L6- Delirium & Dementia Flashcards
Which nursing interventions is priority for the management of delirium?
Select one:
a.
Providing psychological support through cognitive and social stimulation
b.
Giving the client a clock, a watch and calendars to provide the client with temporal orientation
c.
Giving the client low-dose oxygenation and maintaining his or her fluid and electrolyte balance
d.
Reducing noise and placing familiar objects in the client’s environment
c.Giving the client low-dose oxygenation and maintaining his or her fluid and electrolyte balance
Which exemplify appropriate communication techniques for dealing effectively with people with dementia?
Select one:
a.
When the person forgets something, remind him or her not to forget next time.
b.
Ask open-ended questions so the person feels he or she can make choices.
c.Maintain good eye contact and use a relaxed and smiling approach.
d.
For people in the later stages of Alzheimer disease, talk as you would to a child.
c.Maintain good eye contact and use a relaxed and smiling approach.
A nurse develops a plan to addressing dementia-related behaviors in an older adult with dementia. All of the following interventions should be included in this plan except?
Select one:
a.
Test the client’s memory with each conversation.
b.
Place pictures of familiar people in every visible places.
c.
Implement regular rest periods.
d.
Maintain a clutter-free environment.
e.
Lay out clothing in the order in which the items are to be donned.
a.
Test the client’s memory with each conversation.
An 80-year-old client was referred to a neurologist after several months of worsening cognitive deficits and has subsequently been diagnosed with Alzheimer disease. Which statement by the nurse to the client’s family demonstrates appropriate use of terminology.
Select one:
a.
“It’s very difficult and stressful when a loved one becomes senile.”
b.
“We always try our best to foster wellness in persons who have dementia.”
c.
“Even though your parent is demented, we will do all we can to promote his quality of life.”
d.
“This form of organic brain syndrome is a common health problem in the ninth decade of life.”
b.
“We always try our best to foster wellness in persons who have dementia.”
A client was diagnosed 3 years ago with a cognitive impairment, a condition that worsened over the next several months and which culminated in his recent death. An autopsy revealed numerous infarcted brain regions resulting from vessel occlusions. This client most likely suffered from which type of dementia?
Select one:
a.
Vascular dementia
b.
Alzheimer disease
c.
Lewy body dementia
d.
Frontotemporal degeneration
a.
Vascular dementia
A long-time resident of an assisted living facility has just been diagnosed with Alzheimer disease. A nurse who provides care at the facility has remarked to a colleague, “It’s a real shame, but at least she’ll never know what’s happening to her.” Which fact should underlie the colleague’s response?
Select one:
a.
Certain types of dementia are occasionally marked by older adults’ awareness of their disease.
b.
An awareness of dementia is an indication that the condition is either latent or resolving.
c.
Older adults with Alzheimer disease and other dementias rarely have insight into their cognitive deficits.
d.
Many persons with dementia are acutely aware of the fact that they are experiencing a cognitive deficit.
d.
Many persons with dementia are acutely aware of the fact that they are experiencing a cognitive deficit.
A gerontological nurse has been providing ongoing care for an older adult who has a diagnosis of dementia. Which goal should the nurse prioritize when conducting ongoing assessment of this client?
Select one:
a.
Identifying factors affecting the client’s functioning and quality of life
b.
Identifying strategies that can be used to cure the client’s dementia
c.
Determining whether the client has Alzheimer disease, Lewy body dementia or frontotemporal lobe dementia
d.
Identifying genetic or lifestyle factors that may have contributed to the client’s dementia
a.
Identifying factors affecting the client’s functioning and quality of life
A 74-year-old client is diagnosed with mild Alzheimer disease. He has no other noted health issues. When speaking with the nurse, he expresses concern regarding the progression of his disease. Which statement by the nurse is most appropriate?
Select one:
a.
Yes, progression is usually fairly fast, you might want to start making plans.
b.
As you have no other health issues, the progression is usually gradual.
c.
The medications stop the progression of the disease.
d.
We never know how fast Alzheimer disease will progress.
a.
Yes, progression is usually fairly fast, you might want to start making plans.
A nurse councils a care partner of a client with dementia. The care partner states, “He fights me when I try and bath him; he hasn’t had a shower in 2 months!” Which response by the nurse is most appropriate?
Select one:
a.
“He wants to feel he has a choice. How do you get him to shower?”
b.
“Whatever worked before should work now.”
c.
“I would just put him in there, he needs to be clean.”
d.
“I hear your frustration. What other ways have you tried to assure he is clean?”
d.“I hear your frustration. What other ways have you tried to assure he is clean?”
A nurse assesses a 91-year-old client in long-term care healing from bilateral broken legs caused in a fall. Today, the client developed new onset confusion and combativeness. Which set of factors must the nurse investigate as possible sources of this mental status state?
Select one:
a.
Social separation, positional pain
b.
Loneliness, immobility
c.
Medication interactions, urinary tract infection
c.Medication interactions, urinary tract infection
3 D’s of cognitive impairment in older adults
-delirium
-dementia
-depression
Delirium
-acute confusion characterized by sudden and temporary changes in cognition, attention, memory and perception
Cause of Delirium
Unknown, thought to be disturbances in the neurostansmitters with multifactorial causes
Prevalence of Delirium
*22% IN COMMUNITY-LIVING PEOPLE
* 15% TO 70% IN LONG-TERM CARE RESIDENTS
* 11% TO 33% UPON ADMISSION TO HOSPITAL
* + 5% TO 35% DELIRIUM DEVELOPING AFTER ADMISSION
* 80% OR MORE IN INTENSIVE CARE SETTINGS
Types of Delirium
-hyperactive
-hypoactive
-mixed
Hyperactive Delirium
-agitation, hallucinations, restlessness and hyperactivity
