Dementia

Question 1

risk factors for dementia

Answer 1

CV diseases, head trauma, genetics

Question 2

CV risk factors for dementia

Answer 2

DM, HTN, stroke, CAD, smoking, high cholesterol & triglycerides

Question 3

PET scan

Answer 3

differentiates alzheimer’s from other types of dementia

Question 3

mild s/s

Answer 3

can’t find right words, can’t do simple math (pay cash), misplaces items, changes in mood/personality

Question 4

Alzheimer’s dx

Answer 4

supportive until autopsy

Question 4

supportive dx

Answer 4

mini mental status exam, H&P, labs to r/o other causes

Question 4

family teaching - mild

Answer 4

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

Question 5

moderate s/s

Answer 5

incontinence, can’t dress themselves, wandering, behavioral problems, trouble recognizing friends/family

Question 6

family teaching moderate

Answer 6

door locks/security systems, reduce fall risks, label drawers and faucets, use distraction and diversion, provide memory triggers, consider adult day care

Question 7

severe s/s

Answer 7

unable to preform ADLs or communicate, dysphagia, immobility, incontinence

Question 8

family teaching severe

Answer 8

consider LTC placement, provide oral & skin care, continue communicating, toileting schedule

Question 9

what not to do with dementia patients

Answer 9

correct them, argue, rush them, force participation, ask them to explain why

Question 10

medications to help with memory loss

Answer 10

donepezil, rivastigmine, memantine

Question 11

medications for depression

Answer 11

sertraline, citalopram, trazadone

Question 12

antipsychotic examples

Answer 12

haloperidol, risperidone

Question 13

antipsychotic considerations

Answer 13

can kill patient - try other methods first

Question 14

if a pt is exhibiting behavioral problems, what should you do

Answer 14

first - assess physical status/identify needs
second - assess environment, identify triggers/needs

Question 15

redirection examples

Answer 15

folding towels, sweeping

Question 16

distraction examples

Answer 16

snacks, car ride, listening to music, walking, look at photos

Question 17

reassurance examples

Answer 17

tell patient they’re safe, calming music or massage

Question 18

sundowning

Answer 18

confusion/agitation worsens in late afternoon/evening

Question 19

how to reduce sundowning

Answer 19

maximize exposure to daylight, close blinds at night, limit naps & caffeine, quiet, calm environment

Question 20

what kind of food should an alzheimer’s pt get

Answer 20

pureed or finger foods, thickened liquids, nutritional supplements

Question 21

meal time considerations

Answer 21

do not rush, do not give too many options, avoid distractions, quiet environment
check for pocketing

Question 22

oral care

Answer 22

tooth decay/abscesses can increase agitation

Question 23

benefits of adult day care

Answer 23

provides stimulating activities so pt comes home tired and content; gives family more space for their lives

Question 24

wander risk interventions - in hospital

Answer 24

hourly rounding, bed close to nurse’s station, bed alarm, consistent care givers

Question 25

what can you do if pt is pulling out tubes

Answer 25

covers, abd binders

Question 26

risk factors for delirium

Answer 26

dementia, comorbidities, combination of pain, stress, sleep deprivation, sensory overload, etc

Question 27

early manifestations of delirium

Answer 27

inability to concentrate, irritability, insomnia, anorexia, restlessness, confusion

Question 28

late manifestations of delirium

Answer 28

agitation, hallucination, misperception/misinterpretation

Question 29

delirium management

Answer 29

reorient often, calm environment, bring family or object from home, avoid restraints, music, massage, consistent nursing staff

Question 30

quetiapine

Answer 30

antipsychotic not tolerated by Alzheimer’s pts