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foundations 310 > Cognitive Process > Flashcards

Cognitive Process Flashcards

1
Q

“the systematic way a person thinks, reasons, and uses language”

A

cognition

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2
Q

What does cognition require?

A
  • consciousness
  • thought
  • memory
  • learning
  • language
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3
Q

What part of brain coordinates cognition?

A

Cerebral Cortex

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4
Q

3 things required for perception to occur?

A
  • functioning sensory system
  • neurotransmission
  • processing
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5
Q

what is neurotransmission?

A

when receive stimuli and sensory receptors receive it, neural impulse is sent to brain to be interpreted

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6
Q

What are 3 types of sensory receptors?

A

extero, proprio, intero (receptors)

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7
Q

3 things about exteroreceptors?

A
  • external
  • vision, hearing, pain, and somatic receptors
  • anything that responses to stimuli from external environment
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8
Q

3 things about proprioreceptors?

A
  • position
  • inner ear, muscles, tendons, joints
  • relates to bodiesphysical state, position, sensation of movement
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9
Q

3 things about interoreceptors?

A
  • internal
  • viscera and deep tissue-reflex level (unaware- BP,O2)
  • relates to change in internal environment
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10
Q

“state of awareness, responsiveness”

A

consciousness

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11
Q

“insight process of reasoning- take a stimuli and determine its meaning”

A

judgement

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12
Q

“ability to store and recall”

A

memory

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13
Q

“ones ability to understand”

A

comprehension

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14
Q

Language is based on ____ data

A

subjective

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15
Q

Newborn/infants do not have______developed and interpret through _________

A

Sensorimotor- speech not developed, interpreting through 5 senses and expressive through behavior

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16
Q

which age develops object permanence?

A

toddler-preschooler

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17
Q

which age is egocentric, develops concrete thinking and can say 200/understand 300 words?

A

toddler/preschooler

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18
Q

which age develops abstract thinking?

A

school age to adolescent

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19
Q

Are cognitive impairments considered normal part of aging?

A

nope

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20
Q

Factors affecting cognitive fxn?

A 
Oxygenation**- most important 
Circulation
Nutrition
Fluid and Electrolyte Balance
Medications
Medical
Environment
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21
Q

brain requires ___% of oxygen for functioning

A

20

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22
Q

What comes first in CPR?

A

CAB- circulation!

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23
Q

What mineral is needed for hemoglobin?

A

Iron

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24
Q

Low iron increases risk for what?

A

oxygen deficiency, anemia

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25
Q

____% of glucose is used by the brain

A

25

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26
Q

Which electrolyte has the biggest influence on water? why?

A

Na, can pass thru BBB Freely

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27
Q

most important electrolyte for changes in mental status?

A

Na

-low/high sodium = confusion

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28
Q

Which metabolic by-product affects cognition?

A

high ammonia

Metabolic by-products
-kidney or liver impairment

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29
Q

med to lower ammonia?

A

lactalose

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30
Q

Meds that effect cognition?

A
  • Act directly on CNS- anti seizure, opioids, hypnotics
  • Side Effect
  • Toxicity- too much med/not clearing med properly
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31
Q

define delirium

A

ACUTE change in mentation, consciousness, or the ability to maintain attention.

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32
Q

is delirium preventable?

A

yep

33
Q

2 things delirium increases

A
  • mortality risk

- length of hospital stay

34
Q

Can delirium cause long term cognitive impairment?

A

yep

35
Q

Where does delirium most commonly occur?

A

icu

36
Q

3 tyoes of delirium

A
  • hyperactive
  • hypoactive
  • mixed
37
Q

what is hyperactive delirium, how is it manifested?

A

patient is disruptive, jumping out of bed, inattention, calling out frequently
**easiest to assess

38
Q

how is hypoactive delirium manifested?

A

most common, patient lying in bed sleepy/lethargic/uneasy to rouse
**Highest risk of mortality , most common, least diagnosed

39
Q

which delirium is most common and has highest mortality risk?

A

hyoactive

40
Q

What is mixed delirium?

A

hyperactivity + very sleepy, wax on/wax off

41
Q

delirium risk factors

A

Medications (benzo)

Anesthesia

ICU on Ventilator

Stroke

Dementia

Respiratory Failure

Sepsis

Drug Abuse

Alcohol Abuse

Isolation

42
Q

2 steps for assessing delirium?

A
  • patients cognitive baseline must be determined

- Confusion Assessment MEdthod (CAM)

43
Q

CAM assesses for:

A

onset, inattention, disorganized thinking, altered level of consciousness

is this acute change from baseline?
did patient experience inattention in conversation?
was patient disorganized in thinking?
Was patient anything other than alert?

44
Q

Nursing Management of Delirium

A

Early ambulation

Limit restraint use

Promote adequate sleep

Frequent reorientation

Enhance sensory stimuli

45
Q

do meds prevent delirium?

A

heck no

46
Q

define dementia

A

Progressive impairment of intellectual function and memory.
Gradual Decline- not acute
Permanent

47
Q

causes of dementia

A

trauma, circulation, genes, alteration in neurotransmitters, infection agents

48
Q

dementia: Cerebral atrophy or shrinking of cortex =

A

Alzheimer Dementia

49
Q

dementia: Inadequate blood flow due to plaques or arterial brain lesions =

A

Vascular dementia

50
Q

which patients are at high risk for vascular dementia?

A

patients with strokes are at higher risk

51
Q

dementia: Nerve cell loss and impairment of frontal and anterior temporal lobes

A

Frontotemporal Dementia

52
Q

dementia: Clumps of protein causing neurodegeneration=

A

Lewy Body Dementia

53
Q

parkinson’s dementia diagnosis?

A

If dementia occurs greater than 1 yr after Parkinson’s

54
Q

symptoms of depression in elderly

A

Forgetfulness
Fatigue
Changes in behavior or mood

55
Q

which of the 3 D’s does not have treatment?

A

Dementia

56
Q

Which of 3 D’s has acute onset?

A

Delirium

57
Q

What is Dysarthria?

A

-Impaired speech related to motor control, weakness, paralysis, or incoordination of the oral musculature
-Hearing not impacted
-Can write or select words appropriately
→ damage to peripheral or central nervous system might be cause

58
Q

is hearing impacted with dysarthria?

A

nope

59
Q

Primary cause of aphasia?

A

stroke

60
Q

what is aphasia?

A

Complete or partial loss of language abilities.

61
Q

what is expressive aphasia?

A

limited, unable to find right words they want to express

Anomia→ problems with word retrieval

62
Q

which kind of aphasia has anomia?

A

expressive aphasia

63
Q

what is anomia?

A

problem with word retrieval

64
Q

what is receptive aphasia?

A

speech is articulated but they are having a hard time understanding what you are saying or what is written in front of them

65
Q

what is global aphasia?

A

severe and extensive damage - can’t speak, read, write

66
Q

expressive aphasia effects what part of brain?

A

broca or motor

67
Q

Receptive aphasia effects what part of brain?

A

wernicke or sensory

68
Q

What can the nurse use to assess alterations in cognitive function?

A

Mini-Mental Status Exam or Pfeiffer

Pfeiffer
10 questions
A correct response gets a 1
Score of 7 or less indicates cognitive impairment

69
Q

on the Pfieiffer exam a score less then what indicates cognitive impairment?

A

7

70
Q

First neurological signs of reduced oxygen?

A

confusion, lethargy, altered mental status

71
Q

Electrolytes linked to cognitive impairment?

A

sodium, calcium

72
Q

What would a problem with kidneys or liver show?

A

confusion, ammonia/urea build up, jaundice

73
Q

What do you do if someone has trouble speaking or understanding and it is acute?

A
  • mini mental status exam

- check O2

74
Q

What do you do if someone has trouble speaking or understanding? (chronic)

A
  • creating structure to day
  • familiarity
  • allowing time for rest breaks for self and patient
  • gestures, communication board
75
Q

What can you use to help orient the patient back to reality?

A

whiteboard, open blinds, who you are,

76
Q

What would you NOT want to do with confused patient?

A

argue

77
Q

What may help make a hospital less unfamiliar to a patient?

A

-decorate, personal items, continuity of care

78
Q

Recommendations for individuals with progressive cognitive impairment

A
  1. family support
  2. day and respite care
  3. Socialization therapies
  4. Long term care

foundations 310 (28 decks)

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