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Nursing 120 > Exam 5 - Cognition and Neuro pt. 1 > Flashcards

Exam 5 - Cognition and Neuro pt. 1 Flashcards

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1
Q

what are the different types of dementia?

A

primary and secondary

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2
Q

what is primary dementia?

A

organic brain disease

untreatable

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3
Q

what is secondary dementia?

A

caused by or related to another condition

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4
Q

what is the most common death for those with alzheimers?

A

pneumonia aspiration

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5
Q

what are the 3 types of pathophysiology for alzheimers disease

A

neurofibillary tangles
neuritic plaques
shrinkage and death of neurons

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6
Q

what are the neurofibrillary tangles

A

hair like protein fibers tangled together like yarn

INSIDE CELLS

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7
Q

what are neuritic plaques

A

made of a protein core called beta
amyloid surrounded by debris from degenerating neurons
outside neurons near synapse

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8
Q

what is the shrinkage and death of neurons and how does it cause AD

A

greater significance than plaques and tangles

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9
Q

what neurotransmitter is decreased in AD

A

acetylcholine (but not the cause of AD)

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10
Q

what are the neurotransmitters involved in AD

A

norepinephrine
serotonin
dopamine
amino acid glutamate

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11
Q

how is norepinephrine affected in alzheimers

A

slows everything down

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12
Q

how is serotonin affected in alzhemiers

A

sleep too much during day and sleep too little at night

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13
Q

how is changes in dopamine affected in alzheimers

A

muscles, cognition, motivation, ability to process pain all effected

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14
Q

what does increased amino acid glutamate do?

A

kill cells

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15
Q

etiology of AD

A

unknown

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16
Q

risk factors of AD

A 
less education
previous brain injury
down syndrome
65+
smoking and family history
herpes
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17
Q

diagnostic tests for AD

A

brain biopsy

diagnosis by exclusion

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18
Q

what are the stages of AD

A

1-3

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19
Q

what is stage 1 of AD

A 
memory loss (short term)
lack of spontaneity 
subtle personality changes
disorientation to time and date
may forget to eat
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20
Q
  1. Impaired cognition and abstract thinking
  2. Restlessness and agitation
  3. Wandering, “Sundown syndrome”
  4. Inability to carry out ADLs
  5. Impaired judgment
  6. Inappropriate social behavior
  7. Lack of insight, abstract thinking
  8. Repetitive behavior
  9. Voracious appetite

all are examples of what stage of AD

A

stage 2

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21
Q

anomia is what? and what stage is it in for AD?

A

inability to recall names or objects - 2

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22
Q
  1. Also called the terminal stage
  2. Emaciation, indifference to food
  3. Inability to communicate
  4. Urinary and fecal incontinence
  5. Seizures
  6. Total loss of ability to care for self

all are examples of what stage of AD

A

stage 3

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23
Q

how long does each AD stage last?

A 
1 = 2-4 years
2= several years
3 = 1-2 years, terminal stage
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24
Q

what is the treatment for AD

A

no meds cure, but slow progress
emotional and educational support to patient and caregivers
behavior interventions

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25
Q

what is the prevention of AD

A 
bilingualism 
activity
mild to moderate consumption of alcohol
mediterranean diet
living with companion or pet
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26
Q

what drugs should be used for AD

A

cholinergic drugs

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27
Q

produce actions which stimulate or mimic actions of parasympathetic nervous system

A

cholinergic drugs

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28
Q

is cholinergic drugs direct or indirect?

A

direct action and mimic AcH

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29
Q

what does acetylcholine do?

A

for memory and motor control

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30
Q

when is acetylcholine increased?

A

parkinsons and depression

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31
Q

what is acetylcholinerase?

A

enzyme that destroys acetylcholine

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32
Q

when is acetylcholinerase useful?

A

inhibiting properties utilized when a med wants more ACH as desired result

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33
Q

what does serotonin do?

A

regulates sleep and sensory perception helps with EPS and limbic system

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34
Q

when is serotonin increased and decreased

A

increased during mania and anxiety

decreased during depression

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35
Q

what does norepinephrine do?

A 
regulates mood, 
cognition, 
perception, 
locomotion, 
cardiovascular function/ CNS & PNS sympathetic
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36
Q

when is norepinephrine increased/decreased?

A

during mania and anxiety

decreased during norepinephrine

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37
Q

what does dopamine do?

A 
movement
cognition, 
motivation, 
pleasure, 
pain processing, 
other/limbic system, 
PNS/sympathetic, 
hypothalamus
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38
Q

when is dopamine decreased

A

during parkinsons

39
Q

what does gamma do or GABA

A

regulate neuronal excitability

muscle tone/cns

40
Q

what med is related to GABA

A

epilepsy control

41
Q

what does glutamate do?

A

work with GABA and CNS

42
Q

what effect does anticholinergic drugs have on the AD patient

A

it may speed up progression

risk vs benefit

43
Q

what does anticholinergic drugs do?

A

inhibit the breakdown of the enzyme acetylcholinerase

44
Q

what are cholinesterase inhibitors

A

block degradation of acetylcholine by inhibiting acetylcholinervse

45
Q

what are the cholinesterase inhibitor medication

A

tacrine (cognex) and donezipil (aricept)

46
Q

tacrine cautions

A

client with hepatic dysfunction/not used much due to this

47
Q

what cholinesterase drugs are used the most

A

donezipil (aricept)

48
Q

what are side effects of aricept

A 
nausea
vomitting
diarrhea
bradycardia
cholinergic effects
49
Q

what are the serious adverse for aricept or donezipil

A

resp depression

seizures

50
Q

what is the newer therapy for AD

A

memantine (nemanda)

51
Q

what does nemanda do?

A

shields brain from excess glutamate damage

52
Q

side effects of nemanda

A

dizziness, headache
confusion
constipation

53
Q

how long does it take for nemanda to work

A

several weeks

54
Q

what shouldnt be used for AD treatment anymore

A

estrogen

55
Q

what meds slow progress

A 
NSAIDs
vitamins(vit E)
antidepressants
antianxiety
antipsychotic
56
Q

how to antidepressants slow AD

A

decrease depression
enhance social function
improve appetite and sleep

57
Q

what are adverse drug reactions to antidepressants

A

ortho hypo

58
Q

what adverse drug reactions happen with tricyclic acid

A

sedation

anticholinergic

59
Q

what adverse drug reactions happen with SSRI

A

nerovusness
agitiation
insomnia
irritability

60
Q

how are anti anxiety helpful with AD

A

help with sundowning

help with insomnia

61
Q

adverse drug reactions for anti anxiety

A

drowsiness
dizziness
fatigue
slow reaction

62
Q

what is toxicity for anti anxiety meds?

A

loss of coordination

speech difficulty

63
Q

antipsychotics help relieve behavioral issues for AD, but what are their adverse effects?

A

ortho hypo
cholinergic effects
sedation
extrapyramidial symptoms

64
Q

what are extrapyramidal symptoms

A

acute dystonia reactions

65
Q

what does extrapyramidal symptoms involved

A

eyes
jaw
neck

66
Q

treatment for EPS

A

anticholinergic

antihistamine

67
Q

what med is helpful for EPS

A

congentin

68
Q

what are tardive dyskinesia

A

bizaare facial and tongue movement

stiff neck

69
Q

when does EPS and tardive happen

A

eps within days of treatment

tardive within 3 months

70
Q

treatment for EPS

A

dont do antiparkinsons anymore and reduce neuroleptic

benzo, clonidine and propanol usually help

71
Q

what is complementary and alt therapy for AD

A

DHEA
gingko biloba
CO Q10

72
Q

what is DHEA

A

precursor to androgen and estrogens

73
Q

what is gingko biloba

A

natrual herbal antiinflammatory and antioxidant

74
Q

what is CO Q10

A

antioxidant in our body

75
Q

alexia

A

inability to see words or read

76
Q

agnosia

A

inability to interpret sensations and recognize things

77
Q

apraxia

A

inability to carry out fine motor skills

78
Q

what is dysarthria

A

slurred slow speech that is difficult to comprehend and make sense of

79
Q

expressive aphasia

A

inability to produce language

80
Q

gloabal aphasia

A

effects for expressive and receptive language

81
Q

what is receptive aphasia

A

or wernicke’s

inability to understand language

82
Q

parasympathetic nervous system

A

rest and digest

83
Q

sympathetic nervous sytem

A

fight or flight

84
Q

what kind of receptors do the parasympathetic nervous system have

A

cholinergic

85
Q

what kind of receptors does sympathetic have?

A

adregenic

alpha and beta

86
Q

what is the neurotransmitter for the parasymp?

A

acetylcholine

87
Q

what is the neurotransmitter for the sympathetic?

A

dopamine

norepineprhine

88
Q

what do anticholinergic meds do

A

go from para symp to sympathetic

89
Q

Dilate pupils, inhibit saliva, accelerate heart rate, dilates bronchi, inhibits peristalsis and secretion, inhibits bladder contraction all are a part of what?

A

sympathetic nervous system

90
Q

Mental process by which knowledge is acquired and processed including is what?

A

cognition

91
Q

Assess “What is happening?”,
Try to reorient them – it is not chronic,
Safety measures,
Make sure they are having enough sleep, Manage pain as best as we can,
Reduce stimuli,
What can we remove that is bothering them (ex: catheters, too much tubing, BP cuff?), Monitor electrolytes and hydration all are assessments for what?

A

delirium

92
Q

Acquired, persistent intellectual impairment with compromised function in multiple spheres of mental activity?

A

dementia

93
Q

What are the memory impairements of dementia?

A

apraxia
aphasia
agnosia
loss of executive function

94
Q

What is loss of executive functioning?

A

incontinence

Nursing 120 (21 decks)

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