Dementia and Delirium Exam 2

Question 1

what is delirium

Answer 1

acute confusional states

transient disorder of cognitive function, consciousness, or perception

Question 2

hyperactive delirium

Answer 2

acute disturbance in attention or awareness
typically develops over 2-3 days
usually in: ICUs, post-surgery, withdrawal, hospitalized elderly

can be caused by hypoxia and insomnia

manifestations: restlessness, irritability, difficulty concentrating

can lead to aggression, combativeness, pain, rapid breathing

patient has no idea whats going on

Question 3

hypoactive delirium

Answer 3

associated with right-sided frontal basal-ganglion disruption (areas with coordinated movements and alertness)

common with metabolic disorders - liver or kidney failure

decreased alertness and attention span, decreased ability to perception and interpretation of environment, forgetful, apathetic, SLOW SPEECH, frequently falls asleep

Question 4

treatment and evaluation of delirium

Answer 4

identify cause and remove causative agents - if they have kidney issue try and treat kidneys

prevented by not giving CNS altering meds

Question 5

what is dementia

Answer 5

acquired deterioration and progressive failure of cerebral functioning
impaired intellectual processes –> memory, language, judgement, decision making, orientation

pathophysiology: neuron degeneration (atrophy), compression of brain tissue, atherosclerosis of cerebral vessels, brain trauma, infection, neuro-inflammation

generally slow onset and is irreversible

no cure

Question 6

alzheimers disease risk factors

Answer 6

being older than 65, family history, genetics, down syndrome, unhealthy lifestyle, previous head trauma, isolation

Question 7

pathophysiology of AD

Answer 7

MOST COMMON
accumulation of neuritic plaques and intraneuronal (between neurons) neurofibrillary tangles of TAU PROTEIN (accelerates nerve cell degeneration
brain has difficulty with transmission

starts as mild short-term memory loss to total loss of cognitive executive function

Question 8

donepezil (Aricept) MED

Answer 8

MOA: works centrally in the brain to increase levels of acetylcholine by inhibiting acetylcholinesterase
for moderate AD
DOES NOT CURE BUT SLOWS DOWN

SE: normally none to mild

since patient is forgetful must have a way to ensure patient is taking meds

Question 9

memantine (Namenda)

Answer 9

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

SE: uncommon: constipation