Cognitive impairment and neurological disorders pt 11

Question 1

Degenerative dementias

Answer 1

Alzheimer’s, parkinson’s, lewy body, frontotemporal dementias

Question 2

Most dementia is caused by…

Answer 2

Alzheimers

Question 3

Vascular cognitive impairment

Answer 3

Vascular dementia

Question 4

Lesser common dementias

Answer 4

Creutzfeldt-jakob, HIV, Korsakoff

Question 5

Reversible dementia

Answer 5

Normal pressure hydrocephalus, treated with a shunt

Question 6

Alzheimers

Answer 6

• Cell death in brain caused by plaques and tangles
• Brain shrinks
• Increasing memory loss, inability to concentrate, personality deterioration, impaired judgement

Question 7

Early-onset dementia

Answer 7

Rare, 30-60 yrs, stronger genetic component

Question 8

How do you confirm a diagnosis of AD?

Answer 8

Brain autopsy

Question 9

Preclinical Stage AD

Answer 9

• Measurable changes in brain, CSF, blood markers
• No symptoms
• Affects on brain can start for 20 years before symptoms occur

Question 10

Mild cognitive impairment stage AD

Answer 10

• Change in cognition
• More than expected at pts. age and background
• Enough to be measured and noticeable

Question 11

Vascular dementia

Answer 11

_ Group of heterogenous disorders arising from cerebrovascular insufficiency, ischemic, or hemorrhagic brain damage
- memory may not be impaired/less

Question 12

Three common concerns w dementia

Answer 12

Behaviour, ADL’s, monitoring

Question 13

Progressively Lowered Stress Threshold Model

Answer 13

• Those with dementia typically experience a
  progressively lowered stress threshold
• Agitation
• Idea is to reduce stress in environment

Question 14

Need-Driven Dementia-Compromised behaviour model

Answer 14

• Proposes that the behaviour of a person w dementia indicates need that can be addressed appropriately if the pts history, habits, physiological status, and environment are evaluated

Question 15

Recognition of retained abilities approach

Answer 15

Emphasized importance of focusing on abilities rather than disabilities

Question 16

Iatrogenic excess disability

Answer 16

When care providers “do for” rather than assisting/facilitating

Question 17

Relating well

Answer 17

care provider-resident relationships enhance the quality of life of residents

Question 18

Three kinds of nursing actions to soothe residents w dementia

Answer 18

• Stay during care episode
• Altering pace of care by recognizing rhythm and adapting to it
• Focusing on care beyond the task

Question 19

Use of antipsychotics

Answer 19

Excess use is a serious concern, adverse reactions, risks including sedation and ortho hypotension

Question 20

PHarm is considered when…

Answer 20

Danger to self or other, comprehensive assessment of causes of behaviour, non-pharmacological

Question 21

Cerebrovascular Disease

Answer 21

Group of pathological process in cerebral blood vessels resulting in brain injury

Ischemic or hemorrhagic

Question 22

Ischemic vs hemorrhagic

Answer 22

Hemorrhagic have more focal neurological changes, seizures, more depressed consciousness

Question 23

Parkinson’s

Answer 23

• Slowly progressing
• Destruction of cells in substantia nigra
• cannot regulate movement
• Must be diagnosed with 2 of symptoms, one being resting tremor or bradykinesia

Question 24

Management of PD

Answer 24

Relieving symptoms with meds, increase functional ability, prevent excess disability and injury

Question 25

Exercise - PD

Answer 25

Important for treatment