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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
Q

Cognitive disorders that fall under dementia

A

Alzheimer’s, Vascular, Lewy body, frontotemporal, huntingtons, mixed dementia

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26
Q

Dementia from more than one cause

A

Mixed dementia

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27
Q

S/S of dementia

A

Memory loss/decline, difficulty with problem solving and decision making, changes in language and communication skills, impaired judgement and reasoning, behavioral and mood changes

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28
Q

Nursing priorities for dementia

A

Ensuring safety and preventing falls, promoting supportive environment, encouraging activities that stimulate cognitive function, supporting emotional well-being of patients and caregivers

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29
Q

Dementia diagnostics are focused on

A

Determining the cause

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30
Q

First steps in dementia diagnostic studies

A

Medical, neurologic, and psychosocial history (review cognitive and behavioral changes and include family members/significant others)

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31
Q

Delirium is _________, while dementia is __________

A

Reversible; irreversible

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32
Q

Chronic, progressive, irreversible neurogenerative brain disease that most often affects persons age 65+

A

Alzheimer’s disease

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33
Q

Alzheimer’s symptoms

A

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

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34
Q

Why are Alzheimer’s cases increasing?

A

Because people are living longer lives with chronic diseases

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35
Q

Small number of people develop AD under age ___

A

60

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36
Q

Early onset AD develops in persons less than ___ years old

A

60

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37
Q

Last onset AD occurs in people greater than ___ years old

A

60

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38
Q

The greatest risk factor for AD is

A

Age (most diagnosed 65+, although age alone does not cause AD)

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39
Q

AD pathophysiology

A

Amyloid plaques, neurofibrillary tangles, loss of connections between neurons, neuron death

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40
Q

Etiologic development of AD

A

Plaques formed from B-amyloid; chemical changes in tau proteins result in twisting and tangling

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41
Q

Pathologic changes preceded clinical manifestations of AD by at ___ years

A

15

42
Q

10 clinical manifestations of AD

A

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
Q

Definitive diagnosis of AD usually requires

A

Brain tissue exam at autopsy

44
Q

B-amyloid accumulation in the brain indicates injured or degenerating nerves cells, which is a sign of

A

AD

45
Q

Examples of Alzheimer’s exams

A

Alzheimer’s questionnaire (mild, moderate, severe), clock drawing test

46
Q

On the clock drawing test, scores ___-___ are passing, and scores ___-___ are failing

A

1-2; 3-6

47
Q

True or False: medications do not cure or reverse progression of AD

A

True

48
Q

Medications for decreased memory and cognition related to AD

A

Cholinesterase inhibitors, N-methyl-D-asparate (NMDA)

49
Q

Examples of cholinesterase inhibitors for AD

A

Donepezil (Aricept), rivastigmine (Exelon), galantamine (Razadyne)

50
Q

N-methyl-D-asparate blocks the action of

A

Glutamate

51
Q

Example of NMDA

A

Memantine (Nemenda)

52
Q

Donepezil nursing consideration

A

Do not administer if pulse is less than 60 bpm

53
Q

Pharmacological treatment of depression associated with AD

A

SSRIs: fluoxetine (Prozac), sertraline (Zoloft), fluvoxamine (Luvox), citalopram (Celexa)

54
Q

Medication for sleep disturbances related to depression and AD

A

Trazodone

55
Q

Examples of antipsychotics given for behavioral problems related to AD

A

Haloperidol (Haldol), risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), aripiprazole (Abilify)

56
Q

Antipsychotic drugs _________ the risk of death and cognitive decline in patients with AD

A

Increase

57
Q

State of delirium that develops over hours to days

A

Delirium

58
Q

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

A

Delirium

59
Q

S/S of hyperactive delirium

A

Agitated, aggressive, delusional, combative

60
Q

S/S of hypoactive delirium

A

Lethargic, withdrawn, confused, mute

61
Q

_____ delirium includes periods of hyperactive and hypoactive delirium

A

Mixed

62
Q

Common causes of delirium

A

CVA, infection, medications, metabolic, organ failure, seizure, toxicologic, sleep deprivation (noisy ICU, uncontrolled pain, frequent checkups)

63
Q

Metabolic causes of delirium

A

Hypoglycemia, fever/hypothermia, electrolyte disorders, wernickes encephalopathy

64
Q

Toxicologic causes of delirium

A

ETOH withdrawal, BZD, gabapentin, baclofen, opioids, SNRIs, intoxication/poisoning

65
Q

Reversible causes of delirium

A

Uncontrolled pain, inadequate sleep, immobility, metabolic disturbances, malnutrition, constipation, infection, substance or drug abuse

66
Q

Drug induced causes of delirium

A

Sedatives, muscle relaxants, antihistamines, antimicorbials, metaclopramide, TCAs, zolpidem, corticosteroids, dopamine agonists

67
Q

Delirium usually develops over a ___ to ___ day period

A

2-3 (can develop within hours)

68
Q

Delirium can last ___ to ___ days

A

1-7 (can persist for months or years and some patients do not fully recover)

69
Q

Delirium causes (hint: PINCH ME)

A

Pain, infection, constipation or urinary retention, hydration, medications and substances, environmental triggers

70
Q

Delirium pharmacology is reserved for patients with severe agitation when

A

interferes with needed medical therapy, puts patient at increased risk for falls and injury, nonpharmacologic interventions have failed

71
Q

Delirium pharmacology

A

Dexmedetomidine (Precedex) for sedation, antipsychotics like haloperidol and risperidone, short-acting Benzos such as lorazepam (Ativan)

72
Q

Patients with dementia and delirium may have symptoms of

A

Depression

73
Q

Depression and _________ are often mistaken for one another, especially with older adults

A

Dementia

74
Q

Manifestations of depression in older adults

A

Sadness, difficulty concentrating, fatigue, apathy, feelings of despair, and inactivity

75
Q

Function of frontal lobe

A

Memory, judgment, thinking

76
Q

Function of temporal lobe

A

Hearing, language, sensations

77
Q

Function of occipital lobe

A

Vision

78
Q

Function of parietal lobe

A

Language

79
Q

Inability to perform certain motor movements

A

Apraxia

80
Q

Inability to speak and understand speech

A

Aphasia

81
Q

Inability to recognize objects or people; loss of senses

A

Agnosia

82
Q

Memory loss

A

Amnesia

83
Q

Inability to remember the names of objects

A

Anomia

84
Q

Unintentional lying and creation of false scenarios

A

Confabulation

85
Q

Confabulation is seen in

A

Early dementia/alzheimers and ETOH abuse

86
Q

As the sun goes down, confusion gets worse

A

Sundown syndrome

87
Q

Acute forgetfulness related to trauma, ETOH abuse, etc.

A

Delirium

88
Q

Patients with dementia/alzheimer’s commonly die as a result of

A

Aspiration pneumonia

89
Q

Alzheimer’s risk factors

A

Genetics, Trisomy 21 (down syndrome), impairment of chromosome 1 and 14, age 65+

90
Q

Delirium risk factors

A

Hospitalization, ICU delirium, polypharmacy, old age, stroke, surgery, restraints, secondary to medical condition (infection, electrolyte imbalance, substance abuse)

91
Q

Delirium manifestations

A

Disorganization (time and place, most commonly at night), decreased memory, anxiety and agitation, delusional thinking, ranges from lethargic to hypervigilence

92
Q

Delirium interventions

A

Safety (prevent physical harm), avoid restraints when possible, physical needs (hygiene, water, sleep), antiaxiety/antipsychotic medications

93
Q

Alzheimer’s risk factors

A

Genetics (family hx), head injury, advanced age (65+), CV disease and lifestyle (inactivity, unhealthy diet, high cholesterol, obesity, diabetes)

94
Q

Stages of mild Alzheimer’s disease

A

Early stage (may not be noticeable to others), memory lapse, misplacing things, difficulty focusing, can still accomplish own ADLs

95
Q

Moderate stage of Alzheimer’s disease

A

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
Q

Severe Alzheimer’s disease

A

Requires full assistance, needs assistance with all ADLs, losing physical skills (walking, sitting, swallowing), may result in death or coma

97
Q

Alzheimer’s interventions

A

Monitor nutrition, weight, and fluid status, maintain a quiet environment to decrease stimuli, cholinesterase inhibitors

98
Q

Cholinesterase inhibitors are used in _____ and _____ stages of dementia and Alzheimer’s disease

A

Mild and moderate

99
Q

Examples of cholinesterase inhibitors for dementia and Alzheimer’s

A

Donepezil (Aricept), galatamine (Razydyne), rivastigmine (Exelon)

100
Q

Communication with the client with Alzheimer’s

A

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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