neurcognitive Flashcards

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1
Q

what is aphasia?

A

loss of language ability. either expressive or receptive

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2
Q

what is apraxia?

A

loss of purposeful movements

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3
Q

what is agnosia?

A

loss of ability to recognize objects

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4
Q

what is confabulation?

A

unconscious creation of storied or answers in place of actual memories

usually to maintain self esteem

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5
Q

what is hyperorality?

A

tendency to put things in the mouth

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6
Q

what are the Acetyl/cholinesterase inhibitors?

A

-donepezil
-rivastigmine
-galantamine

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7
Q

what is the NMDA antagonists?

A

memantine

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8
Q

what are common causes of delirium?

A

-medications
-INFECTIONS
-F and E imbalance
-hypoxia
-brain alterations

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9
Q

what are s/s delirium

A

-disturbance in attention and awareness
-acute onset
-memory deficit
-disorientation
-language changes
-visuospatial changes
-delusions/hallucinations
-disturbances in sleep-wake pattern

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10
Q

what are the four cardinal features of delirium?

A
  1. acute onset
  2. reduced ability to direct, focus, shift, and sustain attention
  3. disorganized thinking
  4. disturbance consciousness
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11
Q

what are the nursing interventions to orient someone with delirium?

A

-encourage to express fears
-comfort measures
-frequent verbal orientation
-frequent brief interaction
-attempt consistency in nursing staff
-play non verbal music
-approach patient slowly and from the front
-allow TV during day

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12
Q

what environmental nursing interventions should you make for a patient with delirium?

A

-adequate lighting
-easy to read calendars and clocks
-reasonable noise level
-sleep hygiene
- provide safety
-provide symptomatic and supportive care

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13
Q

what are the pharmacological intervention for delirium?

A

-small doses of antipsychotics
-benzos
-sleep aids (mirtazapine)
-pain control
-idenitify drug drug interactions
-treat underlying cause

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14
Q

what is dementia?

A

Degenerative, progressive neuropsychiatric disorder
that results in cognitive impairment, emotional and
behavioral changes, physical and functional decline,
and ultimately death

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15
Q

what is the definition of neurocognitive disorder?

A

Progressive deterioration of cognitive functioning and
global impairment of intellect

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16
Q

what is the deference in mild and major neurocognitive disorder?

A

mild doesn’t interfere with ADLs and major interferes with daily functioning

17
Q

what are the major neurocognitive disorders?

A

-alzheimers
-frontotemporal dementia
-dementia with lewy bodies
-vascular dementia
-TBI
-Substance induced dementia
-HIV
-prion disease
-parkinsons disease
-huntingtons disease

18
Q

s/s of alzheimers

A

-disturbances in executive functioning
-aphasia
-apraxia (loss of purposeful movement)
-agnosia (inability to recognize objects)
-memory impairment
-preservation
-hyperorality (put things in their mouth)

19
Q

r/f for alzheimers

A

-age
-family hx
-CCVD
-social engagement
-head injury
-HTN
-neuronal -degeneration
-genetics

20
Q

what is the etiology of alzheimers

A

tau proteins and beta-amyloid plaques create abnormal collections of protein threads inside nerve cells causing inflammation and brain atrophy

oxidative stress and free radicals

21
Q

what neurotransmitters are involved in alzheimers?

A

-less acetylcholine
-more glutamate

22
Q

what does acetylcholine do?

A

involves learning, memory, and mood

23
Q

what does glutamate do?

A

involved in cell signaling, learning and memory

24
Q

what does mild Alzheimer’s look like?

A

Forgetfulness, misplace articles, decreased recall, social
withdrawal, frustrated with self, changes may not be apparent
to others

25
Q

What does moderate Alzheimer’s look like?

A

decreased ability for self-care; way-finding;
disoriented to time and place; wandering, pacing, possible
hallucinations or delusions begin, decreased visual perception
leading to accidents; needs supervision; emotional lability-big
swings; symptoms noticeable

26
Q

what does severe Alzheimer’s look like?

A

cannot care for self; loss use of language; minimal
long-term memory; constant complete care

27
Q

what should be included in the psychological assessment for someone with dementia ?

A

-suspiciousness, delusions, and illusions
-hallucination
-mood changes
-anxiety
-catastrophic reactions

28
Q

what are common defense mechanisms for someone with dementia?

A

-denial
-confabulation
-perseveration
-avoidance of questions

29
Q

what are the priority care issues for someone with dementia?

A

-cognitive decline (mild)
-safety from self (moderate)
-physical needs (severe)

30
Q

what two classes of meds are used for alzheimers?

A

-acetylcholinesterase inhibitors
-NMDA antagonists

31
Q

what meds are AChEI?

A

-donepezil
-rivastigmine
-galantamine

32
Q

do AChEIs decrease cognitive decline?

A

NOOOO!! only delay not decreaw

33
Q

what meds are NMDA antagonists?

A

-memantine

34
Q

what is the MOA of NMDA antagonists?

A

-restore function of damaged nerve cells and reduce abnormal excitatory signals of the NT glutamate

35
Q

what off label meds are used for dementia/alzheimers?

A

-antipsychotics
-antidepressants
-antianxiety
-anticonvulsants

36
Q
A