Neurologic System Flashcards
unrecognized, undiagnosed, and misdiagnosed as depression.
Is a MEDICAL EMERGENCY
Delirium
priority in delirium
safety and communication
A COMMON DISORDER, occurring in 50% of older persons admitted to acute care settings.
Delirium
UNDERREPORTED (masked by dementia, by commorbidities, or stigma of aging)
Depression
what are the symptoms of depression?
mood, interest, suicidal ideas, concentration, psychomotor agitation or retardation, appetite, guilt, fatigue or loss of energy.
DSM-5: the individual must be experiencing five or more symptoms during the same 2-week period and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure.
Depression
Neurocognitive disorder
Dementia
An umbrella term for a number of neurological conditions, of which the major symptom is the decline in brain function due to physical changes in the brain.
Dementia
it is distinct from mental illness
Dementia
is the most common type of Dementia in the older persons
Alzheimer’s Disease
symptom of Dementia:
Expressive/Receptive
- A-PH(F)ADING language of comprehension of speech.
Aphasia
Symptoms of Dementia:
inability to carry out motor activities
Apraxia
Symptoms of Dementia:
inability to recognize or identify objects despite intact sensory function
Agnosia
symptoms of Dementia:
higher order decision making and planning
- S-O-A-P sequencing, ordering, abstract thinking and planning
Executive dysfunction
the difference between minor and major neurocognitive disorder is based on the six cognitive domains: give the six
- perceptual-visual perception (praxis)
-complex attention
-Executive ability
-learning and memory
-language
-social cognition
types of dementia
-Alzheimer’s Disease ( most common)
-vascular dementia
-Lewy body disease
-fronto-temporal dementia
neurologic system
ASSESSMENT TOOLS:
what is:
CAM
MMSE
C D T
GDS
CAM- Confusion Assessment Method (Delirium)
MMSE- Mini Mental Status Examination or Mini-Cog (Dementia)
C D T- Clock Drawing Test (Dementia) supplement to MMSE
GDS- Geriatric Depression Scale (Depression)
give the 4 features of CAM- Confusion Assessment Method
f1: Acute Onset or Fluctuating Course
f2: Inattention
f3: Disorganized thinking
f4: Altered level of consciousness
3 words + clock drawing test
MMSE- Mini Mental Status Examination or Mini-Cog
assessment tool for depression
GDS- Geriatric Depression Scale (Depression)
drawing test for dementia
C D T- Clock Drawing Test (Dementia) supplement to MMSE
neurologic system
2 management
- Pharmacologic management
- Non-Pharmacologic management
neurologic system management that START LOW, GO SLOW
Pharmacologic management
neurologic system management that:
-CBT: Cognitive Behavior therapy
-communication, consistency
-SAFETY AND COMMUNICATION
Non-Pharmacologic management
A chronic, progressive neurologic disorder
PARKINSON’S DISEASE (PD)
Symptoms are caused by the loss of nerve cells in the pigmented substantial nigra pars compact and the locus coeruleus in the midbrain.
PARKINSON’S DISEASE (PD)
present in the basal ganglia, brain stem, spinal cord, and sympathetic gangilia
PARKINSON’S DISEASE (PD) Lewy bodies
considered an extrapyramidal syndrome: that involuntary twitching of the limbs or facial muscles
PARKINSON’S DISEASE (PD) chorea
considered an extrapyramidal syndrome: involuntary muscle contractions forcing unusual or painful positions
PARKINSON’S DISEASE (PD) dystonia
increases with AGE; more common in men and than women
PARKINSON’S DISEASE (PD)
that has an unknown cause
PARKINSON’S DISEASE (PD)
the loss of the dopaminergic cells situated deep in the midbrain in the substantia nigra
PARKINSON’S DISEASE (PD)
early warning signs of PARKINSON’S DISEASE (PD)
-tremor
-loss of smell
-small handwriting
-sleep problems
-trouble moving
-constipation
-voice changes
- masked face
- dizziness
- stooping
what are the nursing care
- improve functional mobility
-maintain independence in activities of daily living
-achieve adequate bowel movement
-attain and maintain acceptable nutritional status
-achieve effective communication
-develop positive coping mechanisms
are significant public health
are the second leading cause of accidental or unintentional injury deaths
FALL
Environmental modifications are necessary to compensate for functional disabilities
enlist assistance of an occupational therapist as indicated
SELF-CARE
increase oral fluid intake and encourage to eat food with moderate fiber content
-A raised toilet seat is useful, because the patient has difficulty in moving from a standing to a sitting position
Establish a regular bowel routine
BOWEL ELIMINATION
-promote swallowing and prevent aspiration by having patient sit in upright position during meals
-provide semisolid diet with thick liquids that are easier
SWALLOWING AND NUTRITION
QUESTION?
A patient with PARKINSON’S DISEASE has a diagnosis of impaired physical mobility related to bradykinesia. Which action will the nurse include in the plan of care
a. instruct the patient in activities that can be done while lying or sitting
b. suggest that the patient rock from side to side to initiate leg movement
c. have the patient take small steps in a straight line directly in front of the feet