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NUR 325 PATHO > Dementia and Delirium (Exam 2) > Flashcards

Dementia and Delirium (Exam 2) Flashcards

1
Q

Delirium

A

-Acute confusional states

-Transient disorder of cognitive function, consciousness, or perception

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2
Q

Onset of Delirium

A

Can be sudden or gradual

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3
Q

When can delirium be seen

A

-Other medical conditions

-Drug and Alc intox

-Hypoglycemia

-Build of metabolites

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4
Q

2 main types of Delirium

A

-Hyperactive confusional state

-Hypoactive confusional state

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5
Q

Hyperactive Delirium

A

-Acute disturbance in attention or awareness

-Typically develops over 2-3 days

-Autonomic NS of activated

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6
Q

Where is Hyperactive delirium seen?

A

ICU, post-opp, withdrawl, and hospitalized elderly

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7
Q

Hyperactive Delirium: Risk Factors

A

-Medication
-Acute infection
-Surgery
-Hypoxia
-Insomnia

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8
Q

Hyperactive Delirium: Manifestations

A

-Restlessness, Irritability, difficulty concentrating, insomnia, tremulousness.

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9
Q

Fully developed delirium

A

-Hallucinations, person completely inattentive, grossly-altered perception

-Patient often distressed and very confused, difficult calming down

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10
Q

If hyperactive delirium is not resolved it can lead to what?

A

Excited delirium syndrome

Which can cause death

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11
Q

Hyperactive Delirium: Treatment

A

-Remove risk factors

-Usually self-resolves in 2-3 days but can stay for weeks

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12
Q

Hypoactive Delirium

A

-Associated with right-sided frontal basal-ganglion disruption

-More common in those with metabolic disorders (liver or kidney failure)

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13
Q

What failures can lead to hypoactive delirum

A

-Kidney or Liver failure

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14
Q

Hypoactive Delirium: Manifestations

A

-Decreased alertness and attention span, decreased ability to perception, and interpretation of the environment, forgetful, apathetic, slow speech, frequently falling asleep

-Everything slows down

-catatonic

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15
Q

Treatment and Evaluation of Delirium

A

-Identify cause and remove causative agents, modify risk factors when possible

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16
Q

Can Delirium be prevented?

A

Yes

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17
Q

Who is at greater risk of delirium?

A

People who have dementia

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18
Q

What medications can we use for acute delirium

A

-Anti-psychotics

-When there is a danger to the patient or the provider

-Only short term solution

19
Q

If symptoms of delirium do not resolve with time

A

The patient needs to be evaluated with other conditions. It is not longer delirium that is causing symptoms

20
Q

Dementia

A

-Acquired deterioration and progressive failure of cerebral functioning

-Impaired intellectual processes. Memory, language, judgment, decision making, orientation

21
Q

How might a person with dementia present?

A

-As being agitated, wandering, and aggression

-Not remembering or doing things like they use to

-You see this with people who observe the patient. Not the patient because they do not know what is happening

22
Q

Dementia: Pathophysiology

A

Neuron degeneration, compression of brain, atherosclerosis of vessels, brain trauma, infection, and inflammation

23
Q

What predisposition is associated with many dementia-related disorders?

A

Genetic-predispostion

24
Q

Dementia: Onsent

A

-Generally slow, and symptoms are IRREVERSIBLE

25
Q

Dementia: Manifestations

A

-Depend on the cause

-Memory loss, decreased concentation and memory, overall cognitive slowing

26
Q

Dementia: Causes

A

Complicated process, not completely understood

27
Q

Cure for dementia

A

-NO CURE

-Treatment directed at restoring and optimizing functional capacity and accommodating with lost abilities

28
Q

Types of Dementia

A

-Alzheimer’s (50-75%)

-Vascular (20-30%)

-Lewy Body (10-25%)

-Frontotemperal (10-15%)

29
Q

Types of Dementia con

A

-Usually multiple types combined

30
Q

Alzheminier’s Disease

A

-Leading cause of severe cognitive dysfuntion in the elderly

-Almost 6 million americans have the disease

-2/3 females

31
Q

Alzheimers Disease: Cause

A

-Exact cause unknown

-Genetic associations–More common in early onset AD

-Sporadic late-onset AD is most common and does not have a specific genetic association

32
Q

AD: Diagnosis

A

-Made by ruling out other conditions

-Is not one test or scan

33
Q

AD: Risk Factors

A

-Older 65

-Family History

-Existing cognitive impairment

-Head trauma

-Social Isolation

34
Q

Pathophysiology of AD

A

-Accumulation of neuritic plaques and intraneronal neurofibrillary tangles of tau protein

-Plaques dirupt nerve impulse transmission and kill neurons

-More centralized in cerebral cortx and hippocampus

-Loss of synapses, acetylcholine, and other neurotransmitters contributes to memory and cognitive decline

-Loss of neurons lead to brain atrophy

-Decreases levels of acetylcholine

35
Q

Key factor in nerve cell degenration

A

Tau Protein (Neurofibrillary tangles)

-Accelerated nerve cell degeneration

36
Q

When do changes occur in AD disease

A

-Changes occur DECADES prior to symptoms occurring

-Starts as short term little lapses in memory. Leads to total loss of cognitive function

37
Q

Vascular Dementia

A

-2nd most common

-Related to cerebrovascular disease

-Large artery disease, cardioembolsim, small vessel disease, and stroke. (HYPOERFUSION to the brain)

38
Q

Vascular Dementia: Risk factors

A

-Things that hypofuse the brain

-DM, HLD, HTN, and smoking

39
Q

Vascular Dementia: Treatment

A

-Prevent risk factors

-DM, HLD, HTN, smoking

40
Q

Frontotemporal Dementia

A

-Pick disease (RARE)

-Familial association with age of onset less than 60

41
Q

How does frontotemporal dementia occur?

A

-Occurs as result of mutations in genes that encode for the tau protein

42
Q

FTD: 3 distinct syndromes

A
  1. Behavioral variant
  2. Progressive non-fluent behavior (Langauge Writting)
  3. Semantic dementia (Speech)
43
Q

Delirium vs Dementia

A

Talk through the comparison screen shot

NUR 325 PATHO (34 decks)

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