Neurocognitive Disorders Flashcards
Define delirium
Delirium is a mental state characterized by an acute disturbance of cognition, manifested by short term, confusion, excitement, disorientation, and clouded consciousness hallucinations and illusions are common
What is delirium characterized by?
A disturbance in attention and awareness, and a change recognition that develops rapidly over a short period of time
What are symptoms of delirium?
Difficulty, sustaining, and shifting attention
Very distractible repeatedly reminded to focus
Disorganized, thinking, reflected by speech that is rambling, irrelevant, pressured, and incoherent, and switches from subject to subject
Reasoning, ability and goal directed behavior are impaired
Disorientation to time and place
Impairment of recent memory
Perceptions of environment,
Illusions
False perceptions
Hallucinations
Disturbances in the sleep cycle 
What is an individuals state of awareness with delirium?
Hyper vigilance, heightened awareness of environmental stimuli
To stupor or semicoma
How was the sleep of a patient with the
Fluctuate from excessive, sleeping in, insomnia, vivid, dreams, and nightmares are common
How is psycho motor activity of a patient with delirium
Fluctuate between agitated, purposeless, movements, restless, hyperactivity, striking out at nonexistent objects
And a vegetative state resembling cat atomic scooper
Tremors are frequent
How is the emotional status of a patient with delirium?
Emotional instability may be manifested by fear, anxiety, depression, irritability, anger, euphoria, or apathy
Patient may be crying out for help. Cursing, muttering, moaning acts of self-destruction, fearful, attempt to fleet or attack on others, who are falsely viewed as threatening.
What are some physical symptoms of a patient with delirium?
Tachycardia
Sweating
Flushed face
Dilated pupils
Elevated blood pressure
How quickly do symptoms of delirium occur?
They begin abruptly, following head injury or seizure
Sometimes may proceed for several hours or days
What is the duration of deli?
Brief one week rarely more than one month
After elimination of underlying cause symptoms usually diminish over 3 to 7 day. Period.
Why is delirium associated with a high mortality rate
Because of serious precipitating medical conditions
Define neurocognitive
A term used to describe cognitive functions, closely linked to particular areas of the brain that have to do with thinking, reasoning, memory, learning, and speaking
Define dementia
A major neurocognitive disorder
A disease process in which there is a progressive decline and cognitive ability in the presence of clear consciousness
It involves many cognitive deficits, and significantly impaired social and occupational functioning
What is a mild NCD
Mild cognitive impairment and is a focus of early intervention which is critical to preventing or slowing the progression of the disorder
What is a major NCD
A disease process in which there is progressive decline and cognitive ability in the presence of clear consciousness, involves many cognitive deficits, and significantly impairs, social and occupational functioning
What is a reversible NCD occur from
Stroke
Depression
Side effects of medicines
Nutritional deficiencies
Metabolic disorders
What is a primary NCD?
Alzheimer’s disease
In which the NCD itself is a major sign of an organic brain disease, that is not directly related to any other organic illnesses
What is the secondary NCD?
 caused by or related to another disease or conditions, such as HIV, disease, or cerebral trauma
What are some symptoms of an NCD?
Impairment in abstract, thinking
Disregard of social conduct
Inappropriate behavior
Hygiene neglected
Difficulty naming objects or language
And severe forms of NCD what are some symptoms?
Aphasia
Personality change,
Apraxia (inability to carry out purposeful motor activities, despite intact, motor function and inability to use objects properly)
Irritable moody
Can’t be left alone
Risk for injury
Wandering
Incontinence
Inability to perform ADLs
What is stage one of Alzheimer’s disease?
No apparent symptoms
What happens in stage one no appearance symptoms of Alzheimer’s disease
There’s no apparent decline in memory, despite changes that are beginning to occur in the brain
What is stage two of Alzheimer’s disease?
Very mild changes
What happens in stage two very mild changes of Alzheimer’s disease
Individual begins to lose things, forget names of people
Losses in short-term memory or common
Individual aware of intellectual decline
Begins to feel ashamed, anxious depressed
Maintain organization with less and structured routine
Often not noticed by others, and do not interfere with individuals, ability to work or live independently
What is stage three of Alzheimer’s disease?
Mild cognitive decline
What is stage three mild cognitive decline of Alzheimer’s disease
Changes in thinking, and reasoning that interfere with work performance, and become noticeable to coworkers
Get lost driving
Concentration interrupted
Difficulty, recalling names or words
What is stage four of Alzheimer’s disease?
Moderate cognitive decline
What is stage four moderate cognitive decline of Alzheimer’s disease
Forget, major events in personal history, such as his or child’s birthday
Decline ability to perform tasks
Unable to understand current news
Deny problem exist by covering up memory loss with confabulation
Depression and social with withdrawal
Some Assistance needed to maintain safety
What is stage five of Alzheimer’s disease?
Moderate severe cognitive decline
What is stage five moderately severe cognitive decline of Alzheimer’s disease
Loses the ability to independently, perform some ADLs, such as hygiene, dressing and grooming
Assistance required to maintain task
Forget, address, phone number names of close relatives
Disoriented about place and time, but maintain knowledge about themselves
Frustration withdrawal and self absorption
What is stage six of Alzheimer’s disease?
Severe cognitive decline
What is stage six severe cognitive decline of Alzheimer’s disease
Unable to recall their name of their spouse and Miss identify people
Disorientation
Unable to recall day season or year
Unable to manage ADLs without assistance
Delusions become a parent
Urinary and fecal incontinence are common
Wandering agitation and aggression occur
Sundowning occurs
institutionalization usually recovered
What is stage seven of Alzheimer’s disease?
Very severe cognitive decline
What is stage seven very severe cognitive decline of Alzheimer’s disease
Unable to recognize family members
Confined to bed and aphasic
Problems with immobility
Lose interest in food lacks awareness of meal times or cannot remember if they have eaten
Swallowing and chewing difficulties
Body jerking
Hospitalization and diagnosed in the fourth stage of NCD due to A.D. a client when asked about the previous evening describes a wonderful evening spent on a cruise which symptom is the client exhibiting
Aphasia
Confabulation
Delirium
Apraxia
Confabulation
How is the onset and progression in an NCD due to AD
Onset is slow and insidious
Course of the disorder is generally progressive and deteriorating
Memory impairment is an early prominent feature
What are some predisposing factors to an NCD due to Ad
Neurotransmitter alterations
Planks and tangles
Head traumas
Genetic factors
A client is newly diagnosed with second stage NCD due to an A.D., which cognitive change with a nurse observe
Memory disturbance
Confabulation
Apraxia
Inability to plan or organize
Memory disturbance
What is a vascular NCD
Occurs as a result of significant cerebral vascular disease when blood flow to the brain is impaired
What is the onset of vascular NCD?
More abrupt onset and changes in thought process occur in noticeable steps downward rather than a gradual deterioration
How does a vascular NCD occur?
Hypertension
Cerebral emboli
Cerebral thrombosis
May have experience of small strokes
What are some symptoms of vascular NCD?
 weakness and limbs
Small steed gate
Difficulty with speech
What is a frontaltemporal NCD
Occurs as a result of shrinking of the frontal and temporal interior lobes
What are symptoms of a frontotempral ncd
Behavioral and personality changes in speech and language problems
How does a frontal temporal NCD onset occur?
Disease, progresses steadily, and often rapidly ranging from less than two years in some individuals to more than 10 years
What is an NCD due due to a traumatic brain injury
Impact of the head, or other rapid movement, or displacement of the brain within the skull with one more of the following loss of consciousness, post traumatic Nija disorientation to confusion or neurological signs
What is the most common neural behavioral symptoms finally hit trauma
Amnesia
Repeated head trauma can result in dementia pugilistica what is that
Syndrome, characterized by emotional liability, dysarthria, attack, and impulsivity
Is neurocognitive disorders due to traumatic brain injury permanent
Depending on severity symptoms may eventually subside or become permanent
What is neurocognitive disorder due to Louie body dementia
Similar to Alzheimer’s disorder, but progresses more rapidly
Appearance of Louie bodies in the cerebral cortex and brainstem
Is Louie bodies disease reversible?
No, it is progressive and irreversible
It has early appearances of visual hallucinations in Parkinson features
Accountable for 25% of all NCD
What is neurocognitive disorder due to Parkinson’s disease?
Caused by a loss of nerve cells, located in the substantia nigra and decreases in dopamine activity
Cerebral changes in NCD due to Parkinson’s disease sometimes resembles those of A.D.
What is neurocognitive disorder due to HIV infection
Caused by brain infection with opportunistic organisms by the HIV virus directly
Symptoms range from barely perceptible to acute delirium to profound cognitive impairment
What is an NCD substance induced?
In NCD can result from substance resistance, overuse or abuse
What a NCD due to Huntington’s disease
Huntington’s disease is transmitted as a dominant gene
Damage occurs in the areas of the basal ganglia in the cerebral cortex
The client usually declines into a profound state of dementia and ataxia
What is an NCD due to prion disease?
Brian disease is a group of disorders caused by infectious agents called prions and characterized by its insidious onset in rapid progression
What are some symptoms of neurocognitive disorder due to prion disease?
Problems with coordination and other movement disturbances along with rapidly progressing. Dementia.
Extremely rapid from diagnosis to death being less than two years 
Which statement is true about vascular dementia
Vascular dementia is reversible
Vascular dementia is characterized by plaques in tangles in the brain
Vascular dementia involves a gradual, progressive cognitive deterioration
Vascular dementia involves a variable pattern of cognitive functioning
Vascular dimension involves a variable pattern of cognitive functioning
What is the first step in treatment of delirium?
Determination and correction of the underlying cause
Additional attention must be given to fluid and electrolyte status, hypoxia, anoxia, and diabetic problems
Staff remain with patient at all times
Room should remain level of stimuli
When would you give a patient with delirium and antipsychotic?
Low-dose antipsychotic agents to relieve agitation in aggression
Benzodiazepine is commonly used when ideology is substance withdrawal
What is the primary consideration in the definite diagnosis of NCD treatment?
Treatment of the disorder is the ideology focus must be directed to identify and resolve potential reversible processes
What are some formal psychological agents for cognitive impairment?
Physotigmine ( antilirium)
Tacrine (cogex)
Donepezril( aricept)
Rivastigmine( exelon)
Galantamine( razadyne)
Mematine ( namenda)
What is the treatment for moderate to severe Alzheimer’s disease?
Namenda
A client has recently been diagnosed with mild to moderate and CD due to ADD. What medication would the nurse expect the physician to order in this client cognitive impairment
Nortriptyline (Pamelor)
Zalpelon (Sonya)
Donepezil( aricept)
Quetiapine (Seroquel)
Donepezil( aricept)
