neurcognitive Flashcards
what is aphasia?
loss of language ability. either expressive or receptive
what is apraxia?
loss of purposeful movements
what is agnosia?
loss of ability to recognize objects
what is confabulation?
unconscious creation of storied or answers in place of actual memories
usually to maintain self esteem
what is hyperorality?
tendency to put things in the mouth
what are the Acetyl/cholinesterase inhibitors?
-donepezil
-rivastigmine
-galantamine
what is the NMDA antagonists?
memantine
what are common causes of delirium?
-medications
-INFECTIONS
-F and E imbalance
-hypoxia
-brain alterations
what are s/s delirium
-disturbance in attention and awareness
-acute onset
-memory deficit
-disorientation
-language changes
-visuospatial changes
-delusions/hallucinations
-disturbances in sleep-wake pattern
what are the four cardinal features of delirium?
- acute onset
- reduced ability to direct, focus, shift, and sustain attention
- disorganized thinking
- disturbance consciousness
what are the nursing interventions to orient someone with delirium?
-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
what environmental nursing interventions should you make for a patient with delirium?
-adequate lighting
-easy to read calendars and clocks
-reasonable noise level
-sleep hygiene
- provide safety
-provide symptomatic and supportive care
what are the pharmacological intervention for delirium?
-small doses of antipsychotics
-benzos
-sleep aids (mirtazapine)
-pain control
-idenitify drug drug interactions
-treat underlying cause
what is dementia?
Degenerative, progressive neuropsychiatric disorder
that results in cognitive impairment, emotional and
behavioral changes, physical and functional decline,
and ultimately death
what is the definition of neurocognitive disorder?
Progressive deterioration of cognitive functioning and
global impairment of intellect
what is the deference in mild and major neurocognitive disorder?
mild doesn’t interfere with ADLs and major interferes with daily functioning
what are the major neurocognitive disorders?
-alzheimers
-frontotemporal dementia
-dementia with lewy bodies
-vascular dementia
-TBI
-Substance induced dementia
-HIV
-prion disease
-parkinsons disease
-huntingtons disease
s/s of alzheimers
-disturbances in executive functioning
-aphasia
-apraxia (loss of purposeful movement)
-agnosia (inability to recognize objects)
-memory impairment
-preservation
-hyperorality (put things in their mouth)
r/f for alzheimers
-age
-family hx
-CCVD
-social engagement
-head injury
-HTN
-neuronal -degeneration
-genetics
what is the etiology of alzheimers
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
what neurotransmitters are involved in alzheimers?
-less acetylcholine
-more glutamate
what does acetylcholine do?
involves learning, memory, and mood
what does glutamate do?
involved in cell signaling, learning and memory
what does mild Alzheimer’s look like?
Forgetfulness, misplace articles, decreased recall, social
withdrawal, frustrated with self, changes may not be apparent
to others
What does moderate Alzheimer’s look like?
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
what does severe Alzheimer’s look like?
cannot care for self; loss use of language; minimal
long-term memory; constant complete care
what should be included in the psychological assessment for someone with dementia ?
-suspiciousness, delusions, and illusions
-hallucination
-mood changes
-anxiety
-catastrophic reactions
what are common defense mechanisms for someone with dementia?
-denial
-confabulation
-perseveration
-avoidance of questions
what are the priority care issues for someone with dementia?
-cognitive decline (mild)
-safety from self (moderate)
-physical needs (severe)
what two classes of meds are used for alzheimers?
-acetylcholinesterase inhibitors
-NMDA antagonists
what meds are AChEI?
-donepezil
-rivastigmine
-galantamine
do AChEIs decrease cognitive decline?
NOOOO!! only delay not decreaw
what meds are NMDA antagonists?
-memantine
what is the MOA of NMDA antagonists?
-restore function of damaged nerve cells and reduce abnormal excitatory signals of the NT glutamate
what off label meds are used for dementia/alzheimers?
-antipsychotics
-antidepressants
-antianxiety
-anticonvulsants
