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From Flashcardlet first semester > Exam 8 COGNITION > Flashcards

Exam 8 COGNITION Flashcards

0
Q

Awareness

A

The degree a person is aware of their surroundings

must have awareness to have cognition

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1
Q

Cognition

A

The way we think, learn and make judgements.
Intellectual functioning-thinking, reasoning, use of language
——controlled by the cortex of the brain

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2
Q

Disorders that affect cognition and awareness

A

Anything that interrupts cognition - impaired thinking

  • inadequate blood flow
  • ventilation
  • pulmonary circulation
  • cardiac
  • abnormal HGB levels - leads to hypoxia
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3
Q

Delirium

A
  • Rapidly occurring, temporary, short term cognitive alterations
  • may be anxious
  • confused, disorientated, agitated
  • resolves when the cause resolves
  • like a high fever with a child - when the fever goes away the symptoms of delirium goes away
  • With Elders
  • —-Present with dehydration
  • —-hospital psychosis
  • —-Sundowners
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4
Q

Dementia

A
  • Permanent Disorder
  • Based on more serious damage to the brain
  • Alzheimer’s
  • Problems with memory
  • problems with judgement, abstract thinking
  • changes in personality
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5
Q

3 Types of cognitive problems that occur with Delirium and Dementia

A
  • Hallucinations
  • Illusions
  • Delusions
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6
Q

Cognitive Disorders

A 
Delirium
Dementia
Hallucinations
Illusions
Delusions
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7
Q

Hallucinations

A

Seeing or hearing something that is not there.
EX: I see a pink elephant
EX: Hearing voices

Visual, Auditory or Olfactory

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8
Q

Illusions

A
  • Misinterpretations of real sights, sounds or smells.

- See a dog outside and think it is a Tiger

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9
Q

Delusions

A

Persistent false psychotic belief regarding self, or persons or objects outside self.

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10
Q

Alterations in Awareness

A
  • Consciousness - able to talk and respond to stimuli - Alert
  • Lethargy/ Somnolence/ Drowsiness - Sleepy appears to be resting- dozing can be with stimuli
  • Stupor - Sleepy needs continual stimuli to stay awake
  • Light Coma / Semi Comatose - no longer responds to verbal stimuli - may respond to physical stimuli
  • Deep Coma/ Comatose - Totally unresponsive- responds to severe pain- no voluntary movement
  • ——–protective reflexes are lost- gag, cough and blink are gone.
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11
Q

Assessment for Cognitive problems

A
  • Interview - client and family
  • —-If ever any problems with interview always go back to the orientation (person, place, time)
  • Physical
  • —-Grooming and hygiene
  • Highest level to lowest level
  • —-1.mental status, questions about physical problems - habits
  • —-2.Vital signs
  • —-3. Cranial nerve function
  • —-4. Sensory function
  • —-5. Motor function
  • —-6. Reflexes - hand grips
  • Vital signs
  • —-changes with pulse pressure can indicate increased innercranial pressure
  • —-Blood pressure meds can cause this too
  • Assessment of level of consciousness/awareness—-? Alert
  • Orientation - person, place, and time
  • —-always go back to orientation if something is wrong
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12
Q

Assessment of Cognition

A
  • Attention span
  • —-serial 7s…….world backwards
  • Memory
  • —-what did you eat for breakfast
  • Judgement
  • —-See someone pick pocket- what would you do?
  • Abstract thinking
  • —-A rolling stone gathers no moss
  • Emotional state
  • —-Stressors
  • Thought processes
  • —-? disruptive thoughts and if they are able to control disruptive thoughts
  • Perception
  • —-Do they hear voices? Do they smell strange odors?
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13
Q

MMSE

A
  • Orientation
  • —-Person, place, time
  • Registration
  • —-Name 3 objects - later ask the patient what 3 objects you said
  • Attention and calculation
  • —-5 - serial sevens
  • Recall
  • —-3 - registration recall
  • Language
  • —-2-naming a pencil and a watch
  • Total points

Praxis- planned coordinated movement

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14
Q

Aphasia

A

Impairment of language function due to brain involvement.

  • Expressive
  • Receptive
  • Global
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15
Q

Dysarthria

A

Interference with annunciation and articulation

Impairment of motor nerves to muscles of speech

16
Q

Nursing Diagnosis for Cognitive problems

A 
High risk for Injury
Altered Health maintenance
Altered thought process
Self-care deficits
Anxiety
17
Q

Planning and Implementation with cognitive problems

A
  • –Reality orientation
  • —-Adults benefit from this
  • –Validation therapy
  • —-Irreversible cognition impairment
18
Q

Care for the client with speech impairment

A
  • Need a way to communicate with the patient
  • Speech therapist is your friend
  • Communication
  • –may be agitated, depressed or frustrated
  • Do not shout
  • Don’t talk down to them
  • –Use simple words
  • Maintain eye contact
  • —–speak slowly and distinctly
  • Follow speech therapist plan to help relearn speech
  • A quiet well organized environment is best
  • Simple symbol board
  • Dry erase board
19
Q

Care of a client with decreased awareness

A
  • Protect from Injury
  • —-heating pads
  • —-do not inject or stick side effected
  • —-bed in low position
  • Supplement deficiencies
  • Assess level of Awareness
  • —Glasco Coma Scale is best way to do this
  • —-Coma patient - tell them you are going to touch them
20
Q

Types of Aphasia

A
  • Expressive
  • REceptive
  • Global
21
Q

Expressive Aphasia

A
  • Problems expressing correct word for objects although understanding is intact
  • EX: client may call a chair a television but they know that it is a chair
22
Q

Receptive Aphasia

A

Problem understanding spoken or written word.

Have difficulty following directions.

23
Q

Global Aphasia

A

Refers to having a problem with both Expressive and Receptive Aphasia
Very difficult to communicate with this patient

24
Q

Reality Orientation

A
  • Adults benefit from this
  • Calendar with correct date
  • Clock with correct time
  • Pictures of Family
  • Comforting touch

used with Delirium

25
Q

Validation Therapy

A
  • Used with Dementia
  • I want to see my mother (when their mother is dead)
  • ——-Ask them to tell you about their mother
  • ——-Do not agree with a confused client
  • ——-Do not argue with them
  • Use short directions
  • —-raise your arm
  • Frequent observations - frequently check on them
  • used for irreversible cognitive impariment
26
Q

Dysphasia

A

Difficulty in swallowing

27
Q

Depression

A

Being in an unfamiliar environment

28
Q

Delusion

A

I went to see a James Bond movie and I think I am a Bond girl

29
Q

Hallucinations

A

There is spiders all over the wall lets kill them.

30
Q

Illusion

A

See a garden hose in the yard and think it is a snake!

31
Q

Pain Response

A
  • Talk louder and louder
  • put thumb under—–press in
  • pinch or squeeze the muscle b/t neck and shoulder
  • sternal rub
  • If no response after 20-30 seconds do not keep doing it.
32
Q

Conscious States

A 
Delirium
Dementia
Confusion
Normal Consciousness
Somnolence
33
Q

Unconscious States

A

Asleep
Stupor
Coma
Vegetative State

From Flashcardlet first semester (43 decks)

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