Sensorimotor Flashcards
Three most common cognitive problems in adults
Dementia
Delirium
Depression
Nursing concerns delirium/dementia/Alzheimer’s/Parkinson’s
Safety
Nutrition
Communication
Support system/caregiver
What is depression often associated with
Dementia and delirium
What is known as acute confusion
Delirium
Delirium effects about ____% of people who are critically ill
80%
Can delirium be both hypoactive and hyperactive
Yes!
Common infection that causes delirium
UTI
The patho of delirium has something to do with…
Acetylcholine
What is a condition that has been linked to delirium
Chronic stress
Who is more likely to experience delirium men or women
Men
Nurses role with delirium
Prevention
Early recognition
Treatment
Protection and safety
How can you focus on eliminating precipitating factors of delirium
Protect patient from harm
Encourage family members to stay at bedside or may need a sitter
What are two things used in all patients with delirium
Reorientation and behavioral interventions
A patient who is experiencing delirium is also at risk for what two things
Immobility
Skin breakdown
Is delirium preventable?
Yes it is usually preventable
When do you use Drug Therapy for somebody with Delirium
Reserved for those patients with severe agitation. This is because it interferes with needed meds and puts pt at increased risk for falls
What drugs are used to treat Delirium
Low dose antipsychotics
Ex- Haldol
What is Dementia characterized by
Syndrome characterized by dysfunction or loss of
MEMORY and at least one of the others:
-orientation, attitude, language, judgement, reasoning
What are some behavioral problems with dementia
Agitation, delusions, hallucinations
When do physicians usually diagnose Dementia
When 2 or more brain functions are significantly impaired
Problems that dementia can disrupt
Work
Social responsibilities
Family responsibilities
Two most common causes of dementia
- neurodegenerative conditions
- vascular disorders
Important risk factors of Dementia
Advanced age
Family history
What infectious diseases can result in vascular and neurodegenerative changes that can lead to dementia
Bacterial meningitis
Viral encephalitis
What is loss of cognitive function d/t brain lesions caused by cardiovascular disease called
Vascular dementia
How does vascular dementia happen
Decreased blood supply from narrowing and blocking or arteries that supply brain
What type of dementia tends to be abrupt
Vascular dementia
Type of dementia that tends to be gradual and progressive over time
Insidious and gradual
3 classifications of dementia
Mild
Moderate
Severe
Examples of mild dementia
Forgetfulness beyond what is seen in a normal person, short-term memory impairment, geographic disorientation
Examples of moderate dementia
Impaired ability to recognize close friends and family, wandering, getting lost, forgets how to do simple task, delusions, hallucinations
Examples of late stage dementia
Little memory, unable to process information, difficulty eating and swallowing, cannot understand words, incontinence
What can dementia and depression occurring together cause
Extreme intellectual deterioration
True or false: depression is often mistaken for dementia
True!!
Vice versa also
Manifestations of depression..especially seen in older adults
Sadness and difficulty thinking and concentrating
What should you screen for during the physical exam to rule out other medical conditions
Cobalamin (vitamin B 12) deficiencies
Hypothyroidism
Possibly neurosyphilis
What is the most common tool used to assess cognitive function
Mini-Mental State Examination
Diagnostic studies for dementia
CT
MRI
To monitor changes : SPECT and PET
Chronic, progressive, degenerative disease of the brain
Alzheimer’s Disease
How long do most people live after the diagnosis of Alzheimer’s
8-10 years
Who is more likely to develop Alzheimer’s?
- women because of longer life expectancy
- African and Hispanic Americans
What are characteristics of familial Alzheimer’s disease
Earlier onset, occurs around age of 50
More rapid disease course
What comes first with Alzheimer’s pathological or clinical manifestations? By what amount of time ?
Pathological first by 5 to 20 years. Something is going on long before you see symptoms
What are clinical manifestations in Alzheimer’s disease that has progressed?
Dysphasia, apraxia, visual agnosia, dysgraphia, some long term memory loss, wandering, aggression
What are 3 things you could see in late stages of Alzheimer’s disease
- unable to communicate
- cannot perform ADL
- pt may be unresponsive and incontinent, requiring total care
Ways to decrease risk of Alzheimer’s disease
Reading, crossword puzzles, learning a new language, regular physical activity
Parkinson’s is a disease of the ________.
Basal ganglia (gray matter within each cerebral hemisphere)
4 characteristics of Parkinson’s disease
- Slowness in the initiation and execution of movement (bradykinesia)
- Increased muscle tone (rigidity)
- Tremor at rest
- Impaired postural reflexes
When do symptoms of Parkinson’s disease occur
When 80% of the neurons are lost
Goal of Parkinson’s disease
- Maximize neurological functions
- Maintain independence
- Optimize psychosocial well-being
- Keep safe from falls
Diagnostic study for Parkinson’s disease
Positive response to antiparkinsonian drugs
