Cognitive Process Flashcards
Is the systemic ways a person, thinks, reasons, and uses language
-Requires conscious thought, memory, learning, and language
Cognition
Cognition is coordinated by what part of brain?
Cerbral Cortex
What three things are required for perception to occur?
A functioning sensory system
Neurotransmission
Processing
What are the three types of sensory receptors?
Enteroceptors
Propioceptors
Interoceptors
EXTERNAL
Vision, hearing, pain, and somatic receptors.
Anything that responds to stimuli from external environment
Exteroceptors
POSITION
Inner ear, muscles, tendons, and joints.
Relates to body’s physical state, position and sensation of movement.
Proprioceptors
INTERNAL
Viscera and deep tissues
Relates to change in internal environment
Interoreceptors
Nursing and Cognitive FXN
Consciousness Orientation Judgement Memory Comprehension Language
Newborn Infant
Sensorimotor
Toddler-Preschool
Object permanence
Verbal language and reasoning develop
Egocentric view
Concrete thinking
School age- Adolescent
School-age develops abstract thinking
Adolescents begin to perform complex mental processes
Adult-Older Adult
Rational thinking
Increased age=higher likelihood of neurological impairments.
Cognitive impairments are not considered a “normal” sign of aging.
Factors affecting cognitive function
Oxygenation/Circulation Nutrition Fluid and Electrolyte Balance Medications Medical Environment
Oxygen
- 20% is used for brain functioning
Nutrition
-25% of glucose is used by the brain
Iron
is needed for hemoglobin
F&E
Which electrolyte has the biggest influence on water?
Metabolic by-products
Medication
Act directly on CNS
- Side effect
- Toxicty
Medical
- Head Trauma
- Degenerative Process
- Infectious Process
Environment
Multiple Factors
Delirium
Acute change in mentation, consciousness, or the ability to maintain attention.
Delirium increases what
- Increases mortality risk, hospital length of stay, long term cognitive impairment
Hyperactive
Easiest to assess. Disruptive
Hypoactive
Most common. underdiagnosed. higher risk of mortality. often labled ad “sleepy/quiet/sedated/withdrawn/
Mixed
Presence of both wax and wane
Risk Factors of Delirium
- Meds, Anesthesia, ICU on ventilator, Stroke, Dementia, Resp failure, spesis, drug abuse, alcohol abuse, isolation
Nursing Management of Delirium
- Pt’s cognitive baseline
- Confusion Assessment Method (CAM)
- Early ambulation
- Limit restraint use
- Promote adequate sleep
- Frequent Isolation
- Enhance Sensory Stimuli
Dementia
Progressive impairment of intellectual function and memory.
Gradual Decline
Permanent
Alzheimer Dementia
Cerebral atrophy or shrinking of cortex
Vascular Dementia
Inadequate blood flow due to plaques or arterial brain lesions
Frontotemporal Dementia
Nerve cell loss and impairment of frontal and anterior temporal lobes
Lewy Body DEmentia
Clumps of protein causing neurodegeneration
Parkinson’s Disease Dementia
If dementia occurs greater than 1 yr after Parkinson’s
Depression
Treatable Disease
Consider experiences that the aging person may experience
Symptoms of depression in elderly
Forgetfulness
Fatigue
Changes in behavior or mood
Dysarthria
Impaired speech related to motor control, weakness, paralysis, or incoordination of the oral musculature
Hearing not impacted
Can write or select words appropriately
Aphasia
- Complete or partial loss of language abilities.
- Expressive Aphasia
- Anomia
- Receptive Aphasia
- Global Aphasia
Expressive aphasia
Oral: nonfluent, telegraphic
Written: Limited
Comprehension: usually good
Receptive
Oral: FLuent, speech is well-articulated, disorganized content
Written: Impaired
Comprehension: Impaired
Anomic
ORal: Speech fluent, talks around the subject
Written: Variable, mild- severe impairment
Comprehension: VAriable, mild-severe impairment
GLobal
ORal: speech very poor, meaningless recurrent sounds
Written: Severely impaired
Comprehension: Severely impaired
What can the nurse use to assess alterations in cognitive function
Mini-Mental Status Exam or Pfeiffer - Pfeiffer (Box 39-3) 10 questions A correct response gets a 1 Score of 7 or less indicates cognitive impairment
Family suppport
Educate family members
Observe for signs of caregiver burnout
Observe for signs of elder abuse
Day and Respite care
Measure to help relieve family members of caregiver role strain
Socialization therapies
Social groups
Hobbies
Promotes pleasant memories
LTC
- Support caregivers in the decision to move a family member to a facility
- Can provide a consistent structured environment with others for interaction
