Dementia Flashcards
risk factors for dementia
CV diseases, head trauma, genetics
CV risk factors for dementia
DM, HTN, stroke, CAD, smoking, high cholesterol & triglycerides
PET scan
differentiates alzheimer’s from other types of dementia
mild s/s
can’t find right words, can’t do simple math (pay cash), misplaces items, changes in mood/personality
Alzheimer’s dx
supportive until autopsy
supportive dx
mini mental status exam, H&P, labs to r/o other causes
family teaching - mild
take keys, use clocks, calendars, write notes, keep a consistent routine, put items in specific locations, do not correct them/their memory, have pt do advanced directive
moderate s/s
incontinence, can’t dress themselves, wandering, behavioral problems, trouble recognizing friends/family
family teaching moderate
door locks/security systems, reduce fall risks, label drawers and faucets, use distraction and diversion, provide memory triggers, consider adult day care
severe s/s
unable to preform ADLs or communicate, dysphagia, immobility, incontinence
family teaching severe
consider LTC placement, provide oral & skin care, continue communicating, toileting schedule
what not to do with dementia patients
correct them, argue, rush them, force participation, ask them to explain why
medications to help with memory loss
donepezil, rivastigmine, memantine
medications for depression
sertraline, citalopram, trazadone
antipsychotic examples
haloperidol, risperidone
antipsychotic considerations
can kill patient - try other methods first
if a pt is exhibiting behavioral problems, what should you do
first - assess physical status/identify needs
second - assess environment, identify triggers/needs
redirection examples
folding towels, sweeping
distraction examples
snacks, car ride, listening to music, walking, look at photos
reassurance examples
tell patient they’re safe, calming music or massage
sundowning
confusion/agitation worsens in late afternoon/evening
how to reduce sundowning
maximize exposure to daylight, close blinds at night, limit naps & caffeine, quiet, calm environment
what kind of food should an alzheimer’s pt get
pureed or finger foods, thickened liquids, nutritional supplements
meal time considerations
do not rush, do not give too many options, avoid distractions, quiet environment
check for pocketing
oral care
tooth decay/abscesses can increase agitation
benefits of adult day care
provides stimulating activities so pt comes home tired and content; gives family more space for their lives
wander risk interventions - in hospital
hourly rounding, bed close to nurse’s station, bed alarm, consistent care givers
what can you do if pt is pulling out tubes
covers, abd binders
risk factors for delirium
dementia, comorbidities, combination of pain, stress, sleep deprivation, sensory overload, etc
early manifestations of delirium
inability to concentrate, irritability, insomnia, anorexia, restlessness, confusion
late manifestations of delirium
agitation, hallucination, misperception/misinterpretation
delirium management
reorient often, calm environment, bring family or object from home, avoid restraints, music, massage, consistent nursing staff
quetiapine
antipsychotic not tolerated by Alzheimer’s pts
