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NURS 406 > Neurocognitive Disorders > Flashcards

Neurocognitive Disorders Flashcards

Exam 4 (Final)

1
Q

Cognition

A

Brain’s ability to process, retain, use information

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2
Q

Cognitive Processes

A

Processes: reasoning, judgment, perception, attention, comprehension, memory

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3
Q

Neurocognitive disorders

A

disruption or impairment in higher level brain functions

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4
Q

Delirium

A

Syndrome involving disturbance of consciousness with change in memory, orientation and language

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5
Q

How long is delirium?

A

Short period

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6
Q

Etiology of Delirium

A

infections, fluid and electrolyte imbalances, metabolic disturbance, hypoxia (COPD, emphysema, pneumonia), medications (Table 39.2), drug intoxication or withdrawal

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7
Q

Treatment for Delirium

A

Treat cause of delirium

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8
Q

Assessment of Delirium: History

A

medical history, medications

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9
Q

Assessment of Delirium: General appearance and motor behavior

A

disturbed psychomotor behavior (hypo or hyper), possible speech problems

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10
Q

Assessment of Delirium: Mood and affect

A

unpredictable shifts (agitated to lethargic)

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11
Q

Assessment of Delirium: Thought process and content

A

thoughts may be fragmented, severely impaired memory especially most recent.

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12
Q

Assessment of Delirium: Sensorium and intellectual processes

A

decreased awareness of environment

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13
Q

Assessment of Delirium: Judgment and insight

A

impaired

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14
Q

Assessment of Delirium: Roles and Relationships

A

inability to fulfill roles

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15
Q

Assessment of Delirium: Self concept

A

fear, feel threatened

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16
Q

Assessment of Delirium: Physiological and self care

A

sleep problems, ignore or fail to perceive internal body cues

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17
Q

Delirium: outcome identification

A

Freedom from injury *
Increased orientation, reality contact
Balance of activity and rest
Adequate nutrition and fluid balance
Return to optimal level of functioning

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18
Q

Delirium: Intervention

A

Promoting client safety
Managing client’s confusion: orienting cues; speaking in low, clear voice; avoiding sensory overload
Promoting sleep, proper nutrition

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19
Q

Delirium: Treatment

A

No specific medications

Supportive measures and treatment of precipitating factors are most effective & preferred

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20
Q

Dementia/ Alzheimer’s Disease

A

Progressive cognitive impairment*; language impairment

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21
Q

Issues involving Dementia/ Alzheimer’s Disease

A

Executive function

Aphasia

Apraxia

Agnosia

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22
Q

Executive function

A

(difficulty w/ ability
to think abstract, plan, initiate, sequence

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23
Q

Aphasia

A

(difficulty with speech)

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24
Q

Apraxia

A

(difficulty with movements on command)

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25
Q

Agnosia

A

(loss of ability to identify things or objects)

26
Q

Stages of Dementia/ Alzheimer’s Disease - How many and what are they

A
  1. Mild
  2. Moderate
  3. Severe
27
Q

Dementia/ Alzheimer’s Disease : Mild Stage

A

Loss of memory (forgetting recent conversations, events)

Language difficulties

Mood difficulties

Personality changes

Diminished judgement

28
Q

Dementia/ Alzheimer’s Disease : Moderate Stage

A

Inability to retain new information

Behavioral, personality changes

Increasing long term memory loss

Wandering, agitation, aggression, confusion

Requires assistance with ADLS

29
Q

Dementia/ Alzheimer’s Disease : Severe Stage

A

Gait and motor disturbances

Bedridden

Unable to perform ADLs

Incontinence

Requires long term care placement

30
Q

Etiology of Dementia/ Alzheimer’s Disease: There are multiple factors involved in the development and progression of this disorder:

A

There are multiple factors involved in the development and progression of this disorder

Genetic factors APOE-e4 gene
Prior risk for head injury*
Metabolic syndrome associated w/ microvascular changes
B-amyloid protein accumulation
Reduced neurotransmission which affects acetylcholine, norepinephrine, and serotonin

31
Q

Dementia Assessment: History

A

client may be unable to provide accurate history.

32
Q

Dementia Assessment: General appearance and motor behavior

A

aphasia; apraxia; uninhibited behavior

33
Q

Dementia Assessment: Mood and affect

A

depression prevalent in early stages*;

34
Q

Dementia Assessment: Thought process and content

A

impaired abstract thinking; delusions, visual hallucinations

35
Q

Common Delusional Beliefs

A

Belief that their partner is engaging in marital infidelity

Belief that other patients or staff members are impersonators

Belief that people are stealing their belongings

Belief that strangers are living in their home

Belief that people on television are real and not actors

36
Q

Most common type of hallucinations

A

Visual hallucinations are the most common

37
Q

Example of a common visual hallucination

A

Frequent complaint that children, adults, or strange creatures are entering the house or the patient’s room

38
Q

Dementia Assessment: Sensorium and intellectual processes

A

memory deficits; confabulation*

39
Q

Dementia Assessment: Judgment and insight

A

: poor judgment

40
Q

Dementia assessment: self concept

A

sadness; eventual loss of self-awareness

41
Q

Dementia assessment: Roles and relationships

A

profoundly affected

42
Q

Dementia assessment: Physiological and self care

A

disturbed sleep; incontinence; hygiene deficits

43
Q

Dementia interventions

A

Safety
Sleep, proper nutrition, hygiene, activity
Environmental, routine structure
Emotional support
Interaction and involvement

44
Q

Mental Health promotion: Measures to decrease risk of Alzheimer’s disease

A

Regular participation in brain-stimulating activities

Leisure-time physical activity during midlife

Large social network

45
Q

Role of the caregiver: Needs of caregivers

A

Education about dementia, required client care

Assistance in dealing with own feelings of loss

Respite to care for own needs*, role strain

Support groups

Assistance from agencies

Support to maintain personal life

46
Q

Self-Awareness Issues

A

Teaching clients with dementia can be frustrating.

Discuss frustrations with a mentor or supervisor.

May be difficult to deal with feelings about people who will never “get better and go home”
Importance of dignity for client and family

47
Q

Medications for Alzheimer’s/Dementia

A

No cure exists, but medications and management strategies may temporarily improve symptoms

48
Q

What does Alzheimer’s do to levels of chemical messengers?

A

Alzheimer’s disease decreases levels of a chemical messenger (acetylcholine) which is needed for alertness, memory, thought and judgment

49
Q

Cholinesterase inhibitors

A

Cholinesterase inhibitors boost the amount of acetylcholine available to nerve cells by preventing its breakdown in the brain.

50
Q

What do Cholinesterase inhibitors NOT do?

A

Cholinesterase inhibitors can not reverse Alzheimer’s disease or stop the destruction of nerve cells.

51
Q

Why do cholinesterase inhibitors eventually lose effectiveness?

A

Eventually these medications lose effectiveness because dwindling brain cells produce less acetylcholine as the disease progresses.

52
Q

Example drugs for Alzheimer’s/Dementia:

A

Galantamine (Razadyne)

Rivastigmine (Exelon)

Memantine (Namenda)

Donepezil and Memantine (Namzaric)

Donepezil (Aricept)

53
Q

Galantamine (Razadyne): what does it treat and

A

treats mild to moderate Alzheimer’s.

54
Q

Galantamine (Razadyne): how is it taken

A

It’s taken as a pill once a day or as an extended release capsule twice a day

55
Q

Rivastigmine (Exelon)

A

treats mild to moderate Alzheimer’s disease.

56
Q

Rivastigmine (Exelon): How is it taken?

A

It’s taken as a pill.

A skin patch is available that can also be used to treat severe Alzheimer’s disease.

57
Q

Memantine (Namenda)

A

treats moderate to severe Alzheimer’s Disease.

58
Q

Donepezil and Memantine (Namzaric)

A

) treats moderate to severe

59
Q

Donepezil (Aricept)

A

treats All stages of the disease. It’s taken once a day as a pill.

60
Q

Medication Most Common Side effects

A

Headache, dizziness, nausea and diarrhea.

61
Q

How to mitigate medication side effects

A

Mitigation Strategies; Start at a low dose with slow titration up. Take with food. Over time side effects will dissipate

NURS 406 (29 decks)

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