Neurocognitive Disease

Question 1

delirium

Answer 1

disturbance in level of awareness and change in cognition; develops rapidly, brief duration

SLOWER ONSET if systemic illness or metabolic imbalance

Question 2

symptoms of delirium

Answer 2

attention and reasoning deficit
distractible
incoherent speech
time and space disorientation
short-term memory deficit
hallucinations, illusions
emotional instability

Question 3

treatment for delirium

Answer 3

treat underlying cause
low-stimulus room
low-dose antipsychotics for aggression

Question 4

neurocognitive disorder

Answer 4

impairment of cognitive functions; may be mild or major

Question 5

NCD symptoms

Answer 5

impaired thinking, judgment, and impulse
may do things never done before
personality changes

as disease progresses…
aphasia, apraxia, irritability; ADL deficiency; wandering, incontinence

Question 6

NCD due to Alzheimer’s Stages (7)

Answer 6

Stage 1: no s/s
Stage 2: forgetfulness
Stage 3: mild cognitive decline
Stage 4:mild-moderate cognitive decline
Stage 5: moderate cognitive decline
Stage 6: moderate-severe cognitive decline (forget name of spouse, own birthday; incontinence, wandering)
Stage 7: severe cognitive decline (bedbound)

Question 7

NCD due to Alzheimer’s onset and etiologies

Answer 7

onset is slow and insidious

etiologies: plaques and tangles; neurotransmitter alterations
90% genetics, head trauma can cause

Question 8

Vascular NCD

Answer 8

caused by hemorrhagic and embolic strokes, HTN

more abrupt onset, cognition waxes and wanes

Question 9

Frontotemporal NCD

Answer 9

shrinking of frontal and temporal lobes

personality changes – aggression

Question 10

NCD due to TBI

Answer 10

repeated head trauma

leads to emotional lability, impulsivity, dysarthria, ataxia

Question 11

NCD due to Lewy Body Disease

Answer 11

progressive, rapid, and irreversible

caused by Lewy bodies in cortex and brainstem

diagnosis to death is usually 2-5 years

Question 12

other causes of NCD

Answer 12

substance-induced
Parkinsons
HIV infection
Huntington’s disease
prions
imbalances, tumors, etc

Question 13

Nursing process: assessment of NCD

Answer 13

MSE is vital for catching early NCD
Labs: CKD, liver disease; electrolytes, hormones, infections, liver/kidney functioning
imaging is helpful to identify but can be expensive and not covered by insurance

Question 14

Management priorities for NCD

Answer 14

patient safety, ADLs, reality orientation

nutrition, hygiene, behaviors

medications, and maintaining patient respect

Question 15

Medical treatment

Answer 15

1: fix the cause

#2: prevent AD (antioxidants, exercise, etc)

Question 16

Medications for anti-alzheimers

Answer 16

Donepezil (Aricept)
Memantine (Namenda)

Question 17

Medications for aggression, hallucinations, and wandering

Answer 17

Ziprasidone (Geodon)
Olanzapine (Zyprexa)

VERY LOW DOSES!!

Question 18

Medications for depression, anxiety, and sleep

Answer 18

depression: SSRIs, dopamine agents

Anxiety and sleep: benzos (SHORT TERM)