes, chg in LOC (not aaox3)
delirium is secondary to another condition, t or f
true - something else is happening (alcohol withdraw (delirium tremons))
once you treat the underlying condition, delirium will go away, t or f
true
population most likely affected by delirium
older adults (poly pharmacy)
cause of delirium
unknown
co-morbidities r/t delirium
UTI, drugs, CHF
4 cardinal features of delirium
acute onset (within a couple hrs)
disorganized thinking
disturbance of conscious
inattention
*difference between delirium and dementia
delirium = altered level of consciousness - reversible dementia = they are awake and alert - may not know themselves - not reversible
cognitive/perceptual disturbances of delirium
illusions - false perception of real stimuli - iv tubing a snake
hallucinations - false sensory stimuli - tactile
physical manifestations of delirium
autonomic hyperactivity = increased everything (HR, sweating, BP)
mood and behaviors r/t delirium
mood changes from happy to angry
how to assess delirium
assess fluctuating LOC
rely on family for info (baseline fxn?)
risk for injury - acute
VS/Neuro signs
if delirium is not reversed what can occur
brain damage
what is dementia
deteriorated cognitive, social and occupational fxn, levels of alertness generally not disturbed
dementia is progressive t or f
true
Is Alzheimer’s reversible
no
risk factors for alzheimers***
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
is there a genetic component for alzheimers
yes - apolipoprotein E gene (APO4 allele)
what causes alzheimers
cell death (cerebral atrophy)
neurofibrillary tangles inside cell
neuritic plaques are outside cell
those with alzheimers have low levels of acetylcholine (neurotransmitter), t or f
true
environmental fxrs r/t alzheimers
low socioeconomic status
inadequate medical care
dx tests for alzheimers
assessment MMSE
brain weight
what is the only verification of alzheimers
autopsy
behaviors r/t alzheimers are the same across cultures, t or f
true - aggression (late stage)
cultural groups most commonly affected by alzheimers
Native Americans
African Americans
the way we perceive behaviors of alzheimers is different across cultures, t or f
true - we believe behaviors can be controlled, other cultures don’t believe that
***4 A’s of cognitive impairment of alzheimers
amnesia - memory loss aphasia - language/speech loss apraxia - difficulty w/movement agnosia - difficulty recognizing objects loss of executive functioning
during an assessment for alzheimers what might we see
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
dementia primary vs secondary
primary - irreversible and progressive
secondary - result of some other process (AIDS relt’d dementia)
***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.
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
