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NU 350 Test 2 > Impaired Cognition/Alzheimer's > Flashcards

Impaired Cognition/Alzheimer's Flashcards

1
Q

Dementia characteristics?

A 
Loss of memory
Language
Judgment 
Orientation 
Reasoning 
Attention
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2
Q

How old are older clients?

A

Over 65

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3
Q

What is the etiology of dementia?

A 
Neurodegenerative Condition (AD) is most common
Vascular disorders - second leading cause (stroke)
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4
Q

Risk factors for dementia

A

Aging = greatest risk
Family Hx
Diabetes

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5
Q

Delirium comes on

A

abruptly

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6
Q

Sometimes dementia is mistaken for

A

Depression

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7
Q

What are other risk factors for dementia?

A

obesity, smoking, cardiac dysrhythmias, CAD, hypertension, hypercholesterolemia

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8
Q

Dementia clinical menifestations are

A

Insidious or abrupt

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9
Q

What is the most common form of dementia?

A

Alzheimer’s

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10
Q

What is the characteristic of alzheimer’s

A

chronic, progressive, degenerative-most common form of dementia

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11
Q

What is early on set alzheimer’s disease

A

Early-onset AD-people younger than 60 years old

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12
Q

Early-onset AD is a ______ % other family members will be diagnosed

A

50%

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13
Q

What is late-onset AD?

A

Late-onset AD-people older than 60 years old

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14
Q

Familial Alzheimer’s disease [FAD]

A

inheritance type. Most have early onset

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15
Q

What are the changes in the brain structure?

A
  1. Amyloid plaques
  2. Neurofibrillary tangles
  3. Loss of connections b/t neurons
  4. Death of neurons
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16
Q

Overproduction of ________ is a risk factor for AD

A

amyloid protein

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17
Q

What are the 3 stages of AD?

A

Mild
Moderate
Severe

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18
Q

What is the rate of progression for AD

A

3 to 20 yrs

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19
Q

Can you stop the progression of the disease.

A

No.

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20
Q

Alzheimer’s is really common is pts that have had

A

Brian injuries

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21
Q

How is AD diagnosed. The only true way.

A

autopsy. Before death it is diagnosed with process of elimination.

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22
Q

Early signs and symptoms.

A

Forgetfulness (short-term)

Memory

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23
Q

Mild:

A

Forgetfulness

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24
Q

Moderate:

A

agitated, trouble with recognition

Developmental (3yrs)

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25
Q

Severe:

A

not being able to ALDS, immobile, incontinence, feeding

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26
Q

Are women or man more likely to have AD

A

women

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27
Q

The average lifespan after diagnosis is

A

4 to 8 yrs

28
Q

What is retrogenesis?

A

The decline of life. In reverse order. Going back to infancy.

29
Q

Seen pts with lower

A

Socioeconomic status and lower education level

30
Q

Diagnostic criteria

A

Preclinical stage
Mild cognitive impairment
Dementia

31
Q

During preclinical stages

A

look at the plaque. CT scan and MRI

32
Q

Midl cognitive impairment

A

Second stage, forgetting, troubled higher thinking, and executive cognition decline

33
Q

What is the nursing goal for AD?

A

Controlling undesirable behaviors and providing support for the family/caregiver.

34
Q

Drug therapy for decreased memory and cogntion

A

Donepezil (Aricept)
Rivastigmine (Exelon) Patch
Galantamine (Razadyne)
Memantine (Namenda)

35
Q

Drug therapy for depression

A

Sertraline (Zoloft)
Citalopram (Celexa)
Trazodone (Desyrel) for sleep also

36
Q

Drugs for behavioral problems

A

Risperidone (Risperdal)
Olanzapine (Zyprexa)
Quetiapine (Seroquel)

37
Q

Drug therapy for sleep disturbance

A

zolpidem (ambien)

38
Q

Drugs are not a cure but to ______ behaviors

A

control

39
Q

Important subject data to find out?

A 
Orientation and alert 
Can you tell me what day it is?
Who are you?
Full name?
What year were you born in?
Who is this who came to visit with you today? (Relevant to stage)
40
Q

Important objective data to find out?

A

Agitated
Frustration
Crying (antidepressants)
Look at the appearance

41
Q

What are some nursing diagnoses?

A

Impaired memory
Self-neglect
Risk for injury
Wandering

42
Q

What is a goal for the pts

A

Keep safe

43
Q

What is a goal for the caregiver

A

Stay healthy

44
Q

Implementations

A

Health Promotion
Acute Intervention
Ambulatory and home care.

45
Q

What are some health promotions

A 
Crossword puzzles 
Not harmful supplements 
Read a lot
Learn new skills
Exercise regularly (30 q 3 days)
Social activités are important
46
Q

What are signs of depression?

A

Loss of interests
Insomnia
Appetites

47
Q

What are some acute interventions?

A

hospitalization
Hospice (q 6 months) gives family a break
Respite: Staying in the hospital.

48
Q

What is the most frequent complication of hospitalization in older pts?

A

Delirium

49
Q

What is delirium?

A

acute mental confusion, temporary, life-threatening.

50
Q

Clinical manifestations of delirium?

A

Agitation
Hallucinations
Hyperactivity
Lethargy

51
Q

Acute delirium?

A

Pts that wakes up from surgery, and pulls off all lines.

52
Q

What time frame does delirium develop over?

A

2-3 days

53
Q

Early signs in delirium?

A

Look at latest labs
Surgery
Infection

54
Q

What is the treatment for delirium?

A

Treating the physiological symptoms. Temp, etc.

55
Q

What is confabulation?

A

Making up stories.

Loss of memories so they try to fill in the gaps.

56
Q

What is preservation?

A

Repeating things multiple times.

57
Q

What is executive functioning?

A

Planning organizing thoughts in the brain.

58
Q

What is aphasia?

A

Loss of language and ability to speak

59
Q

What is apraxia?

A

Not able to move. ADLS

60
Q

What is agnosia?

A

Not able to identify familiar objects or people

61
Q

What is hyperorality?

A

Excessively putting things in the mouth. Pleasure

62
Q

What is hypermetamorphosis?

A

Wanting to touch everything

63
Q

What is sundowning?

A

getting crazy though the night.

64
Q

What is Agraphia?

A

Losing ability to Writing, reading,

65
Q

What is retrogenesis?

A

Reverting back to infancy. Reverse developmental stages.

NU 350 Test 2 (4 decks)

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