S2. Ch 30: Cognitive: Delirium, Dementia, and Alzheimer's

Question 1

the reversible alteration in cognition caused by acute conditions

Answer 1

delirium

Question 2

the irreversible impairment in cognition caused by disease or injury to the brain.

Answer 2

dementia

Question 3

Cause: Disruption in brain function due to medication side effect, circulatory disturbance, dehydration, low or high blood pressure, low or high thyroid activity, low or high blood glucose, surgery, stress, etc.

Answer 3

delirium

Question 4

Cause: Damage to brain tissue due to Alzheimer’s or other degenerative diseases, circulatory problems, lack of oxygen, infection, trauma, hydrocephalus, tumor, alcoholism, etc.

Answer 4

Dementia

Question 5

Which disorder is rapid? Which is slow?

Answer 5

rapid: delirium
slow: dementia

Question 6

Short-term memory impaired more than long-term, disoriented, confused, distorted thinking, incoherent speech, may be suspicious of others, see or hear things that are not there (illusions, hallucinations), exaggeration of personality features

Answer 6

delirium

Question 7

Poor short- and long-term memory, disoriented, confused, difficulty finding proper word to use, impaired judgment, problems with arithmetic and problem-solving, personality changes

Answer 7

dementia

Question 8

hallucinations and illusions occur in which disease?

Answer 8

delirium

Question 9

During the initial acute stage of delirium, __ and ___ are primary goals.

Answer 9

establishing medical stability and minimizing stimulation

Question 10

an irreversible, progressive impairment in cognitive function affecting memory, orientation, judgment, reasoning, attention, language, and problem-solving.

Answer 10

dementia

Question 11

An estimated _% older adults suffer some form of dementia.

Answer 11

5%

Question 12

____ is the most common form of dementia

Answer 12

Alzheimer’s disease

Question 13

Alzheimer’s disease is characterized by two changes in the brain. The first is the presence of ___

Answer 13

neuritic plaques, which contain deposits of β-amyloid protein

Question 14

Alzheimers: β-Amyloid protein is a fragment of amyloid precursor protein that helps _______.

Answer 14

the neurons grow and repair.

Question 15

Alzheimers: The β-amyloid fragments clump together into plaques that ____

Answer 15

impair the function of nerve cells in the brain.

Question 16

Alzheimers: The second characteristic brain change is ___

Answer 16

neurofibrillary tangles in the cortex.

Question 17

Microtubules, structures within healthy neurons, are normally stabilized by a special protein called ___

Answer 17

tau

Question 18

In Alzheimer’s disease, tau is changed and begins to pair with___. This causes the microtubules to disintegrate and collapse the neuron’s transport system.

Answer 18

other threads of tau that become tangled

Question 19

Alzheimers: The 2 brain changes lead to a ___, especially within the neocortex and hippocampus

Answer 19

loss or degeneration of neurons and synapses

Question 20

There are also changes in neurotransmitter systems associated with Alzheimer’s disease, including reductions in __ receptors, serotonin uptake into __, production of __ in the areas of the brain in which plaque and tangles are found, ___ (which breaks down acetylcholine), and choline ____.

Answer 20

serotonin
platelets
acetylcholine
acetylcholinesterase
acetyltransferase

Question 21

The transitional stage between normal cognitive aging and dementia in which the person has short-term memory impairment and challenges with complex cognitive functions is referred to as a ___

Answer 21

mild cognitive impairment.

Question 22

the prevalence of Alzheimer’s disease is higher in families with __

Answer 22

Down’s syndrome

Question 23

An altered chromosome 21 in people with Alzheimer’s disease causes production of an abnormal ___

Answer 23

amyloid precursor protein

Question 24

There is some investigation into the role of ___ in the development of Alzheimer’s disease

Answer 24

free radicals

Question 25

___ are molecules that can build up in neurons, resulting in damage (called oxidative damage)

Answer 25

Free radicals

Question 26

Higher than normal levels of __ and ___ have been found in the brain cells of Alzheimer’s disease patients, causing some speculation regarding the role of environmental toxins in the disease

Answer 26

aluminum and mercury

Question 27

Some risks hypothesized to be associated with Alzheimer’s disease include:

Answer 27

hyperlipidemia, hypertension, smoking, head injury, and physical and mental inactivity.

Question 28

What is Creutzfeldt-Jakob disease?

Answer 28

an extremely rare brain disorder that causes dementia. It has a rapid onset and progression and is characterized by severe neurological impairment that accompanies the dementia. The disease progresses rapidly, and death typically occurs within 1 year of diagnosis.

Question 29

What is a disease with rapid onset and progression of disease to death?

Answer 29

Creutzfeldt-Jakob disease

Question 30

3 ways to care for a patient with Dementia:

Answer 30

• ensuring patient safety
• promoting therapy and activity
• providing physical care

Question 31

T/F: The onset of behavioral problems in a person with dementia indicates the need for medications to suppress the behavior problem identified.

Answer 31

False

Question 32

therapeutic breathing exercises to stimulate oxygenation to brain

Answer 32

Qigong

Question 33

CAM therapies include

Answer 33

• herbs
• minerals
• vitamins
• nutritional supplements

Question 34

Respecting the individual: need to promote what 5 things?

Answer 34

• Individuality
• Independence
• Freedom
• Dignity
• Connection

Question 35

How do you support the patients family w Dementia?

Answer 35

• Consideration of physical, emotional, and socioeconomic burdens of caregiving
• Review/educate basic care techniques
• Help prepare for feelings that may accompany the role of caregiver
• Community resources

Question 36

Dementia: Brain damage caused by multiple strokes.

Answer 36

Vascular dementia

Question 37

Dementia: A disease that can change a person’s personality and their ability to live an independent life

Answer 37

Frontotemporal dementia

Question 38

Dementia: A type of dementia accompanied by changes in sleep, behavior, cognition, movement, and autonomic bodily functions

Answer 38

Lewy body dementia

Question 39

Dementia: The presence of neurological symptoms caused by biochemical lesions of the central nervous system after exhaustion of B-vitamin reserves, in particular thiamine (vitamin B1)

Answer 39

Wernicke encephalopathy

Question 40

Dementia: a progressive nervous system disorder that affects movement.

Answer 40

Parkinson’s disease

Question 41

Dementia: Decline in mental processes is a complication of advanced HIV infection

Answer 41

AIDS dementia

Question 42

Is there a treatment for Alzheimers and what is it?

Answer 42

there is none

Question 43

Alzheimers: Clinical trials in place to improve function and __ __ __

Answer 43

slow disease progression

Question 44

Alzheimers: medications that slow __

Answer 44

acetylcholinesterase

Question 45

Alzheimer patients have levels of __ and __ in their brain

Answer 45

aluminum & mercury

Question 46

interventions during the initial acute stage of delirium:

Answer 46

• Establishing medical stability
• Minimizing stimulation
• Consistency in care
• Prevention of harm to self & others
• Support and realistic expectations