Neurocognitive Disorders Flashcards
What is the definition of delirium?
A disturbance in attention that develops over a short period of time, with an additional disturbance in cognition.
What is the prevalence of delirium among clients older than 85 years?
About 14%.
What percentage of post-operative patients experience delirium?
15–53%.
What is dementia defined as by the American Psychiatric Association?
Significant cognitive decline from previous level of performance in one or more cognitive domains.
Name the cognitive domains affected by dementia.
- Complex attention
- Executive function
- Learning and memory
- Language
- Perceptual-motor
- Social cognition
What distinguishes delirium from dementia in terms of onset?
Delirium has an onset of hours to days, while dementia has an onset of months to years.
What are some contributing factors to delirium?
- Dehydration
- Hypoglycemia
- Fever
- Infection
- Hypotension
- Drug reaction
- Head injury
How does cognition differ between delirium and dementia?
Delirium has impaired memory, judgment, attention, calculations, while dementia also includes impaired abstract thinking and agnosia.
True or False: The level of consciousness is altered in delirium.
True.
What is the prognosis of delirium compared to dementia?
Delirium can be reversed with intervention, while dementia progresses.
List some types of neurocognitive disorders according to DSM-5.
- Alzheimer’s disease
- Frontotemporal lobar degeneration
- Lewy body disease
- Vascular disease
- Traumatic brain injury
- Substance/medication use
- HIV infection
- Prion disease
What is the strongest risk factor for Alzheimer’s disease?
Age.
What are the manifestations of mild Alzheimer’s disease?
- Friends and family notice subtle changes
- Misplaces objects
- Forgets names
- Trouble with planning/organizing
- Makes up words (neologisms)
What characterizes severe Alzheimer’s disease?
Difficulty communicating, responding to their environments, and controlling movement.
What are the manifestations of vascular dementia?
- Cognitive decline
- Decreased processing speed
- Impaired executive function
What are some common emotional disturbances associated with delirium?
- Rapid mood swings
- Aggressiveness
- Fearfulness
- Anxiety
- Paranoia
Fill in the blank: The nursing process involves recognizing cues during a comprehensive assessment related to _______.
[mood, cognition/perception, physical needs, communication, physical symptoms, mobility, vital signs, diagnostic/laboratory tests]
What safety measures should be implemented in a home setting for clients with neurocognitive disorders?
- Ensure supervision
- Prevent elopement
- Evaluate house for safety hazards
- Assure locks and windows are secure
What is the role of the nurse in caring for clients with neurocognitive disorders?
- Provide equitable and sensitive care
- Knowledge
- Compassion
- Advocacy
What are some pharmacologic actions for treating delirium?
Treat cause and use benzodiazepines for delirium.
What is the purpose of using the MMSE in assessing Alzheimer’s disease?
To determine the stage of cognitive decline.
True or False: Cognitive decline in Lewy body dementia precedes motor manifestations.
True.
What dietary approach can help delay progression of neurodegenerative diseases?
Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND).
What is a common manifestation of frontotemporal lobar dementia?
Disinhibition and loss of empathy.
What is one of the primary goals when generating solutions in the nursing process?
Patient-centered care.
What are finger foods?
Foods that can be eaten with the fingers, often used to assist with eating in individuals with difficulties
What should be checked for during mealtime?
Pocketing
How often should weight be monitored?
Weekly
What may help stimulate appetite?
Music
What services can be considered to assist with meal preparation?
Food delivery services
What should be encouraged to support independence in daily activities?
Use of ADLs as long as possible
What should be encouraged for individuals who need them?
Use of hearing aids
What has been shown to decrease the risk of cognitive decline in men?
Hearing aids and other supportive measures
What dietary approach is associated with neurodegenerative delay?
Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND)
What components are included in the MIND diet?
DASH + Mediterranean
What nutrients are shown to delay progression of cognitive decline?
Flavanols and Omega-3s
What is the first step in managing delirium?
Treat the cause
What medication is used for delirium tremens (DTs)?
Benzodiazepines
Name a cholinesterase inhibitor used for Alzheimer’s.
Donepezil, tacrine, rivastigmine, or galantamine
What drug is used to slow the progression of Alzheimer’s?
Aducanumab
What should be targeted in other dementias?
Cause or symptoms
Which medications are used for Lewy body dementia?
Antidepressants and antipsychotics
What medications are used for vascular disorders?
Statins, anticoagulants, and aspirin
What is the treatment for Parkinson’s disease?
Levodopa and COMT inhibitors
Which medications are used for HIV-related dementia?
Antiretrovirals
What is the treatment for Huntington’s disease?
Tetrabenazine
What should be frequently assessed for in patients?
Changes in cognition/behavior
What aspect of caregiver health should be assessed?
Caregiver strain
What can be suggested to alleviate caregiver strain?
Respite
What should be assessed regarding medication?
Adherence and effectiveness
