Quiz 3

Question 1

Dysarthria-

Answer 1

slurred speech, slower responses –due to disturbance in muscular control due to damage to central or peripheral nervous system

Question 2

Dysphasia –

Answer 2

difficulty expressing or comprehending verbal or written language due to brain lesion of injury

Question 3

Interventions for patients with dementia

Answer 3

a. Nutritional supplements, therapeutic exercise, PT, OT, activities, safe environment, prevent abuse,

Question 4

Causes for impaired cognition

Answer 4

fluid/electrolyte imbalance
medications
congestive heart failure
hyperglycemia, hypoglycemia
hyperthermia/hypothermia
hypercalcemia/hypocalcemia
hypothroidism
decreased cardiac function
decreased respiratory function
decreased renal function
CNS disturbances
emotional stress 
pain
malnutrition
dehydration
Anemias
infection
hypotension
trauma
malignancy
alcoholism
hypoxia
toxic substances

Question 5

a. Delirium –

Answer 5

rapid change in disposition, disruption of the brain due to something, can be reversed if treated promptly

Question 6

b. Dementia –

Answer 6

slow change, due to damage of brain tissue from degenerative diseases

Question 7

6. Signs and Symptoms of Parkinson’s Disease

Answer 7

a. Tremors and shuffling gate

Question 8

preventing/managing sundowner

Answer 8

placing familiar objects in persons room
physical activity in the afternoon 
adjust the lighting in environment 
night light on throughout the night
frequent contact with person
using touch to provide human contact
ensure temp is within comfort range
conrolling nnoise and traffic flow in evening
ensuring person has basic needs met

Question 9

8. Risk factors for Transient Ischemic Attacks (TIA) – temporary or intermittent neurological event that can result from any situation that reduces cerebral circulation.

Answer 9

a. Hyperextension and flexion of the head, reduced blood pressure resulting from anemia and certain drugs (diuretics and antihypertensive), smoking causes vascular constriction, sudden stranding from a prone position
b. Light headedness, dizziness, headache, drop attack, memory and behavioral changes
c. Increase risk of CVA (cerebrovascular accident) – strokes

Question 10

9. What are the major signs of a stroke

Answer 10

a. FAST – face drooping, arm weakness, speech difficulty, time to call 911
b. Paralysis, aphasia (loss of ability to understand or express speech)

Question 11

FAST acronym - FAST

Answer 11

– face drooping, arm weakness, speech difficulty, time to call 911

Question 12

11. When does rehab start in a stroke patient?

Answer 12

Once the patient regains consciousness and stabilizes

Question 13

12. What care considerations are there in a patient starting rehab for stroke patient

Answer 13

a. Attention span is reduced
b. Long/complicated directions may be confusing
c. Recent events/explanations are forgotten (older events may be remembered)
d. Inability to transfer information from one situation to another
e. Confusion, restlessness, irritability

Question 14

13. Contributing factors to a stroke

Answer 14

a. Hypertension, severe arteriosclerosis, diabetes, gout, anemia, hypothyroidism, silent myocardial infarctions, TIA’s , dehydration, smoking

Question 15

Interventions to prevent/decrease incidence of aspiration

Answer 15

a. Thicken liquids – speech language pathologist performs swallow study
b. Make sure sitting upright when eating
c. Pureed foods, mechanically altering food
d. Not rushing meals, small bites

Question 16

15. Risk factors for constipation

Answer 16

a. Dehydration
b. lack of dietary fiber
c. physical inactivity
d. medication side effects (Opioids)
e. regular use of laxatives (cause dependence and decreased bowel function)

Question 17

16. Signs and Symptoms of cholelithiasis (formation of gallstones)

Answer 17

– pain, nausea, vomiting, pain

Gallstones- hardened deposits of digestive fluid
Incidence increases with age
Risk- Female, Fat, Fair skin, Forty – 4 f’s
S/S: pain, nausea, vomiting, pain
Management: diet, nutrition
Treatment: if stone gets stuck in duct, might have to remove gallbladder
Upper right quadrant

Question 18

17. Gastrointestinal changes with aging

Answer 18

changes in pancreas, liver, gallbladder and stomach, tongue, esophagus, intestins

Stomach - decreased motility, higher pH, decline in hydrochloric acid, decline in pepsin, slower peristalsis

a. Atrophy of the tongue affects taste buds and decreases taste sensation.
b. Saliva production decreases & Swallowing may be difficult. – decreases motility of food down the mouth
c. Weaker esophageal contractions and weakness of the sphincter-Risk for aspiration and indigestion
d. Stomach motility decreases
e. Decreased elasticity of the stomach
i. Fewer cells on absorbing surface of intestinal wall impact the absorption of dextrose and vitamins B and D
j. Slower peristalsis, inactivity, reduced food/fluid intake, drugs, and low-fiber diet
k. Sensory perception decreases
l. Gallbladder, Bile salt synthesis decreases
m. Pancreatic changes of fibrosis, atrophy, fatty acid deposits
n. Liver size decreased, function should remain within normal limits; blood flow reduced due to decreased cardiac output
o. Pancreas creates enzymes, Slower moving pancreas – type II diabetes, trouble breaking down sugar
p. Liver – decreased in size, blood flow reduced

Question 19

18. Causes of incontinence

Answer 19

DIAPERS
delirium/confusional state
infection
atrophic urethritis/vaginitis
pharmeceuticals
excess urine output
restricted mobility
stool impaction

weakening of the pelvic muscles, enlargement of the prostate, irritations or spasms of the bladder wall, bladder neck obstructions, neuro – cerebral cortex lesions, MS, dementia

Question 20

19. Nursing interventions for stress incontinence

Answer 20

a. kegel exercises – need to ensure they are doing them correctly
b. stopping stream of urine to feel the correct muscles of pelvic floor

Question 21

20. Causes of urinary retention

Answer 21

a. Bladder blockage
b. Medications
c. Nerve issues
d. Infections/swelling

Question 22

21. Age-related physiological changes in the urinary system

Answer 22

a. Hypertrophy and thickening of the bladder muscle – decrease bladder ability to expand
b. Reduces storage capacity
c. Increased urinary frequency
d. Females - Weakening of pelvic diaphragm
e. Males – prostatic hypertrophy – BPH – enlarged prostate
f. Kidney filtration decreases – affects the ability to eliminate drugs
g. Decrease in renal mass
h. Decreased tubular function
i. Incontinence NOT NORMAL

Question 23

5. Understand the symptoms associated with the stages of Alzheimer’s

Answer 23

Stage 1 - normal adult - no impairment
stage 2 - normal older adult - self report memory impaiment - no objective impairments
stage 3 - cognitive impairments recognized by others - early AD
stage 4 - withdrawl, denial, depression, inability to perform ADLS - mild AD
stage 5 - disoriented to time and place, need assistance with clothing - moderate AD
stage 6 - forgets name of spouse and family members, peronsality changes - moderately severe AD
stage 7 - loss of verbal and psychomotor skills, incontinence needs total assistance - severe AD