Cognitive Disorders (Gas #17)

Question 0

Delirium is characterized as what and who can get it?

Answer 0

A disturbance of consciousness and anyone at any age can develop it

Question 1

Delirium short or fast onset?

Answer 1

Short, quick

Question 2

Is delirium reversible?

Answer 2

Yes

Question 3

S/s of delirium

Answer 3

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

Question 4

Autonomic manifestations of delirium

Answer 4

Tachycardia, sweating, flushed face, dilated pupils, elevated bp

Question 5

Causes of delirium

Answer 5

Drug related, rxn to anesthesia, infection (sepsis, UTI)

Question 6

Delirium treatment

Answer 6

Determine and correct underlying cause, low stimulus in room, SAFETY

Question 7

What meds can be used for Delirium to control the accompanying agitation or substance withdrawl

Answer 7

Low dose Neuroleptic agents (haldol, Thorazine) & Benzodiazepines for alcohol withdrawal

Question 8

Dementia a slow onset or fast?

Answer 8

Slow, progressive

Question 9

Dementia s/s

Answer 9

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

Question 10

Is dementia reversible?

Answer 10

If it is caused by a stroke it is but in MOST individuals it’s not

Question 11

Mild stage of dementia s/s

Answer 11

Difficulty remembering names, apathy (lack of emotion)

Question 12

Moderate stage of dementia s/s

Answer 12

Impaired judgement,disorientation, behavior changes, depression

Question 13

Severe stage of dementia s/s

Answer 13

Difficulty speaking, swallowing

Question 14

What stages of dementia are stages where a patient can still live at home if they have lots family support?

Answer 14

Mild & moderate

Question 15

Dementia is associated with which diseases

Answer 15

Alzheimer’s, vascular dementia, picks disease, creutzfedt-Jakob disease, Parkinson’s disease, huntingtons

Question 16

Alzheimer’s disease causes

Answer 16

Acetylcholine alterations, plaques and tangles, head trauma, genetic factors

Question 17

What happens with the brain with Alzheimer’s disease

Answer 17

Cells shrink and die

Question 18

Mixed dementia

Answer 18

Alzheimer’s and vascular neuro cognitive disorder

Question 19

Causes of vascular neuro cognitive disorder

Answer 19

Arterial HTN, cerebral emboli, cerebral thrombosis,

Question 20

Meds for cognitive impairment

Answer 20

Donepezil (aricept), rivastigmine (exelon), galantamine (razadyne), memantine (namenda)

Question 21

Donepezil (aricept), rivastigmine (exelon), galantamine (razadyne), memantine (namenda) are used for?

Answer 21

Cognitive impairment

Question 22

Donepezil (aricept) is used for and when do you take it and what does it do

Answer 22

Used for cognitive impairment, once a day at bedtime, it helps slow memory loss with moderate-severe dementia

Question 23

Side effects of Aricept and what stages is it effective at

Answer 23

All stages; NV, loss of appetite, increased frequency of bowel movements

Question 24

Razadyne side effects and what stage is it most effective at treating

Answer 24

Mild to moderate; NV, loss of appetite, increased frequency of bowel movements

Question 25

Exelon side effects and which stage is it most effective at treating

Answer 25

Mild to moderate; NV, loss of appetite, increased frequency of bowel and bladder movements, skin irritation

Question 26

Namenda side effects and which stage is it most effective at treating?

Answer 26

Moderate to severe; HA, constipation, confusion, dizziness

Question 27

Difference between amnesia and dementia

Answer 27

Amnesia doesn’t have apraxia, aphasia, agnosia (inability to recognize sights, sounds, words, or other sensory info) like dementia pts

Question 28

Amnestic disorders are caused by

Answer 28

Stroke, head injury, chronic alcohol ingestion

Question 29

Amnesia treatment

Answer 29

Remove underlying cause, rehab to try and help memory

Question 30

Communication strategies for dementia

Answer 30

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

Question 31

What’s important to keep with dementia patients?

Answer 31

Routine!