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NUR 325 Patho > Deliruim > Flashcards

Deliruim Flashcards

1
Q

What is Delirium

A
  • Known as acute confusional state
  • transient disorder of cognitive function, consciousness, perception
  • can be sudden or gradual onset
  • usually accompanied by other medical conditions
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2
Q

what are the 2 types of Delirium

A
  • Hyperactive

- Hypoactive

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3
Q

What is hyperactive delirium

A
  • acute disturbance in attention or awareness
  • develops over 2-3 days
  • usually in ICU, post surgery, withdraw, and hospitalized elderly.
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4
Q

Risk factors of hyperactive delirium

A
  • medications (benzos,narcotics)
  • acute infection
  • surgery
    -hypoxia
  • electrolyte or metabolic dysfunction
    insomnia
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5
Q

hyperactive manifestations

A 
restlessness
irritability
difficulty concentrating
insomnia
tremulousness
poor appetite
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6
Q

Fully developed hyperactive delirium

A

Hallucinations
completely inattentive
altered perception

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7
Q

treatment of hyperactive delirium

A

Remove Risk Factors

usually self resolves in 2-3 days but can last for weeks

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8
Q

what is hypoactive delirium

A

right sided frontal basal ganglion disruption

- more common with metabolic disorders (liver and kidney failure)

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9
Q

hypoactive manifestations

A
  • decreased alertness and attention
  • decreased ability to perception and interpretation of environment
  • forgetful
  • apathetic
  • slow speech
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10
Q

Treatment of delirium

A

GOAL - identify cause and remove causation, and modify risk factors
- dementia at baseline is much higher risk of delirium

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11
Q

What is Dementia

A

Acquired deterioration and progressive failure of cerebral function

  • impaired intellectual processes (memory,language, decision making, orientation)
  • may present as agitation wandering and aggression
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12
Q

Patho of dementia

A
  • neuron degeneration
  • compression of brain tissue
  • atherosclerosis of cerebral vessels
  • brain trauma
  • infection
  • neuro-inflammation
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13
Q

onset of dementia

A

generally slow, symptoms usually irreversible

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14
Q

dementia manifestations

A
  • memory loss
  • decreased concentration and memory
  • overall cognitive slowing
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15
Q

treatment of dementia

A

no cure

treatment based on restoring and optimizing functional capacity and accommodation for lost abilities.

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16
Q

Alzheimer’s Disease

A

-Leading cause of severe cognitive dysfunction in the elderly
-Diagnosis made by Rule Out
-Genetic more common in early onset
Late onset is most common and does not show genetic association

17
Q

Risk factors for Alzheimer’s disease

A

-Older than 65
-Family history
-inheriting genes
-Existing mild cognitive impairment
down syndrome
unhealthy lifestyle
previous head trauma
being shut off from community

18
Q

Physiology of Alzheimer’s disease

A

Accumulation of neurotic plaques and intraneuronal neurofibrillary tangles of tau protein.

  • plaques disrupt nerve transmission and kill neurons
  • centralized in cerebral cortex and hippocampus
  • loss of synapses, acetylcholine and other neurotransmitters contributes to memory and cognitive decline
  • brain atrophy
  • decreased levels of acetylcholine
19
Q

Vascular dementia

A

2nd most common
related to cerebrovascular disease
r/t large artery disease, cardio embolism, small vessel disease, and stroke (hypoperfusion to the brain)

20
Q

Risk factors of vascular dementia

A

DM
HPL
HTN
smoking

21
Q

Frontotemporal Dementia

A

known as Pick Disease
Familial association with age of onset less than 60
R/T gene mutations of encoding the tau protein

22
Q

Clinical syndromes of frontotemporal dementia

A

Behavioral variant
progressive non-fluent behavior
semantic dementia

23
Q

Name and MOA of Cholinesterase inhibitor

A

Donepezil (Aricept)

MOA - works centrally in the brain to increase levels of acetylcholine by inhibiting acetylcholinesterase

24
Q

Indication of Donepezil

A

mild-moderate AD

Given PO at bedtime, with food

25
Q

Donepezil Adverse Effects

A 
Normally none to mild, resolves on own
- gi upset
drowsy
dizzy 
insomnia
muscle cramping
bradycardia
syncope
reflex tachycardia
26
Q

N-methyl-D-aspartate (NMDA) receptor antagonist

A

Memantine (namenda)

27
Q

MOA of Memantine

A

blocks the stimulation of NMDA receptors believed to be associated with AD

28
Q

indication of Memantine

A

moderate-severe AD

Given PO with or without food

29
Q

Adverse effects of Memantine

A

uncommon but may result in

  • confusion
  • hypotension
  • headache
  • dizziness
  • constipation

NUR 325 Patho (18 decks)

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