S2. Ch 30: Cognitive: Delirium, Dementia, and Alzheimer's Flashcards
the reversible alteration in cognition caused by acute conditions
delirium
the irreversible impairment in cognition caused by disease or injury to the brain.
dementia
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.
delirium
Cause: Damage to brain tissue due to Alzheimer’s or other degenerative diseases, circulatory problems, lack of oxygen, infection, trauma, hydrocephalus, tumor, alcoholism, etc.
Dementia
Which disorder is rapid? Which is slow?
rapid: delirium
slow: dementia
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
delirium
Poor short- and long-term memory, disoriented, confused, difficulty finding proper word to use, impaired judgment, problems with arithmetic and problem-solving, personality changes
dementia
hallucinations and illusions occur in which disease?
delirium
During the initial acute stage of delirium, __ and ___ are primary goals.
establishing medical stability and minimizing stimulation
an irreversible, progressive impairment in cognitive function affecting memory, orientation, judgment, reasoning, attention, language, and problem-solving.
dementia
An estimated _% older adults suffer some form of dementia.
5%
____ is the most common form of dementia
Alzheimer’s disease
Alzheimer’s disease is characterized by two changes in the brain. The first is the presence of ___
neuritic plaques, which contain deposits of β-amyloid protein
Alzheimers: β-Amyloid protein is a fragment of amyloid precursor protein that helps _______.
the neurons grow and repair.
Alzheimers: The β-amyloid fragments clump together into plaques that ____
impair the function of nerve cells in the brain.
Alzheimers: The second characteristic brain change is ___
neurofibrillary tangles in the cortex.
Microtubules, structures within healthy neurons, are normally stabilized by a special protein called ___
tau
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.
other threads of tau that become tangled
Alzheimers: The 2 brain changes lead to a ___, especially within the neocortex and hippocampus
loss or degeneration of neurons and synapses
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 ____.
serotonin platelets acetylcholine acetylcholinesterase acetyltransferase
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 ___
mild cognitive impairment.
the prevalence of Alzheimer’s disease is higher in families with __
Down’s syndrome
An altered chromosome 21 in people with Alzheimer’s disease causes production of an abnormal ___
amyloid precursor protein
There is some investigation into the role of ___ in the development of Alzheimer’s disease
free radicals
___ are molecules that can build up in neurons, resulting in damage (called oxidative damage)
Free radicals
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
aluminum and mercury
Some risks hypothesized to be associated with Alzheimer’s disease include:
hyperlipidemia, hypertension, smoking, head injury, and physical and mental inactivity.
What is Creutzfeldt-Jakob disease?
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.
What is a disease with rapid onset and progression of disease to death?
Creutzfeldt-Jakob disease
3 ways to care for a patient with Dementia:
- ensuring patient safety
- promoting therapy and activity
- providing physical care
T/F: The onset of behavioral problems in a person with dementia indicates the need for medications to suppress the behavior problem identified.
False
therapeutic breathing exercises to stimulate oxygenation to brain
Qigong
CAM therapies include
- herbs
- minerals
- vitamins
- nutritional supplements
Respecting the individual: need to promote what 5 things?
- Individuality
- Independence
- Freedom
- Dignity
- Connection
How do you support the patients family w Dementia?
- 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
Dementia: Brain damage caused by multiple strokes.
Vascular dementia
Dementia: A disease that can change a person’s personality and their ability to live an independent life
Frontotemporal dementia
Dementia: A type of dementia accompanied by changes in sleep, behavior, cognition, movement, and autonomic bodily functions
Lewy body dementia
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)
Wernicke encephalopathy
Dementia: a progressive nervous system disorder that affects movement.
Parkinson’s disease
Dementia: Decline in mental processes is a complication of advanced HIV infection
AIDS dementia
Is there a treatment for Alzheimers and what is it?
there is none
Alzheimers: Clinical trials in place to improve function and __ __ __
slow disease progression
Alzheimers: medications that slow __
acetylcholinesterase
Alzheimer patients have levels of __ and __ in their brain
aluminum & mercury
interventions during the initial acute stage of delirium:
- Establishing medical stability
- Minimizing stimulation
- Consistency in care
- Prevention of harm to self & others
- Support and realistic expectations
