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nursing care of older adult > Exam 1: neuro > Flashcards

Exam 1: neuro Flashcards

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1
Q

At least ___ of 9 diagnostic tests must be met to be categorized as depression

A

5

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2
Q

Risk of suicide is high in which groups of people with depression?

A

white and asian-american men

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3
Q

what are some common meds used to treat depression?

A

-remeron, effexor, paxil, wellbutrin

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4
Q

dementia is a ___, not a disease

A

syndrome

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5
Q

Most common form of dementia is ___, which constitutes about ____% of cases

A

Alzheimer’s; 50-60%

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6
Q

what are the 4 main types of dementia?

A

alzheimer’s, fronto-temporal,vascular, dementia with lewy bodies,

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7
Q

2 main types of AD disease?

A

familial, nonfamilial

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8
Q

AD type: Only 5-10% of cases
Early onset
Gene mutation

A

familial

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9
Q

AD type: Role of apolipoprotein E (ApoE)

Complex gene/environment interactions

A

nonfamilial

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10
Q

patho of AD

A

amyloid plaques & abnormal deposits of proteins, neurofibrillary tangles, loss of synaptic connections, cell death /neuron (brain atrophy - shrinks)

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11
Q
  • 5th leading cause of death in age >65
A

AD

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12
Q

what is the incidence of AD gender-wise/ethnicity?

A

women get it more, b/c they live longer. higher in African-american and hispanics

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13
Q

Impairment of language

A

aphasia

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14
Q

Inability to perform purposeful acts or manipulate objects

A

apraxia

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15
Q

Inability to recognize familiar objects or persons

A

agnosia

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16
Q

Loss of memory

A

amnesia

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17
Q

what are the 4 A’s related to AD?

A

amensia, agnosia, apraxia, aphasia

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18
Q

3 main causes of death for AD patients?

A

pneumonia (aspiration), malnutrition, and dehydration

19
Q

med for AD:Increases levels of ACh (involved in memory and judgment)
Maintains memory skills for a period of time

Useful only in early stages

A

Cholinesterase Inhibitors

20
Q

what are some meds given for patients with AD?

A

aricept, exelon, razadyne, cognex

21
Q

what is the precaution needed for cognex(AD med)?

A

must monitor liver enzymes

22
Q

med for AD:Regulates activity of glutamate
Used more often in middle to late stage AD
May combine with a cholinesterase inhibitor

A

memantine (namenda)

23
Q

what are the alternative therapies to AD?

A

ginko biloba(vasodilation), huperzine A(cholinesterase inhibitor), Vitamin A

24
Q

caused by reduced or blocked blood flow to the brain

A

vascular dementia

25
Q

Treatment of Vascular Dementia-besides meds

A

Lower blood pressure
Reduce cholesterol
Prevent blood clotting
Control blood glucose

26
Q

meds used to treat vascular dementia-

A

Anticoagulants

Alzheimer’s medications

27
Q

which form of dementia has Parkinsonian sx?

A

DLB dementia with lewy bodies

28
Q

Most striking symptom of DLB (dementia with lewy bodies)

A

visual hallucinations or delusions

29
Q

this disease: Extreme sensitivity to neuroleptic meds (extreme agitation, even death)* no anticholinergic

A

DLB

30
Q

Progressive, degenerative, hereditary neurologic disease (rare)
S/S usually begin in 30s-40s
Child of affected person has 50% chance of inheritance
1 in 10,000 men and women

A

Huntington’s

31
Q

Poor prognosis: death usually occurs due to heart failure, pneumonia/infection, fall, or choking

A

Huntington’s

32
Q

Slow progression (over 10-20 yrs) of:
Involuntary choreiform movements(writhing)
Speech problems
Dementia

A

Huntington’s

33
Q

Rare brain disorder
Progressive degeneration of the gray matter of the brain (spongiform degeneration)
Cause: abnormal glycoprotein
Onset usually around age 60

A

cruetzfeldt-jacob disease

34
Q

Unilateral facial paralysis
Sudden onset
Dysfunction of CN VII

A

Bell’s Palsy

35
Q

Treatment – medications (steroids), artificial tears, sunglasses, facial massage (for pain), soft diet

A

Bell’s

36
Q

Etiology unknown:

Possibly vascular ischemia, viral disease (herpes simplex, herpes zoster), autoimmune disease, or combination

A

Bell’s

37
Q

another name for Trigeminal Neuralgia

A

tic douloreux

38
Q

Chronic pain condition that affects CN V
Sudden, severe facial pain lasting a few seconds to minutes: stabbing and lightning-like
Etiology: likely due to vascular pressure

A

TIC douloreux (trigeminal neuralgia)

39
Q

what are some meds used for trigeminal neuralgia?

A

carbamazepine (Tegretol)
Dilantin
Neurontin
Lioresal

40
Q

Assist w/minimizing episodes of pain
Get creative re: ways to maintain hygiene w/o the typical means
Ex., use cotton to wash face, rinse mouth with mouthwash vs. brushing
Keep bathing water & beverages/food room temp

A

trigeminal neuralgia

41
Q

Abnormal increase in CSF in the brain
Occurs if flow of CSF in brain/spinal column blocked
Ventricles enlarge, creating pressure on brain tissue
Can occur at any age, more common in elderly
May result from head trauma, infection, tumor, complications from surgery, subarachnoid hemorrhage; unknown.

A

Normal Pressure Hydrocephalus

42
Q

what is the classic triad for pts. with normal pressure hydrocephalus?

A

-Progressive mental impairment & s/s dementia
-Impaired gait
General slowing or feeling “stuck” common
-Impaired bladder control leading to urinary frequency &/or incontinence

43
Q

Surgical placement of shunt to drain excess CSF into abdomen (reabsorbed)
Brain then returns to normal size

A

normal pressure hydro.

nursing care of older adult (3 decks)

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