Cognitive Disorders (Gas #17) Flashcards
Delirium is characterized as what and who can get it?
A disturbance of consciousness and anyone at any age can develop it
Delirium short or fast onset?
Short, quick
Is delirium reversible?
Yes
S/s of delirium
Difficulty sustaining & shifting attention, Extreme distractibility, disorganized thinking, impaired reasoning, disoriented to time and place, impaired recent memory, misperceptions about the environment, illusions, hallucinations, they hear things in the wall etc
Autonomic manifestations of delirium
Tachycardia, sweating, flushed face, dilated pupils, elevated bp
Causes of delirium
Drug related, rxn to anesthesia, infection (sepsis, UTI)
Delirium treatment
Determine and correct underlying cause, low stimulus in room, SAFETY
What meds can be used for Delirium to control the accompanying agitation or substance withdrawl
Low dose Neuroleptic agents (haldol, Thorazine) & Benzodiazepines for alcohol withdrawal
Dementia a slow onset or fast?
Slow, progressive
Dementia s/s
Impairment of abstract thinking, judgement and impulse control, doesn’t know how to act in a social setting, appearance and hygiene are neglected, personality changes, language may or may not be affected
Is dementia reversible?
If it is caused by a stroke it is but in MOST individuals it’s not
Mild stage of dementia s/s
Difficulty remembering names, apathy (lack of emotion)
Moderate stage of dementia s/s
Impaired judgement,disorientation, behavior changes, depression
Severe stage of dementia s/s
Difficulty speaking, swallowing
What stages of dementia are stages where a patient can still live at home if they have lots family support?
Mild & moderate
Dementia is associated with which diseases
Alzheimer’s, vascular dementia, picks disease, creutzfedt-Jakob disease, Parkinson’s disease, huntingtons
Alzheimer’s disease causes
Acetylcholine alterations, plaques and tangles, head trauma, genetic factors
What happens with the brain with Alzheimer’s disease
Cells shrink and die
Mixed dementia
Alzheimer’s and vascular neuro cognitive disorder
Causes of vascular neuro cognitive disorder
Arterial HTN, cerebral emboli, cerebral thrombosis,
Meds for cognitive impairment
Donepezil (aricept), rivastigmine (exelon), galantamine (razadyne), memantine (namenda)
Donepezil (aricept), rivastigmine (exelon), galantamine (razadyne), memantine (namenda) are used for?
Cognitive impairment
Donepezil (aricept) is used for and when do you take it and what does it do
Used for cognitive impairment, once a day at bedtime, it helps slow memory loss with moderate-severe dementia
Side effects of Aricept and what stages is it effective at
All stages; NV, loss of appetite, increased frequency of bowel movements
Razadyne side effects and what stage is it most effective at treating
Mild to moderate; NV, loss of appetite, increased frequency of bowel movements
Exelon side effects and which stage is it most effective at treating
Mild to moderate; NV, loss of appetite, increased frequency of bowel and bladder movements, skin irritation
Namenda side effects and which stage is it most effective at treating?
Moderate to severe; HA, constipation, confusion, dizziness
Difference between amnesia and dementia
Amnesia doesn’t have apraxia, aphasia, agnosia (inability to recognize sights, sounds, words, or other sensory info) like dementia pts
Amnestic disorders are caused by
Stroke, head injury, chronic alcohol ingestion
Amnesia treatment
Remove underlying cause, rehab to try and help memory
Communication strategies for dementia
Be below eye level, approach from front, shake hand or hug is able, say name not “honey”, remind them who you or others are if they can’t remember, small direct no more than 7 words, positive
What’s important to keep with dementia patients?
Routine!
