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N104 > Late Adult I > Flashcards

Late Adult I Flashcards

1
Q

What are the three Ds?

A

delirium, dementia, depression

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2
Q

What is the condition of dementia defined as?

A

Development of multiple cognitive deficits manifest by both

1) memory impairment

2 one or more of aphasia, apraxia, agnosia, disturbance in executive functioning

must be severe enough to cause impairment in social or occupational functioning

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3
Q

What type of memory loss is affected first by dementia?

A

STM before LTM

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4
Q

Define aphasia.

A

Impaired ability to communicate through oral or written language

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5
Q

Define apraxia.

A

Impaired ability to execute motor functions despite motor abilities and sensory function

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6
Q

Define agnosia.

A

loss of ability to recognize persons or things

  • may not associate objects with purpose
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7
Q

explain what executive functioning means.

A

planning, organizing, higher level functions and complex behaviours. Judgement

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8
Q

What are the 4 different types of dementia with there percentage of prevalence within dementia cases?

A

Alzheimer’s disease 60%

Vascular dementia 20%
- associated with a CVA

Lewy Body dementia 5-15%
- characterized by fluctuating cognition and vivid hallucinations

Frontotemporal dementia 2-5%
- personality changes, rapid onset, self-stimulating behaviours are common

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9
Q

What percentage of AD patients suffer from delusions, depression/anxiety, and hallucinations?

A

Delusions: 50%

Depression/anxiety: 40%

Hallucinations: 25%

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10
Q

What behavioural disturbances may be associated with dementia?

A

self-destructive behaviour

non-compliance

dependency

aggression

impulsiveness

hiding/hoarding

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11
Q

What are some tests that are done in order to help determine if someone suffers from dementia?

A

MMSE

CT/MRI

psychiatric/psychological evaluations

Medical hx

physical exam

lab tests

ruling out other causes

can be confirmed on autopsy

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12
Q

Describe the progression of dementia

A 
EARLY STAGE (2-4 yrs)
STML, denial, confusion, difficulty with ADLs, withdrawal. Stage where family becomes aware and seeks help

MIDDLE STAGE (several years)

  • significant impairment of ADLs
  • dec language skills, reasoning and planning
  • disinhibition and aggression
  • may be admitted to residential care

LATE STAGE (1-2 yrs)

  • dec engagement with environment, motor skills, and speech
  • dependent with ADLs
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13
Q

What are the aspects of care given to manage dementia?

A
  • multidisciplinary
  • psychological
  • social
  • medication
  • care of primary caregiver (respite)
  • psychosocial health promotion
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14
Q

Describe what Delirium is.

A

syndrome characterized by SUDDEN ONSET, altered behaviour and mental status

can be a transient state
symptoms often fluctuate

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15
Q

List some symptoms of delirium

A
  • difficulty with attention
  • disoriented
  • sensory disturbances (hallucinations)
  • sleep-wake disturbances
  • changes in psychomotor activity
  • anxiety, fear, irritability, euphoria, apathy
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16
Q

What are the three types of changes in consciousness in delirum?

A

HYPERACTIVE: agitation, constant motion, repetitive movements

HYPOACTIVE: inactive, withdrawn, dec motor and verbal responses

MIXED: fluctuation

17
Q

What are the risk factors for delirium?

A
  • dementia
  • > 75 yrs old
  • polypharmacy
  • hx of delirium
  • chronic illnesses
  • recovery from surgery
18
Q

What are some common causes of delirium?

A
  • drug toxicity
  • infection
  • pain
  • dehydration
  • acute illness
  • substance abuse
  • psychosocial problems
19
Q

What interventions may be taken to help care for delirium pts?

A
  • interdisciplinary planning
  • promoting comfort and familiar environment
  • maintaining routine
  • promote normal sleep schedule
  • promote hydration
  • AVOID restraints
  • support/educate family
20
Q

What conditions must be met to be diagnosed with depression?

A
  • at least 2 wks of depressed mood or loss of interest/pleasure
  • change in appetite, weight, sleep, activity
  • feelings of worthlessness and guilt
  • difficulty thinking
  • recurrent thoughts of death, suicidal ideation
  • dec in social, occupational functioning
21
Q

describe the prevalence percentage of depression within the populations in the community, in acute care, and in residential care of those age >65 yrs.

A

Community 15-20%

acute care 21%

residential care 40%

22
Q

list some risk factors for depression

A

> 60 yrs

previous depression

medical illness

chronic pain

substance abuse

lack of social support

stressful events

23
Q

what interventions might be taken in cases of depression?

A

improve sleep patterns

encourage independence for personal care

encourage social activity

encourage verbalizing anxiety/sadness

find hope for the future

pet therapy

pharmacological support

24
Q

What is important to do as a nurse when caring for cognitive impairments?

A

be comprehensive

  • recognize signs of depression
  • distinguish between dementia and delirium
  • consider co-morbidities
25
Q

What should you not do as a nurse when treating people with cognitive impairments?

A

don’t repeat ineffective interventions

don’t be punitive

N104 (10 decks)

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