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Clients with Health Challenges - N3600 > Dementia, delirium and depression - red > Flashcards

Dementia, delirium and depression - red Flashcards

1
Q

When caring for an elderly patient who is confused, ask yourself is it dementia? delirium? or depression?

  • always consider that it may be _______
  • know the client’s cognitive status ______
  • infection such as UTI or pneumonia may be present in the elderly with no signs except for a ______ __ ______ _______
A

infection
baseline
change in mental status

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2
Q

Delirium is the most common complication of hospitalization in ______/______ patients
Delirium is associated with increased morbidity and mortality. it should be considered a _______ _____.

A

elderly/older

medical emergency

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3
Q

Delirium - Dx criteria

  • Develops _______
  • Cause _______ ______ of a client’s medical condition(s)
A

rapidly

physiological consequence

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4
Q

Delirium manifestations:

  • _____ onset
  • _______ course
  • _______ ______
A

acute
fluctuating
disorganized thinking

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5
Q

What is the most common reversible cause of delirium?

A

Medications

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6
Q

What, other than medications is the most important cause of delirium?

A

infection

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7
Q

Depression Dx criteria

- Depressed mood or diminished interest/pleasure in activities most of the day, nearly every day for ___ _____

A

2 weeks

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8
Q

Ageing:
- Majority of seniors are _____, live in their own home and are ____ disabled, dependent or depressed
They desire to be ______ and prefer to be _______
Seniors experience the _____ _____ as anyone else

A

healthy, not
productive
independent
same needs

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9
Q

Dementia refers to a large class of disorders characterized by the _______ ______ of thinking ability and memory as the brain becomes damaged, with no change in concsiousness

A

progressive deterioration

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10
Q

Dx criteria for dementia?

A

Need memory impairments and at least one or more cognitive disturbances (E.g. agnosia, apraxia)

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11
Q

Frontal and temporal lobes control what?

A

Planning and judgement
emotions
speaking and understanding speech
certain types of movement

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12
Q

Frontotemporal dementia used to be called?

age of onset?

A

Pick’s disease

50-60 yo

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13
Q

Alzheimer’s disease - FACTS:

  • No ____
  • ________ protein “plaques” and ___ protein “tangles” develop in the brain, leading to death of brain cells
  • Shortage of NTs (_______) in the brain
  • _______ disease, divided into __ stages
  • Most _______ dementia and is the _______ understood
  • Most commonly develops in the _______ which is why it is often linked to _______ loss
  • Cause is _______, result of multiple factors, which are?
A 
cure
amyloid, tau
acetylcholine
progressive
3
common
best
hippocampus
memory
unknown
genetics, age, lifestyle, environment
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14
Q

Loss of language ability

A

Aphasia

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15
Q

Difficulty remembering words

A

anomia

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16
Q

Inability to write

A

agraphia

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17
Q

Inability to read

A

alexia

18
Q

unable to perform simplest tasks

A

apraxia

19
Q

Inability to recognize everyday objects…loved ones

A

Agnosia

20
Q

Memory loss, first recent events and eventually all

A

Amnesia

21
Q

Taste/chew everything

A

Hyperorality

22
Q

Touching everything in site

A

Hypermetamorphosis

23
Q

What is important to remember in terms of the experience of AD between individuals?

A

No 2 people experience AD in the same way

24
Q

Name the stage of AD based on the description:

A - Can no longer cover up problems
B - Confused about past and present
C - Frequent memory loss, particularly of recent conversations and events

A

A - stage 2
B - stage 3
C - stage 1

25
Q

Name the stage of AD based on the description:

A - Mild coordination problems; writing and using objects becomes difficult
B - Unable to care for self
C - Lost in familiar settings, sleep disturbances, changes in mood and behaviour, aggravated by stress and change

A

A - stage 1
B - Stage 3
C - stage 2

26
Q

Name the stage of AD based on the description:
A - Loss of ability to remember, communicate, or process information
B - Memory loss, including forgetfulness about personal history and inability to recognize friends and family
C - Need reminders for daily activities, and have have difficulty driving

A

A - stage 3
B - stage 2
C - stage 1

27
Q

Name the stage of AD based on the description:
A - Repeated questions, some problems expressing and understanding language
B - Delusions, aggression, and uninhibited behaviour
C - Need structure, reminders and assistance with the ADLs

A

A - stage 1
B - Stage 2
C - Stage 2

28
Q

o Need structure, reminders and assistance with the ADLs:
A - still at home
B - may be admitted into LTC facility
C - definitely admitted into LTC facility

A

A - stage 1
B - stage 2
C - stage 3

29
Q

Most common screening tool for dementia?

A

MMSE

30
Q

Describe the scores for the MMSE.

A

27+ normal
20-26 - mild dementia
10-19 - moderate dementia
less than 10 - SEVERE DEMENTIA

31
Q

What are the words she said in class?

A

Pencil, orange, chair

32
Q

What med type is most important for the early to moderate stages of AD?

A

Cholinesterase inhibitors

33
Q

What medication is effective for the moderate to severe stages of AD?

A

Memantine/Ebixa

34
Q

Match the drug name (/group) based on the description of the function for AD.

A - for low mood and irritability
B - for anxiety, restlessness, verbally disruptive behaviour and resistance
C - for hallucinations, delusions, aggression, agitation, hostility and uncooperativeness
D - for agitated and aggressive behaviour and emotional lability
E - on the horizon
Others?

A 
A - antidepressants
B - anxiolytics
C - antipsychotics
D - anticonvulsants
E - Amyloid vaccine
Others - ginko biloba, antioxidants, vitamins
35
Q

What is the first concern for care planning for AD patients?

A

SAFETY

36
Q

Care strategies:

- Above all, avoid what?

A

CATASTROPHIC REACTIONS

37
Q

Catastrophic reactions are emotional outbursts, sometimes accompanied by physical acting-out behaviour, that seem inappropriate or out of proportion to the situation. The reaction may be triggered by a present event or by one from the distant past

A

Catastrophic reactions

38
Q

What are important care strategies for AD patients/

A

RE SO AP - think like you have to clean them again cuz the water was too cold

Allow adequate rest between stimulating events
Provide a security object
Acknowledge requests, and respond to them
Explore various solutions
Do not take the behaviour personally

39
Q

What is the most important thing to remember when communicating with a person with dementia?

A

Face the person directly - DO NOT APPROACH FROM BEHIND

40
Q

What is the most important thing we can due to alleviate caregiver stress of AD caregivers?

A

Advocate for caregivers, and provide support group/resource information

41
Q

What do we tell caregivers in terms of when to call 911?

A

Anytime dementia client is at risk for harm, or when they are physically aggressive to the point of harming others

42
Q

Which of the following interventions would be beneficial for a loved one with AD? Select all that apply.
A - Discourage wandering by installing locks at the top of doors.
B - Place in hospital gown to discourage client from leaving the house.
C - Register client with the local wandering registry.
D - Teach family members how to successfully redirect loved one.
E - Keep lights on in the house ATC.

A

A, C, D

Clients with Health Challenges - N3600 (22 decks)

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