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54/64 Unit 2 > Senior Mental Health > Flashcards

Senior Mental Health Flashcards

1
Q

Neurological changes with aging

A

Reduction in neurotransmitter production, changes in brain structure, decline in cognitive function, memory loss, slower processing speed, difficulty concentrating

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2
Q

A collective term for a group of neurocognitive disorders characterized by a decline in cognitive functions such as memory, language, recognizing, reasoning, or planning

A

Dementia

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3
Q

Progressive decline in mental functions such as memory, thinking, language, behavior, and mood & personality

A

Dementia

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4
Q

What is the most common type of dementia?

A

Alzheimer’s

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5
Q

Early signs of dementia

A

Confabulation, social isolation that can be accompanied by depression

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6
Q

Why do patients with dementia avoid social interaction?

A

Due to forgetfulness

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7
Q

Moderate dementia is characterized by a

A

Loss in recent and sometimes long-term memory

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8
Q

Symptoms of depression in elderly

A

Feelings of despair/sadness, sleep problems, no desire for socializing, loss of interest in beloved activities, irritability/grumpiness, loss of appetite/weight changes, struggling to think clearly

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9
Q

What are the MOST concerning signs of depression in the elderly population?

A

Feelings of sadness, loss of interest in activities they usually enjoy, change in socialization patterns, missing work

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10
Q

Interventions for geriatric depression

A

Counseling/therapy, connecting with loved ones, exercise, diet

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11
Q

Diet for geriatric depression

A

Diet rich in fruits, vegetables, and whole grains (boosts mood and energy levels)

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12
Q

The aging process related to physical health

A

Various health conditions, chronic illnesses, medication use (polypharmacy), impact on mental well-being, chronic pain leading to increased stress and depression

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13
Q

Discrimination against individuals based on their increasing age

A

Ageism

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14
Q

What is the primary risk factor for cognitive disorders?

A

Age; genetics, lifestyle, and other health conditions contribute to vulnerability

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15
Q

S/S of cognitive disorders

A

Memory loss or decline, difficulty problem solving and decision making, changes in language and communication skills

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16
Q

Choosing an area that is least distracting is beneficial for assessing a patient with

A

Delirium

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17
Q

A patient with delirium may benefit from having a _____ for safety

A

Sitter (task can be delegated to UAP)

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18
Q

Priority assessment of patient with dementia/Alzheimer’s who develops a cough

A

Aspiration pneumonia

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19
Q

Progressive memory loss, cognitive decline, and changes in behavior

A

Alzheimer’s disease

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20
Q

Cognitive disorder caused by reduced blood flow to the brain, leading to cognitive impairment

A

Vascular dementia

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21
Q

Cognitive disorder that involves hallucinations, motor symptoms, and fluctuating cognitive abilities

A

Levy body dementia

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22
Q

Cognitive disorder that affects behavior, language, and personality due to damage in the frontal and temporal lobes

A

Frontotemporal dementia

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23
Q

Cognitive decline beyond what is expected for age, but not meeting criteria for dementia

A

Mild cognitive impairment (MCI)

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24
Q

An umbrella term for loss of memory and other thinking abilities severe enough to interfere with daily life

A

Dementia

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25
Cognitive disorders that fall under dementia
Alzheimer’s, Vascular, Lewy body, frontotemporal, huntingtons, mixed dementia
26
Dementia from more than one cause
Mixed dementia
27
S/S of dementia
Memory loss/decline, difficulty with problem solving and decision making, changes in language and communication skills, impaired judgement and reasoning, behavioral and mood changes
28
Nursing priorities for dementia
Ensuring safety and preventing falls, promoting supportive environment, encouraging activities that stimulate cognitive function, supporting emotional well-being of patients and caregivers
29
Dementia diagnostics are focused on
Determining the cause
30
First steps in dementia diagnostic studies
Medical, neurologic, and psychosocial history (review cognitive and behavioral changes and include family members/significant others)
31
Delirium is _________, while dementia is __________
Reversible; irreversible
32
Chronic, progressive, irreversible neurogenerative brain disease that most often affects persons age 65+
Alzheimer’s disease
33
Alzheimer’s symptoms
Confusion w/ time and location, difficulty completing familiar tasks, misplacing items, difficulty solving problems, memory loss, poor judgment, unfounded emotions, withdrawal from social activities, trouble with images and spaces, difficulty with words
34
Why are Alzheimer’s cases increasing?
Because people are living longer lives with chronic diseases
35
Small number of people develop AD under age ___
60
36
Early onset AD develops in persons less than ___ years old
60
37
Last onset AD occurs in people greater than ___ years old
60
38
The greatest risk factor for AD is
Age (most diagnosed 65+, although age alone does not cause AD)
39
AD pathophysiology
Amyloid plaques, neurofibrillary tangles, loss of connections between neurons, neuron death
40
Etiologic development of AD
Plaques formed from B-amyloid; chemical changes in tau proteins result in twisting and tangling
41
Pathologic changes preceded clinical manifestations of AD by at ___ years
15
42
10 clinical manifestations of AD
Memory loss that affects job skills, difficulty performing familiar tasks, problems with language, disorientation to time and place, poor judgment, problems with abstract thinking, misplacing things, changes in mood or behavior, changes in personality, loss of initiative
43
Definitive diagnosis of AD usually requires
Brain tissue exam at autopsy
44
B-amyloid accumulation in the brain indicates injured or degenerating nerves cells, which is a sign of
AD
45
Examples of Alzheimer’s exams
Alzheimer’s questionnaire (mild, moderate, severe), clock drawing test
46
On the clock drawing test, scores ___-___ are passing, and scores ___-___ are failing
1-2; 3-6
47
True or False: medications do not cure or reverse progression of AD
True
48
Medications for decreased memory and cognition related to AD
Cholinesterase inhibitors, N-methyl-D-asparate (NMDA)
49
Examples of cholinesterase inhibitors for AD
Donepezil (Aricept), rivastigmine (Exelon), galantamine (Razadyne)
50
N-methyl-D-asparate blocks the action of
Glutamate
51
Example of NMDA
Memantine (Nemenda)
52
Donepezil nursing consideration
Do not administer if pulse is less than 60 bpm
53
Pharmacological treatment of depression associated with AD
SSRIs: fluoxetine (Prozac), sertraline (Zoloft), fluvoxamine (Luvox), citalopram (Celexa)
54
Medication for sleep disturbances related to depression and AD
Trazodone
55
Examples of antipsychotics given for behavioral problems related to AD
Haloperidol (Haldol), risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), aripiprazole (Abilify)
56
Antipsychotic drugs _________ the risk of death and cognitive decline in patients with AD
Increase
57
State of delirium that develops over hours to days
Delirium
58
An acute, generalized brain dysfunction known as “cerebral insufficiency” causing disturbance in attention and awareness, disturbance in cognition (memory defect/disorientation), and periods of lucidity between periods of confusion
Delirium
59
S/S of hyperactive delirium
Agitated, aggressive, delusional, combative
60
S/S of hypoactive delirium
Lethargic, withdrawn, confused, mute
61
_____ delirium includes periods of hyperactive and hypoactive delirium
Mixed
62
Common causes of delirium
CVA, infection, medications, metabolic, organ failure, seizure, toxicologic, sleep deprivation (noisy ICU, uncontrolled pain, frequent checkups)
63
Metabolic causes of delirium
Hypoglycemia, fever/hypothermia, electrolyte disorders, wernickes encephalopathy
64
Toxicologic causes of delirium
ETOH withdrawal, BZD, gabapentin, baclofen, opioids, SNRIs, intoxication/poisoning
65
Reversible causes of delirium
Uncontrolled pain, inadequate sleep, immobility, metabolic disturbances, malnutrition, constipation, infection, substance or drug abuse
66
Drug induced causes of delirium
Sedatives, muscle relaxants, antihistamines, antimicorbials, metaclopramide, TCAs, zolpidem, corticosteroids, dopamine agonists
67
Delirium usually develops over a ___ to ___ day period
2-3 (can develop within hours)
68
Delirium can last ___ to ___ days
1-7 (can persist for months or years and some patients do not fully recover)
69
Delirium causes (hint: PINCH ME)
Pain, infection, constipation or urinary retention, hydration, medications and substances, environmental triggers
70
Delirium pharmacology is reserved for patients with severe agitation when
interferes with needed medical therapy, puts patient at increased risk for falls and injury, nonpharmacologic interventions have failed
71
Delirium pharmacology
Dexmedetomidine (Precedex) for sedation, antipsychotics like haloperidol and risperidone, short-acting Benzos such as lorazepam (Ativan)
72
Patients with dementia and delirium may have symptoms of
Depression
73
Depression and _________ are often mistaken for one another, especially with older adults
Dementia
74
Manifestations of depression in older adults
Sadness, difficulty concentrating, fatigue, apathy, feelings of despair, and inactivity
75
Function of frontal lobe
Memory, judgment, thinking
76
Function of temporal lobe
Hearing, language, sensations
77
Function of occipital lobe
Vision
78
Function of parietal lobe
Language
79
Inability to perform certain motor movements
Apraxia
80
Inability to speak and understand speech
Aphasia
81
Inability to recognize objects or people; loss of senses
Agnosia
82
Memory loss
Amnesia
83
Inability to remember the names of objects
Anomia
84
Unintentional lying and creation of false scenarios
Confabulation
85
Confabulation is seen in
Early dementia/alzheimers and ETOH abuse
86
As the sun goes down, confusion gets worse
Sundown syndrome
87
Acute forgetfulness related to trauma, ETOH abuse, etc.
Delirium
88
Patients with dementia/alzheimer’s commonly die as a result of
Aspiration pneumonia
89
Alzheimer’s risk factors
Genetics, Trisomy 21 (down syndrome), impairment of chromosome 1 and 14, age 65+
90
Delirium risk factors
Hospitalization, ICU delirium, polypharmacy, old age, stroke, surgery, restraints, secondary to medical condition (infection, electrolyte imbalance, substance abuse)
91
Delirium manifestations
Disorganization (time and place, most commonly at night), decreased memory, anxiety and agitation, delusional thinking, ranges from lethargic to hypervigilence
92
Delirium interventions
Safety (prevent physical harm), avoid restraints when possible, physical needs (hygiene, water, sleep), antiaxiety/antipsychotic medications
93
Alzheimer’s risk factors
Genetics (family hx), head injury, advanced age (65+), CV disease and lifestyle (inactivity, unhealthy diet, high cholesterol, obesity, diabetes)
94
Stages of mild Alzheimer’s disease
Early stage (may not be noticeable to others), memory lapse, misplacing things, difficulty focusing, can still accomplish own ADLs
95
Moderate stage of Alzheimer’s disease
Noticeable to others, forgetfulness, short term memory loss, personality changes*, gets lost and wanders often, unable to do some ADLs and self care (may be incontinent)
96
Severe Alzheimer’s disease
Requires full assistance, needs assistance with all ADLs, losing physical skills (walking, sitting, swallowing), may result in death or coma
97
Alzheimer’s interventions
Monitor nutrition, weight, and fluid status, maintain a quiet environment to decrease stimuli, cholinesterase inhibitors
98
Cholinesterase inhibitors are used in _____ and _____ stages of dementia and Alzheimer’s disease
Mild and moderate
99
Examples of cholinesterase inhibitors for dementia and Alzheimer’s
Donepezil (Aricept), galatamine (Razydyne), rivastigmine (Exelon)
100
Communication with the client with Alzheimer’s
Speak slowly, give one direction at a time, don’t ask complex or open-ended questions, ask simple and direct questions, face the client directly when speaking

54/64 Unit 2 (8 decks)

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