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Nurs 232 > Dementia and Delirium > Flashcards

Dementia and Delirium Flashcards

1
Q

what is delirium

A

-acute
-days to wks
-course is fluctuating
-consciousness, impaired fluctuates
-attention and memory, inattentive, poor memory without marked inattention
-affect variable
-

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2
Q

what is dementia

A
  • onset: insidous
  • month to years duration
  • course is slowly progressive
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3
Q

types of dementia

A
  • static or fixed
  • slowly progressive
  • rapidly progressive
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4
Q

symptoms of dementia

A
  • memory loss
  • inability to learn or remember new information
  • difficulty with planning and organization
  • difficulty with coordination & motor function
  • personality changes
  • intabliity to reason
  • incontinence
  • dishibitoin
  • poor insight or judgment
  • aggression
  • repetitive behavior
  • paranoia
  • agitation
  • hallucinations
  • difficulty communicating
  • repetive aphasia
  • expressive aphasia
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5
Q

what is repetitive aphasia

A

cannot understand what is said

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6
Q

what is expressive aphasia

A

cannot express themselves verbally

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7
Q

who is at risk for dementia

A

unmodifiable risk factors:

  • Age >65 dementia is not a normal process of aging
  • postive family history (for specific types)
  • female (most likelu to live longer)
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8
Q

who is at risk for dementia

A

unmodifiable risk factors:

  • Age >65 dementia is not a normal process of aging
  • postive family history (for specific types)
  • female (most likely to live longer)
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9
Q

Drugs for dementia

A
  • Acetylcholinestarse inhibitors
  • NMDA receptor antagonists
  • Symptom management: Risperidone, Haloperidol
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10
Q

Acetylcholinesterase inhibitors for dementia

A

ex .donzepil: Aricept

  • works by increasing the levels of aceytlcholine by inhibiting the enzyme which destorys it (cholinesterase)
  • useful for -mild to moderate Alzheimers disease. is ineffective in later stages due to destruction of receptor sites in the later stages of disease. Best preventative effect if treatment starts early
  • goal of treatment: to increase function in 3 domains- ADLS, behaviour and cognition
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11
Q

N-Methyl-D-Asparate (NMDA) recpetor antagonists for dementia

A

ex. memantine, Ebixa
- works by blocking stimulation of these receptors is thought to be part of the disease process of Alzhiemers. Blocking may help reduce the cognitive decline.
- useful for: Mild-Moderate Alzheimer disease

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12
Q

risperidone for symptom managment of dementia

A

useful for schizophrenia, mania, aggression,

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13
Q

risperidone for symptom management of dementia

A

useful for schizophrenia, mania, aggression, or psychosis associated with dementia

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14
Q

halperidol for symptom management of dementia

A

haloperidole used for acute psychosis of schizophrenia and mania or agitation, provides a tranquilizing affect

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15
Q

how to identify Dementia

A
  • Medical history & physical exam
  • Lab & diagnostics to rule out treatable causes
  • CT head
  • MRI
  • Neurphyscholigical tests
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16
Q

cognitive assessment tools

A

-Mini mental status examination (MMSE): takes 10 minutes, tests memory, orientation, and arithmetic good for obtaining a baseline to follow changes in cognition over time . sometimes used in conjuction with other tests to differntiate dementias

-Montreal Cognitive assesment MOCA:
takes 10 minutes, availbe in 35 languages, more sensitive then the MMSE especially designed to help diagnose cases of mild dementia

17
Q

Nursing management:

A
  • support cognitive function
  • promote physical activity
  • promote independence in self care activities
  • reduces anxiety and agitation
  • improving communication
  • providing socialization and intimacy
  • promote adequate nutriton
  • promote balanced activity and rest
  • supporting home and community based
18
Q

Nursing management:

A
  • support cognitive function
  • promote physical activity
  • promote independence in self care activities
  • reduces anxiety and agitation
  • improving communication
  • providing socialization and intimacy
  • promote adequate nutrition
  • promote balanced activity and rest
  • supporting home and community based
19
Q

what is delerium

A

an acute confusional state that is common, serious, often preventable, usually treatable

20
Q

what does delirium look like?

A
  • a disturbance of consciousness
  • a change cognition
  • the disturbance develops over a short period of time (usually hours to days) and tends to fluctuate during the course of the day
21
Q

what is important to remember about delirium

A

prevention is an intervention:

  • discontinuation of inapropriate or unnecessary medications
  • early detection and managment of post-operative complications
  • early mobilization
  • ensuring adequate nutritional intake
  • health proffesionals education on delirium and its prevention
  • minimizing the use of restraints
  • regulating bowel/bladder function: avoid indwelling catheters
  • use of sensory aids
  • pain control
  • ensuring normal sleep patterns

Nurs 232 (8 decks)

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