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Mental Health > Neurocognitive Disorder > Flashcards

Neurocognitive Disorder Flashcards

1
Q

What are the 3 main disorders in this chapter?

A
  1. delirium
  2. Dementia
  3. Alzheimer’s
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2
Q

What is a common complication of hospitalization esp. in older pts?

A

delirium

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3
Q

What causes delirium?

A

underlying physiological causes that are usually multifactorial and immediate factors that precipitate the syndrome

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4
Q

How do you help pts experiencing delirium?

A

help recognize and investigate potential causes ASAP

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5
Q

Define delirium

A

an acute cognitive disturbance and often reversible condition that is common in hospitalized pts.

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6
Q

List the characteristics of delirium

A
  1. altered LOC
  2. disorientation
  3. anxiety
  4. poor memory
  5. agitation
  6. poor memory
  7. delusional thinking
  8. hallucinations
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7
Q

Is delirium a medical ER?

A

yes

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8
Q

What are some screening tools for delirium?

A

mental and neurological status examinations and physical examinations

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9
Q

When should I consider a pt is experiencing delirium?

A
  1. when a pt abruptly demonstrates reduced clarity of awareness of the env
  2. the pt’s ability to direct, focus, sustain, or shift attention becomes impaired
  3. you have to repeat questions b/c the pt might get off easily and need to be refocused
  4. conversation is more difficult
  5. the pt no longer interact meaningfully, staring straight through you and not recalling who he/ she is
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10
Q

When assessing Sam’s neurological status, you expect delirium, why do you think that?

A

he has difficulty concentrated, first to time, then to place, and last to person.

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11
Q

When is delirium the worst?

A

only at night and lucid during the day

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12
Q

What is the difference of cognitive differences with mild and severe delirium?

A

is mild delirium, memory deficits are noticeable only on careful questioning and more severe delirium there is memory problems usually take the form of obvious difficulty in processing and remembering recent events

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13
Q

What is the difference between illusions and hallucinations?

A
  1. you can clarify illusions for the individual

2. illusions are errors in perception while hallucinations are false sensory stimuli

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14
Q

What are the more common hallucinations in delirious pts?

A

visual and tactile

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15
Q

Karen is wandering, pulling out IVs, her folley catheter, and falling out of bed, what are some nursing interventions for delirious pts?

A
  1. make the physical env simple and clear
  2. use clocks and calendar to maximize orientation to time
  3. eyeglasses, hearing aids, and adequate lighting w/o glare
  4. interact w/ the pt whenever he/she is awake
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16
Q

Susan has a HR of 104, diaphoresis, flushed face, dilated pupils and BP of 150/92. What is your nursing intervention?

A

monitor and document these changes carefully

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17
Q

What should i suspect meds as potential cause of?

A

delirium

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18
Q

What is the difference between hypoactive and hyperactive delirium?

A

hyperactive there is agitation and w/ hypoactive there is no agitation

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19
Q

What is the priority with a delirious pt?

A

safety

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20
Q

What are some nursing Dx for a pt w/ delirium?

A
  1. risk for injury
  2. acute confusion
  3. risk for deficient fluid vol.
  4. disturbed sleep or sleep deprivation
  5. Impaired verbal communication
  6. fear
  7. self-car deficits
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21
Q

What is the overall outcome for a person w/ delirium?

A

pt will return to the premorbid level of fxning

22
Q

Cara is a recently confused pt who is yelling to get out out and get your supervisor, what is your nursing action?

A

stay with your pt, never a delirious pt alone

23
Q

What is the difference between dementia and Alzheimer’s?

A

dementia does not interfere with ADLS, but Alzheimer’s does

24
Q

How many stages are in Alzheimer’s Disease?

25
Q

Describe S1 of Alzheimer’s disease

A

no impairment (normal fxn)

26
Q

Describe S2 of Alzheimer’s disease?

A

very mild cognitive decline

27
Q

Describe S3 of Alzheimer’s disease?

A

mild cognitive decline

28
Q

Describe S4 of Alzheimer’s disease

A

moderate cognitive decline

29
Q

Describe S5 of Alzheimer’s disease

A

moderately severe cognitive decline (moderate or mid-stage)

30
Q

Describe S6 of Alzheimer’s disease

A

severe cognitive decline (moderately severe or mid stage)

31
Q

Describe S7 of Alzheimer’s disease

A

very severe cognitive decline (severe or late-stage)

32
Q

Confabulation

A

creation of stories or answers in place of actual memories

33
Q

Perseveration

A

the persistent repetition of a word, phrase, or gesture

34
Q

What are the Sx of Alzheimer’s Disease?

A
  1. Confabulation
  2. Perseveration
  3. Agraphia
  4. Agnosia
  5. Apraxia
  6. Aphasia
  7. Hyperolaity
  8. Hypermetamorphsis
  9. Sundowning
35
Q

What is the most important concern of pt w/ Alzheimer’s?

36
Q

What is the priority Dx for a pt w/ Alzheimer’s?

A

Risk for injury

37
Q

What is the Dx for a pt who can not state their name?

A

impaired verbal communication

38
Q

What is the dx for a pt who’s memory diminishes and disorientation increases?

A
  1. impaired envtl interpretation
  2. impaired memory
  3. confusion
39
Q

What do you need to know about the pt before planing of care of action?

A

identify the level of fxning and assessing caregiver’s needs help

40
Q

What is the best approach for taking care of a pt with Alzheimer’s?

A

patient-centered approach with relationship priority

41
Q

MOA of cholinesterase inhibitors

A

preventing ACHase from breaking down Ach in the brain

42
Q

What is Ach assoc. w/?

A

loss of memory

43
Q

What is the most commonly prescribed cholinesterase inhibitor?

A

Aricept (donepezil)

44
Q

What is the purpose of giving a pt Aricpet?

A

improves cognitive fxns w/o potentially serious liver toxicity

45
Q

What are 2 other meds given for Alzheimer’s besides Aricept?

A
  1. Exelon (Rivastigmine)

2. Razadyne (Galandtamine)

46
Q

What is a pt teaching for Exelon?

A

take w/ food to reduce GI effects

47
Q

When is Razadyne typically given?

A

early stages of dementia

48
Q

What are some side effects of cholinesterase inhibitors?

A
  1. N/V
  2. Bradycardia
  3. syncope
49
Q

When is Memantine (Namenda) typically prescribed?

A

after trying cholinesterase inhibitors

50
Q

MOA of Memantine

A

regulates activity of glutamate

51
Q

What type of dementia pts should take Memantine?

A

moderate to severe

52
Q

Why would a Alzheimer’s pt received a psychotropic med?

A

to treat the behavioral Sxs such as hallucinations, severe mood swings, wandering, anxiety, or agitation

Mental Health (16 decks)

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