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NUR 240 > NCD > Flashcards

NCD Flashcards

1
Q

Primary ncd

A

ncd itself

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2
Q

secondary ncd

A

caused by or r/t another condition
ex hiv

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3
Q

mild ncd

A

Mild to moderate loss of previous
level of cognitive, executive and
memory functioning
* Does not interfere with independence
(may need assistance but NOT
dependent)
* Early intervention to prevent
progression

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4
Q

major ncd

A

Significant cognitive decline
interferes with independence
* Not due to delirium
* Not due to other mental disorder

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5
Q

vascular ncd

A

2nd most common
progressive
more men than women
affects speech and gait
cell death
diseased bv’s

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6
Q

vascular ncd etiology

A

Caused by cerebrovascular disease
* Internal (TIAs or strokes), external (possible past head
injury)
* More abrupt onset (more motor problems initially)
* Progression is variable and symptoms occurs in steps
* Symptoms may clear up & then experience suddenly decline

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7
Q

dementia pugilistica

A

NCD due to Traumatic Head Trauma
impulsivity
emotional lability
repeated head trauma typically

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8
Q

ncd d/t parkinsons

A

slowly progressive
cells are destroyed in certain areas of brainstem
decreased dopamine
language not impacted

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9
Q

ncd d/t huntington’s

A

inheritable
can begin at any age (30-50 more common)
lack of coordination- jerky mvmnts
usually death s caused by another disease

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10
Q

frontotemporal NCD: pick’s disease

A

PERSONALITY CHANGE
unknown etiology
presents 45-65 yo
similar to alz: destroys neurons
tau proteins accululate

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11
Q

creutzfeldt-jakob

A

mad-cow
40-70 yo

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12
Q

ncd dt lewy body

A

protein deposits
develop in neurons
affects thinking, mem, mvmnts
gradually declines
aphasia
hallucinations
simiar to alz and park

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13
Q

amnestic disorders

A

Causes: Head trauma, CVA, substance
intoxication
Inability to learn new information
Normal attention span
Inability to recall previously learned info
Abstract thinking intact
No personality change
Disorientation to time and place
Confabulate events

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14
Q

screening tool for NCD

A

montreal cognitive assessment (MOCA)
look at trends
physician and speech therapy can do it

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15
Q

mini-mental state exam

A

more is better
less is worse

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16
Q

donepezil

A

cholinesterase inhibitor: reversable indirect acting cholinergic
frontline drug
can cause bradycardia and heart disease
used for mild, moderate or severe NCD

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17
Q

memantine

A

N-Methyl-D-Aspartate Receptor
Antagonist
used when pt cant tolerate donepezil
used for moderate-severe ncd

18
Q

donepezil and memantine

A

take once a day
extended release

19
Q

aducanumab

A

IV- monthly infusions
pre-administration MRI d/t hemorrhagic strokes
attacks beta amyloid plaques: proteins
slows progression of alz

20
Q

considerations for NCD

A

do not continuously reorient
thier short-term mem dissapears
instead of telling them their spouse is dead, ask about their spouse
talk ab happy mems, music
create calming environment: low light
sit close to nsg station
holiday decor
bed alarm
pictures at bedside
clock in sihgt
hearing aids and glasses

21
Q

alz

A

Most common type of NCD
* A progressive type of NCD (usually 8-10 years)
* Affects memory, thinking, and behavior

22
Q

possible alz

A

Can’t remember a person later
Forgetting a meal prepared
Incomprehensible language
Getting lost on own street
Forgetting there is a child
Putting watch in sugar bowl
Drastic change in personality
Not knowing work needs done
Knowing what the numbers mean
Having rapid shifts in mood 37

23
Q

etiology of alz

A

slow onset
genetics and early onset
Cholinergic Hypothesis
* Reduced acetylcholine
(needed for learning &
memory)
* Degeneration of cholinergic
neurons- decreased
cognition
* Glutamate Hypothesis-
Glutamate is excitatory
neurotransmitter
* Stimulates NMDA receptors,
calcium ions= degeneration
of cells
* Plaques-Beta amyloids outside
the neuron
* Tangles-neurofibrillary tau
proteins twist inside the neuron
More common in men
educated people at risk

24
Q

alz assessment and diagnostics

A

History & Physical, Labs
* Psychological tests
* CT/MRI, PET, Single photon emission CT scan,
EEG

25
Q

prevention of alz

A

NSAIDS
* Estrogen replacement
* Antioxidants like Vitamin E
* Antihypertensive agents
* Exercise

26
Q

early alz stage

A

FORGETFULNESS
Forgets which bills are paid
* Forgets phone numbers
* Becomes less outgoing
* Loss of initiative
* Sporadic loss of words
* Arrives at appointments at
the wrong time or place
* Forgets to put a coat on
* Forgets what was just said

27
Q

Middle stage alz

A

CONFUSION STAGE
Can’t calculate numbers
* ADLS: wears same clothes
* Can’t follow simple instruction
* Wanders & gets lost
* Suspicious- lost items are
“stolen”

28
Q

late stage alz

A

DEPENDENT
Can’t recognize self in mirror
* No short term, poor long term
* Mostly bed bound
* Diminished communication

29
Q

stage 1 alz

A

no apparent symptoms

30
Q

stage 2 alz

A

forgetfulness

31
Q

stage 3 alz

A

mild: interference with performance
decreased social

32
Q

stage 4 alz

A

confusion- forget day
confabulation: make up stories
risk of wandering
cant sleep

33
Q

stage 5 alz

A

moderate: early dementia
deulsions and paranoia
loss of ald abilities

34
Q

stage 6 alz

A

moderate: severe dementia
sundowning

35
Q

stage 7 alz

A

Severe cognitive decline: late
dementia:
Bedrest, often dies from pneumonia

36
Q

agnosia alz

A

recognition/perception
dont understand what a stop sign means
cant notice stimuli

37
Q

apraxia alz

A

motor mvmnets
shuffling gait

38
Q

aphasia

A

cant speak
speech, naming

39
Q

amnesia

A

forget new or recent mems

40
Q

what could be causing confusion

A

UROSEPSIS

41
Q
A

NUR 240 (7 decks)

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