Cognitive Disorders / Older Adults

Question 1

Define Delirium. What are the causes?

Answer 1

• syndrome involving disturbance of consciousness with accompanying change in cognition; short time period and lasts seconds to days
• REVERSIBLE
• Cause: physiologic, metabolic, infection, drug related

Question 2

What is the treatment for delirium

Answer 2

• identify and treat contributing factors
• almost always transient condition and clears when underlying cause is treated
• Meds: antipsychotics and sedative with EXTREME CAUTION

Question 3

Define dementia

Answer 3

• mental disorder that involves multiple cognitive deficits, primarily memory and at least one of the following: aphasia, apraxia, agnosia, disturbance in executive functioning
• MEMORY IMPAIREMENT IS PROMINENT EARLY SIGN
• irreversible

Question 4

Define Alzheimer’s and risk factors

Answer 4

What it is:

• most common form of dementia with loss of memory and other abilities serious enough to interfere with daily living
• not normal part of aging and affects >65 y/o

Risk factors;

• age = greatest risk
• fam hx and heredity
• risk gene E-e4
• head injury, heart disease, or mercury/aluminum

Question 5

What are the symptoms of Alzheimer’s

Answer 5

• difficulty remembering newly learned info is MOST COMMON EARLY SYMPTOM
• difficulty with normal tasks
• misplacing things
• changes in mood/behavior

Question 6

How do cholinesterase inhibitors work in treating symptoms associated with dementia and Alzheimer’s

Answer 6

• prevent breakdown of acetylcholine
• Side effects: N/V, loss of appetite, diarrhea
• Types: Donezepil, Rivastaigmine, Galantamine, Tactrine

Question 7

How do Memantine (Namenda) works in treating symptoms associated with dementia and Alzheimer’s

Answer 7

• for moderate to severe
• delays worsening of symptoms and effective with 50%
• improves memory, attention, reason, and language and can be taken with cholinesterase inhibitor
• Side effects: headache, constipation, confusion and dizziness

Question 8

Explain the meds Suvorexant (Balsomra) and Aducanumab (Adulhelm)

Answer 8

Suvorexant (Balsomra):
- for insomnia in people with mild to moderate Alzheimer’s

Aducanumab (Adulhelm):
- treatment of mild AD by removing amyloid plaques

Question 9

What are the goals for the patient with dementia

Answer 9

• optimal level of functioning
• free from injury
• improved orientation, maintaining adequate rest, nutrition and fluid balance

Question 10

What are some nursing interventions for the client with cognitive disorders

Answer 10

• tailor dietary needs to patient to make sure they eat
• use finger foods if they don’t stay at the table
• serve favorites often
• use beverage supplements when needed
• get speech therapy involved if they have issues swallowing

Question 11

What are the wandering interventions used for the patient with cognitive disorders

Answer 11

• make exit doors less obvious and provide a safe place to walk
• keep recent photo of patient on file to use if lose
• use GPS device (Medicalert)