Exam 2 - mental health & dementia Flashcards
what are the physiological changes in the brain of older adults?
- neuron loss
- brain atrophy
- dendrites atrophy
everything is lost or shrinking
where is neuron loss more pronounced?
cerebral cortex
what are the neurotransmitters that have a big impact on older adults?
- acetylcholine
- serotonin
- dopamine
why do nurses need a complete assessment (including lab work) with an older adult that exhibits MCI?
to rule out any causes of cognitive impairment
any form of mental health disorders is not normal
true
common mental disorders in late life
- depression
- anxiety
- mood disorders
- alcohol abuse
- alcohol dependence
what type of questions does a nurse ask when conducting a mental health assessment on an older adult?
- history of their ability to cope with stress
- availability of social support
- loss of loved ones
what are the components of an evaluation of an older adult’s mental health?
- cognitive function
- substance abuse
- suicide risk
what are interventions for older adults with mental illness?
- enhance resilience & resourcefulness
- enhance functional status & independence
- promote sense of control
- foster social supports & relationships
- educate about available resources
life events & stressors have a strong correlation to development of anxiety disorders
true
what situations is anxiety associated with?
- excessive healthcare use
- decreased physical activity & functional status
- substance abuse
- decreased life satisfaction
- increased mortality rates
anxiety is a common side effect for many drugs that older adults use
true
anxiety is hard to diagnose in older adults due to their denial
true
it is possible that coexisting medical conditions & certain medications can mimic anxiety & depression
true
pharmacological interventions for anxiety
- SSRIs
- short-acting benzodiazepines
- non-benzodiazepine anxiolytic agents
non-pharmacological interventions for anxiety
- CBT
- meditation
- yoga
how does depression present in older adults?
- low libido
- somatic complaints
- decreased energy
- social withdrawal
- preoccupation with death
- memory problems
- hypochondriasis
what is the most common mental illness among the older population?
depression
what are the assessment tools that nurses use for depression in older adults?
- Depression Screening Scale
- laboratory analysis
- medication review
- Geriatric Depression Scale
- functional assessment
- cognitive assessment
why do men have higher suicide rates than women?
they have the means to carry out their suicidal intentions
which population is most vulnerable to suicide?
old widowers
what are the questions to ask to assess suicide risk?
- Have you thought about killing yourself?
- How often do you have these thoughts?
- Do you have a plan to carry it out?
direct questions
where is substance detoxification best implemented?
inpatient setting
what is the assessment tool for delirium?
Confusion Assessment Method
what are the interventions for delirium?
- sensory enhancement
- ambulate twice a day
- nutritional & fluid enhancement
- pain management
what are the syndromes of dementia?
- aphasia
- apraxia
- agnosia
- disturbances in executive functioning
example of a non-benzodiazepine anxiolytic agent
Buspar
which type of drug is the last resort in treating anxiety?
benzodiazepine
what is the last resort in treating depression?
ECT
which population is more likely to abuse alcohol?
White men
what are the two types of Alzheimer’s disease?
- early onset
- late onset
characteristics of early onset AD
- starts around 30-60 years old
- genetic mutation of 3 genes
what are the stages of Alzheimer’s Disease?
- Preclinical
- Mild Cognitive Impairment
- Final Stage
characteristics of late onset AD
- starts at 60 years old
- combination of lifestyle, environmental factors, & genetic mutation
characteristics of preclinical stage (AD)
- lumbar puncture is indicated
- early cognitive decline (onset 5-20 years prior to obvious manifestations)
characteristics of mild cognitive impairment stage
- amnesiac
- no sense of personal space
- needs full-time assistance
- communication impaired
- risk for pneumonia
characteristic of final stage
Alzheimer’s Dementia fully manifested
what is the most common drug for AD?
Aricet
what is the MOA of Aricet?
slows progression of the onset of dementia
what is important for the perceptions of reality among patients with AD?
a patient’s reality is their own and must not be changed nor discouraged
why is reorientation unnecessary among patients with AD?
the brain is already deteriorating–it does not need to be corrected
what is the most inconvenient problem among patients with AD?
wandering
how can wandering be avoided?
- doorways must be disguised
- patients should never be left alone
- motion detector sensors
how many hours can a search team have in looking for someone with AD / dementia?
6-12 hours
what are the 4 roles of nurses for patients with dementia?
- magician
- detective
- carpenter (use of tools to individualize care)
- jester
what are the medications most commonly taken for anxiety?
- Ativan
- Celexa
- Xanax
- Buspar
syndrome of dementia includes at least one of these:
- aphasia
- apraxia
- agnosia
- disturbances in executive functioning
