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Psych Final > Geriatric Mental Health > Flashcards

Geriatric Mental Health Flashcards

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1
Q

positive attributes for social networking for geriatric patients

A

promote socialization and companionship
Elevating morale and life satisfaction
Buffering the effects of stressful events
Providing a confidant
Facilitating coping skills and mastery

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2
Q

Predisposition to depression

A

bereavement overload

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3
Q

most common causes of psychopathology in older adults

A

neurocognitive disorders

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4
Q

most common affective illnesses occurring after
middle years

A

depressive disorders

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5
Q

psychiatric illnesses in older adults

A

neurocognitive disorders
depressive disorders
schizophrenia
Delirium r/t structural brain disease, reduced capacity for homeostatic regulation,and impaired vision and hearing
Most anxiety disorders begin in early to middle adulthood
Personality disorders are uncommon among elderly
Sleep disorders are very common among elderly

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6
Q

Risk factors for institutionalization

A

Age
Health
Mental health status
Socioeconomic and demographic factors
Marital status, living arrangement, and informal support network
attitudinal factors

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7
Q

elder abuse risk factors

A

White female age 70 or older
Mental or physical impairment
Inability to meet daily self-care needs
Have care needs that exceed caretaker’s ability

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8
Q

psychological indicators of elder abuse

A

depression, withdrawal, anxiety, sleep disorders,
increased confusion, agitation

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9
Q

physical indicators of elder abuse

A

bruises, welts, lacerations, burns, punctures, evidence of
hair pulling, and skeletal dislocations and fractures

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10
Q

neglect indicators of elder abuse

A

consistent hunger, poor hygiene, inappropriate dress,
consistent lack of supervision, consistent fatigue or listlessness,
unattended physical problems or medical needs, or abandonment

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11
Q

indicators of elder sexual abuse

A

pain or itching in the genital area; bruising or bleeding in
external genitalia, vaginal, or anal areas; or unexplained sexually
transmitted disease

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12
Q

indicators of financial elder abuse

A

disparity between assets and satisfactory living conditions or
when the elderly person complains of a sudden lack of sufficient funds for daily living expenses

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13
Q

highest amount of suicides are those ___ and older

A

85

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14
Q

group at highest risk for suicide

A

white men experiencing loneliness, financial problems, physical illness, loss, and/or depression

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15
Q

PSYCH NURSING DIAGNOSES FOR ELDERLY

A

Complicated grieving
Risk for suicide
Powerlessness
Disturbed body image
Social isolation
Risk for trauma (elder abuse)

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16
Q

delirium symptoms

A

Difficulty sustaining and shifting attention
Extreme distractibility
Disorganized thinking
Speech that is rambling, irrelevant, pressured, and incoherent
Impaired reasoning ability and goal-directed behavior
Disorientation to time and place
Impairment of recent memory
Misperceptions about the environment, including illusions and hallucinations

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17
Q

delirium symptoms

A

Difficulty sustaining and shifting attention
Extreme distractibility
Disorganized thinking
Speech that is rambling, irrelevant, pressured, and incoherent
Impaired reasoning ability and goal-directed behavior
Disorientation to time and place
Impairment of recent memory
Misperceptions about the environment, including illusions and hallucinations
Disturbances in the sleep-wake cycle
Psychomotor activity that fluctuates between agitation and
restlessness and a vegetative state
State of awareness may range from hypervigilance to stupor or
semicoma
Sleep may fluctuate between hypersomnolence and insomnia
Vivid dreams and nightmares are common

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18
Q

Disturbances in the sleep-wake cycle
Psychomotor activity that fluctuates between agitation and
restlessness and a vegetative state
State of awareness may range from hypervigilance to stupor or
semicoma
Sleep may fluctuate between hypersomnolence and insomnia
Vivid dreams and nightmares are common

A

delirium

19
Q

delirium autonomic manifestations

A

Tachycardia
Sweating
Flushed face
Dilated pupils
Elevated blood pressure

20
Q

delirium predisposing factors

A

Systemic infections
Febrile illness
Metabolic disorders
Hypoxia and COPD
Hepatic failure or renal
failure
Head trauma
Seizures
Migraine headaches
Brain abscess or brain
neoplasm
Stroke
Nutritional deficiency
Uncontrolled pain
Burns
Heat stroke
Orthopedic and cardiac surgeries
Social isolation
substances

21
Q

progressive decline in cognitive ability in the presence of
clear consciousness

A

major neurocognitive disorder

22
Q

Impairment in cognitive functions
* Thinking, reasoning, memory, learning, speaking
Involves many cognitive deficits and significantly impairs social andoccupational functioning

A

neurocognitive disorder

23
Q

NCD symptoms

A

Impairment in abstract thinking, judgment, and impulse control
Conventional rules of social conduct often disregarded
Behavior may be uninhibited and inappropriate
Personal appearance and hygiene are often neglected
Language may or may not be affected
Personality change is common

24
Q

symptoms as NCD progresses

A

Aphasia
Apraxia
Irritability and moodiness, with sudden outbursts over trivial issues
Inability to care for personal needs independently
Wandering away from the home
Incontinence

25
Q

Alzheimers predisposing factors

A
  • Onset is slow and insidious
  • Course is generally progressive and deteriorating
  • Memory impairment is early and prominent feature
  • Degenerative pathology of the brain that includes atrophy and
    enlarged cerebral ventricles
  • Exact cause is unknown
26
Q

predisposing factors of vascular NCD

A
  • Hypertension
  • Cerebral emboli
  • Cerebral thrombosis
27
Q
  • Shrinking of the frontal and temporal anterior lobes of the brain
  • Previously called Pick’s disease
  • Exact cause is unknown, but genetics appears to be a factor
A

frontotemporal NCD

28
Q

most common neurobehavioral symptom following
head trauma

A

Amnesia

29
Q

Repeated head trauma can result in:

A

dementia pugilistica

30
Q
  • Similar to AD, but progresses more rapidly
  • Progressive and irreversible
  • May account for 25% of all NCD cases
A

NCD due to lewy body disease
* Appearance of Lewy bodies (proteins) in the cerebral cortex and brainstem

31
Q

common manifestations of NCD - lewy body disease

A
  • Depression
  • Parkinsonian features
  • Visual hallucinations
  • Delusions
32
Q
  • Loss of nerve cells located in the substantia nigra
  • Decrease in dopamine activity
A

NCD due to Parkinson’s disease

33
Q

common manifestations of NCD due to Parkinson’s disease

A
  • Involuntary muscle movements
  • Slowness
  • Rigidity
  • Tremor in upper extremities
34
Q

5 steps of NCD nursing assessment

A
  1. Type, frequency, and severity of mood swings, personality and
    behavioral changes, and catastrophic emotional reactions
  2. Cognitive changes, such as problems with attention span,
    thinking process, problem-solving, and memory
  3. Language difficulties
  4. Orientation to person, place, time, and situation
  5. Appropriateness of social behavior
35
Q

factors involved in NCD nursing assessment

A
  • Current/past medication usage, history of drug and alcohol use,
    exposure to toxins
  • Knowledge regarding the history of related symptoms or specific
    illnesses
  • Assessment for diseases r/t confusion, loss of memory, and
    behavioral changes
  • Neurological examination
  • Depression is the most common mental illness in the elderly
  • Often misdianosed
36
Q

wanted NCD nursing outcomes
the client:

A
  • Has not experienced physical injury
  • Has not harmed self or others
  • Has maintained reality orientation to the best of his or her capability
  • Discusses positive aspects about self and life
  • Participates in activities of daily living with assistance
37
Q

NCD nursing evaluation

A
  • Has the client experienced injury?
  • Does the client maintain orientation to time, person, place, and
    situation to the best of his or her cognitive ability?
  • Is the client able to fulfill basic needs? Have those needs unmet by
    the client been fulfilled by caregivers?
  • Is confusion minimized by familiar objects and structured, routine
    schedule of activities?
38
Q

treatment modalities for delirium

A
  • Determination and correction of the underlying causes
  • Additional attention must be given to fluid and electrolyte status,
    hypoxia, anoxia, and diabetic problems
  • Staff to remain with client at all times to monitor behavior and provide
    reorientation and assurance
  • Room with low stimulus level
  • Low-dose antipsychotic agents can relieve agitation and aggression
39
Q

medications for treatment of NCD

A
  • Cholinesterase inhibitors: treatment of mild to moderate cognitive impairment in AD
  • Physostigmine (Antilirium)
  • Donepezil (Aricept)
  • Rivastigmine (Exelon)
  • N-methyl-D-aspartate (NMDA) receptor antagonist: treatment of moderate to severe
    AD
  • Memantine (Namenda)
  • Pimavancerin (Nuplazid): treatment of hallucinations and delusions in Parkinson’s disease
    psychosis
  • Risperidone (Risperdal)
  • Olanzapine (Zyprexa)
  • Quetiapine (Seroquel)
  • Ziprasidone (Geodon)
40
Q

medications for treatment depression from NCD

A
  • Selective serotonin reuptake inhibitors
  • First-line: favorable side effect
    profile
  • Tricyclic antidepressants
  • Often avoided: anticholinergic and
    cardiac side effects
  • Trazodone (Desyrel)
  • Good choice for insomnia
  • Dopaminergic agents
  • Helpful in treating severe apathy
41
Q

treatment meds for NCD insomnia

A
  • Temazepam (Restoril)
  • Triazolam (Halcion)
  • Zolpidem (Ambien)
  • Zaleplon (Sonata)
  • Ramelteon (Rozerem)
  • Eszopiclone (Lunesta)
  • Trazodone (Desyrel)
  • Mirtazapine (Remeron)
42
Q

concerns with treatment methods for insomnia

A

daytime sedation
cognitive impairment
paradoxical agitation

43
Q

treatment meds for anxiety with NCD

A
  • Chlordiazepoxide (Librium)
  • Alprazolam (Xanax)
  • Lorazepam (Ativan)
  • Oxazepam (Serax)
  • Diazepam (Valium)

high risk for falls and oversedation

Psych Final (2 decks)

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