Dementia, delirium and depression - red

Question 1

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 ______ __ ______ _______

Answer 1

infection
baseline
change in mental status

Question 2

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

Answer 2

elderly/older

medical emergency

Question 3

Delirium - Dx criteria

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

Answer 3

rapidly

physiological consequence

Question 4

Delirium manifestations:

• _____ onset
• _______ course
• _______ ______

Answer 4

acute
fluctuating
disorganized thinking

Question 5

What is the most common reversible cause of delirium?

Answer 5

Medications

Question 6

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

Answer 6

infection

Question 7

Depression Dx criteria

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

Answer 7

2 weeks

Question 8

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

Answer 8

healthy, not
productive
independent
same needs

Question 9

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

Answer 9

progressive deterioration

Question 10

Dx criteria for dementia?

Answer 10

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

Question 11

Frontal and temporal lobes control what?

Answer 11

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

Question 12

Frontotemporal dementia used to be called?

age of onset?

Answer 12

Pick’s disease

50-60 yo

Question 13

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?

Answer 13

cure
amyloid, tau
acetylcholine
progressive
3
common
best
hippocampus
memory
unknown
genetics, age, lifestyle, environment

Question 14

Loss of language ability

Answer 14

Aphasia

Question 15

Difficulty remembering words

Answer 15

anomia

Question 16

Inability to write

Answer 16

agraphia

Question 17

Inability to read

Answer 17

alexia

Question 18

unable to perform simplest tasks

Answer 18

apraxia

Question 19

Inability to recognize everyday objects…loved ones

Answer 19

Agnosia

Question 20

Memory loss, first recent events and eventually all

Answer 20

Amnesia

Question 21

Taste/chew everything

Answer 21

Hyperorality

Question 22

Touching everything in site

Answer 22

Hypermetamorphosis

Question 23

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

Answer 23

No 2 people experience AD in the same way

Question 24

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

Answer 24

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

Question 25

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

Answer 25

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

Question 26

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

Answer 26

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

Question 27

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

Answer 27

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

Question 28

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

Answer 28

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

Question 29

Most common screening tool for dementia?

Answer 29

MMSE

Question 30

Describe the scores for the MMSE.

Answer 30

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

Question 31

What are the words she said in class?

Answer 31

Pencil, orange, chair

Question 32

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

Answer 32

Cholinesterase inhibitors

Question 33

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

Answer 33

Memantine/Ebixa

Question 34

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?

Answer 34

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

Question 35

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

Answer 35

SAFETY

Question 36

Care strategies: | - Above all, avoid what?

Answer 36

CATASTROPHIC REACTIONS

Question 37

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

Answer 37

Catastrophic reactions

Question 38

What are important care strategies for AD patients/

Answer 38

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

Question 39

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

Answer 39

Face the person directly - DO NOT APPROACH FROM BEHIND

Question 40

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

Answer 40

Advocate for caregivers, and provide support group/resource information

Question 41

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

Answer 41

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

Question 42

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.

Answer 42

A, C, D