Delirium and Dementia

Question 1

3 D’s of cognitive impairment in Older Adults

Answer 1

1. delirium
2. dementia
3. depression

Question 2

delirium

Answer 2

Acute and sudden onset
acute confusion characterized by sudden and temporary changes in cognitive, attention, memory, and perception

Question 3

hyperactive delirium

Answer 3

agitation
hallucinations
restlessness
hyperactivity

Question 4

hypoactive delirium

Answer 4

lethargy
decreased motor activity

Question 5

mixed delirium

Answer 5

fluctuation between hyper and hypoactive

Question 6

nursing assessment for delirium

Answer 6

assess and treat predisposing factors
keep individual safe until delirium is resolved

Question 7

CAM
confusion assessment method

Answer 7

the diagnosis of delirium requires features 1 and 2 and either 3 or 4
- feature 1: acute onset or fluctuating course
- feature 2: inattention
- feature 3: disorganized thinking
- feature 4: altered LOC

Question 8

non-pharmacological intervention delirium

Answer 8

• physiological stability/ reversable cause
• environmental
• education
• communication

Question 9

dementia

Answer 9

irreversible loss of cognitive functioning
key:
- aphasia
- apraxia
- agnosia
- disturbances in executive functioning
cause:
damage to or loss of nerve cells and their connection in the brain

Question 10

types of dementia

Answer 10

Alzheimer
- genetic and insidious
vascular
- CV and CVA (stroke) diseases
Lewy body
- insidious
frontotemporal
- degeneration

Question 11

nursing assessment for dementia

Answer 11

initial & ongoing assessment
- MMSE
- behavior and psychological symptoms of dementia (BPSD)

Question 12

pharmacological intervention

Answer 12

stabilize disease etiology and progression and manage symptoms

Question 13

non-pharmacological intervention for dementia

Answer 13

• education
• environmental modification
• communication skills
• alternative therapies for dementia

Question 14

nursing process for those with dementia

Answer 14

assessment
- factors affecting QoL
planning
- for QoL and function
diagnosis
- function, cognition, behavioral, caregiver
interventions
- interprofessional
evaluation
- QoL

Question 15

summary of impaired cognition:
– delirium

Answer 15

primary characteristics
- RAPID, ACUTE change in mental status
- develops in hrs to days
- symptoms fluctuate
- preventable and treatable
- nursing care focused on risk factors and symptoms

Question 16

summary of impaired cognition:
– dementia

Answer 16

primary characteristics
- SLOW, CHRONIC change in mental status
- develops in months-yrs
- symptoms progress
- dementia is terminal
- nursing care focused on safety, caregiver strain, and QoL