Neurocognitive Disorders

Question 1

• extreme impairment of basic mental functions (thinking, memory, speech, consciousness)
• usually a clear biological basis

Answer 1

neurocognitive disorders

Question 2

three groups of neurocognitive disorders

Answer 2

• delirium
• mild neurocognitive disorder
• major neurocognitive disorder (aka dementia)

Question 3

rapid onset neurocognitive disorder, usually with short duration
impairment of attention, thinking, speech, emotions, and behavior

Answer 3

delirium

Question 4

additional characteristics of delirium

Answer 4

• disoriented to time and place
• perceptual distortions (illusions/hallucinations) are common
• emotions are very labile
• impairments increase clients’ risk of self-harm

Question 5

prognosis for delirium

Answer 5

• requires prompt medical treatment
• most clients have a full recovery
• some can experience permanent brain damage or die, esp if untreated

Question 6

epidemiology of delirium

Answer 6

• extremely common in healthcare settings
• clients over age 65 at greatest risk
• Medical floor - 30% of older clients
• Post-surgery - 10%-50% of older clients
• ICU - rate as high as 70%
• Hospice - 42% of clients

Question 7

etiology of delirium - medications

Answer 7

• first thing - review medications
• drug overdoses
• drug interactions
• liver/kidney dysfunction
• BEERS medications

Question 8

BEERS medications

Question 9

etiology of delirium - medical illnesses

Question 10

etiology of delirium - intoxication/withdrawal

Question 11

effective treatments of delirium

Question 12

nursing interventions for delirium

Question 13

progressive decline in cognitive functions; almost always permanent

Answer 13

dementia

Question 14

additional characteristics of dementia

Question 15

• most common cause of dementia; 50%-60% of cases

* associated with a build-up of beta-amyloid plaques and neurofibrillary tangles in brain

Answer 15

Alzheimer’s disease

Question 16

characteristics of Alzheimer’s disease - mild stage

Answer 16

• short-term memory loss and confusion
• may get lost in familiar environments
• executive function begins to fade

Question 17

characteristics of Alzheimer’s disease - moderate stage

Answer 17

• significant difficulty with activities of daily living
• wandering
• emotional instability
• increased risk of self-injury
• begin to lose ability to recognize family & friends
• confabulation - unconsciously fill in memory gaps with imaginary events
• require close observation and frequent assistance

Question 18

characteristics of Alzheimer’s disease - severe stage

Answer 18

• profound deficits in cognitive function
• loss of ability to eat, speak, understand language, ambulate, control elimination
• require total care

Question 19

• form of dementia caused by damage to the frontal and temporal lobes of the brain
• aka Pick’s Disease

Answer 19

Frontotemporal Lobe Dementia

Question 20

additional characteristics of Frontotemporal Lobe Dementia (Pick’s Disease)

Answer 20

• significant decline in executive function and language comprehension
• damage to brain may also cause socially inappropriate speech and behavior

Answer 21

HIV infection (especially Type 1)

Answer 22

Huntington’s Disease

Question 23

additional characteristics of Huntington’s Disease

Question 24

jerky movements of the extremities

Answer 24

chorea

Question 25

additional characteristics of Huntington’s disease

Answer 26

Lewy Body Dementia

Question 27

additional characteristics of Lewy Body Dementia

Question 28

• dementia caused by damage to the substantia nigra

* characterized by motor dysfunction

Answer 28

Parkinson’s Disease

Question 29

additional characteristics of Parkinson’s Disease

Answer 30

TBI

Answer 31

Vascular dementia

Question 32

epidemiology of Alzheimer’s disease

Question 33

etiology of Alzheimer’s disease

Question 34

effective treatments for Alzheimer’s disease

Answer 34

• supportive home/setting care
• respite care for caregivers
• medications:
• -anticholinesterase inhibitors (donepezil)
• -memantine
• -2nd Gen antipsychotics for psychosis/aggression

Question 35

nursing interventions for dementia