Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nur 111 > Cognitive Impaired > Flashcards

Cognitive Impaired Flashcards

1
Q

Delirium-
Dementia –
Depression –

Forgetfulness –

A

acute confused state/reversible/once we find out underlying cause we can FIX IT!

generalized impairment of
intellectual functioning, chronic/progressive

A mood disturbance
characterized by feelings of sadness and
despair
**Disorientation, poor judgement, loss of ability
to calculate, loss of language- not normal
aging changes > requires further assessment
Forgetfulness – normal, confusion -abnormal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Disorientation, poor judgement, loss of ability
to calculate, loss of language- are normal
aging changes >
T or F

A

F ! - not normal
aging changes > requires further assessment
Forgetfulness – normal, confusion -abnormal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Delirium

A

Altered mental state caused by a disturbance in brain function, severe confusion

ONSET- sudden over hours to days
Acute, potentially reversible state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Causes of Delirium (7)

A
  1. Alcohol/drug withdrawal
  2. Medications- narcotics, anesthesia, street drugs, drug abuse
    3.Head injuries- concussions, multiple falls
    4.Fever/ sensory deficits,
    sudden confusion,
    UTI,
    Pneumonia
    5.Nutritional deficiencies ( decrease in magnesium leads to confusion)

6.Dehydration/ fluid and electrolyte imbalances
7. Change in sleep cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Delirium signs/symptoms

A

1.Disturbance in consciousness and cognition
2. Restlessness, agitation, hallucinations
3. Mood Labile - an emotional response that is irregular or out of proportion to the situation at hand.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Mood Labile -

A

an emotional response that is irregular or out of proportion to the situation at hand.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

NURSING INTERVENTIONS FOR DELERIUM (6)

A
  1. Remove the causative agent (check lab work, assessments)
    2.Prevent further damage(injury to self and others)
    3.Promote orientation
    4.Mild sedation and restraints only if necessary –minimize immobility(need MD order)
  2. Hydrate and Intake and output (I&O)
  3. Maintain safety for the patient
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Interventions cont’

A

1.Provide a quiet environment, decrease stimuli, adequate lighting due to fluctuating levels of consciousness
2. Plan care when patient appears receptive* ( Mood Labile(irregular emotional response – unstable, rapidly shifting or changing emotions) *
3.Keep conversation simple/clear explanations
4.Don’t ask multiple questions causes frustration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Prevent delerium ( 5)

A

1.Compensate for sensory deficits(glasses, hearing aides)

2.Ambulate or ROJM activities 3 times/day
3.Avoid multiple new medications
Minimize use of immobilizing devices- catheters, IV’s, restraints
4.Encourage fluids to maintain hydration

5.Use warm milk, herbal teas, relaxation tapes, music to induce sleep and reduce anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

I should go into detail what happen to delirium patients .

T or F

A

F. thats too much information for the patient.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Dementia

A

Impairment of cognitive functioning that usually is progressive and permanent, interferes with normal social and occupational functions

ONSET- slow, over years
Progressive, may stabilize at times
Chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Symptoms- dementia ( 4)

A
  1. Cognitive impairment- inability to solve problems

2.Functional losses- ADL’s-something as simple as getting a glass of water

  1. Behavior changes- restless, aggressive, personality changes

4.Neuropsych- anxiety, depression, hallucinations, yelling out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

DEMENTIA- types (6)

A

Alzheimer’s
Parkinson’s
Huntington’s Chorea
Aids
Tertiary syphilis
Vascular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Parkinson’s-degenerative neurologic disorder-

A

Initially physical symptoms may eventually develop confusion, loss of nerve conduction, problem solving, recalling information

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

H untington’s chorea-

A

hereditary with physical and mental deterioration, onset usually in the 40’s, movement disorder, uncontrolled movements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

AIDS –

A

S&S of HIV has progressed to AIDS (l

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Tertiary syphilis –

Vascular –

Korsakoff’s psychosis-

Thiamine-

A

permanent mental deterioration. Syphills needs to be educated how to treat or will lead to this.

decreased blood flow to the brain d/t aging causes change in functioning (ex: athersclerios)

psychotic d/t alcoholism

Vitamin B complex deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

PHASES OF DEMENTIA
Mild-

Moderate –

Severe

A

moderate difficulty learning, remembering, gets lost at times, depression

forgetting old facts, repeats the same stories, difficulty performing tasks. Confusion – severe memory loss for recent events, decreased ability to concentrate, incr. anxiety, denial, confabulation, lose ability to problem solve
( Apraxia & Agnosia)

damage to nerve cells is widespread, groaning, screaming, mumbling, does not recognize family/friends, dependent on others to perform ADL’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Apraxia-

Agnosia-

A

can’t perform MOTOR function

forget how to use something (how to use soap)

20
Q

Short term memory is better than long term memory in dementia patients.

T or F

A

F!
Its poor they sometimes hang onto long term memory.

21
Q

Assessment for dementia ( 4)

A
  1. Be aware of expecataion level
  2. Look at Erikson’s developmental phase that relates to the patient

3.Utilize Mini Mental State Exam (MMSE)

  1. Document patient behavior
22
Q

Signs/symptoms of dementia

A

1.Dependent on others for ADLs (or supervision)

2.Decline in memory for recent events and inability to engage in complex conversations

3.Difficulty finding words
4.Lost of interest in social activities
5Gets lost in familiar areas
6.Abnormal results on MMSE
7. Agitation- restless, wandering, lashing out

23
Q

Nursing Interventions For Dementia

A
  1. Keep safe in the environment
    2.Promote sleep, proper nutrition, hygiene, activity
    3.Structured environment and adapt daily routine to person’s needs( AM person vs night owl)
  2. emotional support to family and care givers- family involvement important
    5.Nursing Interventions cont’
    6.Nutrition – familiar and easy to eat
    7.Clothing- easy to dress and wash
    8.Music, aromatherapy, pets
    9.Reminiscence- short term memory poor, long term memory may still be present. Like to talk about childhood
  3. Promote interaction and involvement to maintain functioning
  4. Reality orientation- limited, do not cause anxiety
  5. Drugs reduce the risk of progression:
24
Q

Drugs reduce the risk of progression of dementia (4)

A

Memantine ( Namenda),
Donepezil HCl (Aricept),
Rivastigmine (Exelon),
Galantamine (Razadyne)

25
Q

Drugs for psychotic symptoms (3)

A

Haloperidol (Haldol),
Carbamazepine ( Tegretol)
Valproic Acid( Depakote)

26
Q

We are forcing orientation when dementia patients.
T or F

A

F.
we are not. settle them down . redirect the conversation to patients.

27
Q

Communication for dementia

A

Get their attention
Make eye contact
Calm tone, nonverbal important
Simple commands
Short sentences
Don’t worsen their anxiety if they are having difficulty

28
Q

Health Teaching for dementia

A

Provide the family with community resources to assist in care
Educate the family about medications
Discuss the safety requirements for the home environment

29
Q

Risk Factors for Dementia (18)

A

Age/Family historyHigh blood pressure/Diabetes
Head trauma
Toxins
Hypothyroidism
Low education level
Impaired vision/hearing
Low physical activity
Low job level
Cardiovascular disease
Smoking
Drug abuse
High alcohol intake
Long term stress
High homocysteine level
History of depression

30
Q

Prevention of dementia

A

NSAIDS( aspirin, motrin)
Antioxidants (Vit E C, berries, green tea&veg.
Lower Cholesterol
Polyunsaturated fats
Daily exercise/ sleep
Stress mgt skills
Treat depression, anxiety
Maintain strong social connections

Lower BP and blood glucose
Modify caloric intake
Stop smoking and dec. alcohol
Increase brain activity/keep mentally active
Vit B 6, 12 and folic acid

Purposeful activity which keeps the mind stimulated – eg. brush teeth with other hand
Recent studies show physical activity 3 times a week for 1 hour has improved cognitive ability
Puzzles and cross word puzzles

31
Q

Depression

A

Older adults have a higher incidence of depression than the population as a whole
Report feelings of hopelessness, sadness, worthlessness, sense of “emptiness” and feelings like everything is an effort “all the time”

32
Q

Causes of Depression

A
  1. Physiological theory – biochemical imbalances from hormonal, neurological or genetic factors

2.Psychodynamic theory – r/t loss, abandonment, emotional detachment, seasonal mood variations

3.Cognitive theory: relates to negative thinking
Social / environmental theory – poor family relationships, difficult interpersonal relationships socioeconomic and political factors

33
Q

Risk for Depression

A

Family history
Hormonal or nutritional imbalance
Inability to externalize anger
Low self-esteem
Negative thinking
Losses
Chronic health problems
Catastrophic stressors (loss of job, death of spouse)

34
Q

How is Depression Treated
Antidepressant medications - (3) *csd *

A

citalopram (Celexa),
sertraline (Zoloft),
duloxetine (Cymbalta)

Therapeutic communication
Promote activity
Promote good nutrition and hydration
Psychotherapy
Allowing patient to talk about their fears and anxieties
Support groups

35
Q

Mini Mental State Exam

A

” sweet 16”

establish level of concious ( days of the week/time/month/year)

36
Q

Relate Donepezil HCL and it affect on dementia patients

A

it delays the destruction of acteycholine ( chemical in the brain nesscary for

37
Q

what time is dementia more pronounced ?

A

twilight sundowners ( more moderate)

38
Q

dementia is insidious t or f?

A

T.
“

39
Q

Antidepressants med ( z)

A

Zoloft (sertlaine )

40
Q

Antipsychotic med ( for hallucinations & schizophrenia patients )

A

Haldol

41
Q

For anxiety med

A

Diazepam (Valuim)

42
Q

aphasia is classic symptom of : (define)

A

difficulty forming words and dementia

43
Q

a·pho·ni·a

A

loss of ability to speak through disease of or damage to the larynx or mout

44
Q

Delrium ALWAYS has an underlying cause. ( secondary)

T or F

A

T

45
Q

What medication is good for mild-moderate dementia ?

A

Doneepizil

Nur 111 (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions