M11 Cognition

Question 1

Haldol does not work for

Answer 1

Elderly with dementia

Has opposite effect

Question 2

Med good for hyperactive delirium

Answer 2

Haldol

Question 3

Beers list

Answer 3

Meds contraindicated in elderly

Also has alternatives

Question 4

Delirium assessment

Answer 4

Confusion assessment model tool
CAM
Can be done without an order

Question 5

Mini COG assessment

Answer 5

Alzheimer

Can be done without orders

Question 6

MMSE

Answer 6

Mini Mental State Examination

Assesses cognitive performance in elderly

Question 7

Cognition in elderly may be affected by

Answer 7

Sensory impairment
Physiologic health
Environment 
Sleep
Psychosocial influence

Question 8

Fluid intelligence and age

Answer 8

Declines

usually due to circulatory or nervous disorders

Question 9

Crystalized intelligence and age

Answer 9

Remains intact

Question 10

Delirium

Answer 10

Acute confused state

Question 11

Delirium can lead to

Answer 11

Changes in level of consciousness

Irreversible brain damage

Death

Question 12

Delirium symptoms

Answer 12

Stupor - hypoactive

Excessive activity - hyperactive

Disorganized thinking

Short attention

Hallucinations, delusion, fear, anxiety, paranoia

Question 13

Dementia symptoms are

where as delirium symptoms are

Answer 13

long term onset

acute onset

Question 14

Because of unknown underlying causes, delirium is considered a

Answer 14

Medical Emergency

Question 15

Delirium prevention

Answer 15

Reorienting
Early Mobilization
Pain control
Good sleep
Enhance communication methods (hearing aids, glasses)
O2 levels
Hydration

Question 16

Delirium treatment

Answer 16

Fall prevention

Discontinue none essential meds

Monitor Nutrition and Fluids

Familiar environment ques like fam interaction

Question 17

Dementia is

most common dementia

Answer 17

General decline in higher brain function

AD

Question 18

Alzheimer Disease

AD

Answer 18

6th leading cause of death in

progressive degenerative neurologic disease

Question 19

AD occurs in people over

Answer 19

65y/o

Question 20

Patho of AD

Answer 20

Neurofibrillary tangles - nonfunctional neurons

Neurotic plagues - deposits of amyloid protein in the brain

Question 21

What neurotransmitter is particularly affected by AD

Answer 21

Acetylcholine

Question 22

Stages of AD

Answer 22

Preclinical - minor forgetfulness, small difficulties

Mild Cognitive - Noticeable mild changes that can be measured

Dementia due to Alzheimer’s - Significant impairment of thinking, behavior and functioning independently

Question 23

Reality orientation

With AD

Answer 23

Who and where a person is in a time continuum

Will only WORSER mental state of AD patient due to increased anxiety

Question 24

Diagnosis of AD

Answer 24

True diagnosis only after death

CBC
CT
MRI
MMSE 
to rule out other possibilities

Question 25

Meds for AD

Answer 25

Cholinesterase inhibitors Donepezil Rivastigmine WILL NOT CURE

Question 26

Nurses roles in AD | Supporting Cognitive Function

Answer 26

Calm predictable routine Simple explanations Memory aids Physical and verbal stimulation Clock/calendar display

Question 27

Nursing roles in AD | Promoting physical safety

Answer 27

Rails, lighting, secure doors leading outside,

Question 28

Nursing roles in AD | Promotion of independence

Answer 28

Make short organized achievable goals to promote autonomy

Question 29

Nursing roles in AD | Anxiety reduction

Answer 29

Keep environment constant and calm Delaying activity until patient is calm is appropriate

Question 30

Nursing roles in AD Improve Communication Provide Socialization

Answer 30

use clear and concise messages, reduce noise support visits, letters, phone calls, hobbies etc.

Question 31

Nursing roles in AD Nutrition Activity and rest

Answer 31

cueing to encourage adequate nutrition and hydration. Small pieces, not too hot. Music, warm milk or other que for sleep Encourage exercise during day

Question 32

Nursing roles in AD Neglect/abuse

Answer 32

Report all suspected abuse | Nurses job is to report, not to prove

Question 33

In AD damage is caused by a substance called

Answer 33

Amyloid

Question 34

3 parts of AD brain tissue damage

Answer 34

Neurofibrillary tangles Neurotic plaque Granulovacuolar degeneration

Question 35

AD Risk factors

Answer 35

``` Aging Low education Down Syndrome Smoking Fam hist Insulin resistance Dyslipidemia ```

Question 36

With AD Depression is present in _ stages

Answer 36

Early

Question 37

Early AD symptom

Answer 37

Impaired sense of smell

Question 38

Diagnosing AD is done by exclusion, meaning

Answer 38

Tests are performed to rule other things out

Question 39

Diagnostics for AD

Answer 39

Electroencephalography | Neuropsychological tests

Question 40

AD PTs should avoid what consumable

Answer 40

Coffee-containing foods Coffee tea cola chocolate

Question 41

Meds that help preserve memory

Answer 41

Memantin | Ginkgo Biloba

Question 42

Cholinesterase inhibiters interact with which drug

Answer 42

NSAIDs