Exam 3-Cognition Flashcards
Cognition
Stages of
LOC
Higher order - Basic order - cognitive impairment (mild-mod-severe)
Oriented x 3
to place, time, person
Definition
Amnesia
short term memory deficit
Definition
Anomia
forgetting names of persons or things
Definition
Agnosia
forgetting purpose of familiar objects
Definition
Apraxia
forget how to perform activities
Definition
Aphasia
mute
Definition
Sundowning
sx’s of acute confusion, disorientation, hallucinations, mood swings. All in late day to night
Characteristcs of Delirium
- hallucinations
- delusions
- psychotic behaviors
Causes of Delirium
- post op (especially ortho)
- ICU
- intoxication
- substance abuse
- electrolyte disturbances
- dementia
- infection
- medications
CAM Tool
Used for what?
Diagnosis Delirium
CAM Tool
Need what parts of it?
A and B, and either C or D
CAM Tool
What is part A?
acute onset and fluctuating course
CAM Tool
What is part B?
Inattention
CAM Tool
What is part C?
Disorganized thinking
CAM Tool
What is part D?
altered level of conciousness
Delirium vs Dementia
Onset
Delirium: sudden
Dementia: gradual
Delirium vs Dementia
Course
Delirium: fluctuating
Dementia: progressive
Delirium vs Dementia
Duration
Delirium: days
Dementia: months to years
Delirium vs Dementia
LOC
Delirium: altered LOC
Dementia: alert
Delirium vs Dementia
Attention
Delirium: impaired
Dementia: normal in early stages, diminished in late
Delirium vs Dementia
Psychomotor Effects
Delirium: increased or decreased
Dementia: normal except in severe stages (agitated)
Tx for Delirium
3
- antipsychotics
- attention to nutrition/hydration
- reality orientation
Tx for Dementia
- antiacytlcholinesterase
- antipsychotics
- attention to nutrition/hydration
- validation therapy, music, art
Name the 3 therapies
- reality orientation
- validation
- reminiscence
Restraints
Requirements
8
- assessment of environment, patient, situation
- alternatives tried
- benefit outweighs risk
- ordered by physician
- monitored and reassessed
- skin integrity assessed
- ROM exercises performed
- document where, why, how long restraints were used
Restraints
Acronym
- Respond to present not past
- Evaluate potential for injury
- Speak w family
- Try alternatives first
- Reassess to determine success
- Alert physician and family of need
- Individualize restraint use
- Note important info in chart
- Time limit use
Restraints
Alternatives
- determine behavior pattern
- assess for pain
- rule out physical causes of agitation
- involve family
- reduce stimulation
- check environment for hazards
- use therapeutic touch
