Test 2: Blueprint (1) Flashcards
What is a mental state characterized by a disturbance of cognition, which is manifested as confusion, excitement, disorientation, and a clouding of consciousness.
delirium
Is delirium acute or chronic?
acute
What is meant by “sundowning”?
symptoms become worse in late afternoon and evening
ex/ pts will wander around
What are some predisposing factors of delirium?
- systemic infections
- febrile illness
- metabolic disorders (hypoxia, hypercarbia, hypoglycemia)
- hepatic encephalopathy
- head trauma
- seizures
- migraines
- brain abscess
- stroke
- postoperative states
- electrolyte imbalance
How should delirium be managed?
1) determine and correct the cause
2) Medications
What meds are commonly used to relieve delirium symptoms?
- benzos for substance withdrawal
- neuroleptics (antipsychotics) for agitation, aggression, hallucinations, illusions
What is a syndrome of chronic and possibly progressive intellectual and functional impairment involving memory, language, emotion, cognition, and changes in the personality?.
neurocognitive disorder
Is neurocognitive disorder associated with alzheimer’s primary or secondary?
Primary
Is neurocognitive disorder associated with HIV, depression, or nutritional deficiency primary or secondary.
Secondary
These things CAUSE NCD.
How is neurocognitive disorder assessed?
- History
- Physical and cognitive assessments
- Blood and urine lab work
- Chest x-ray
- PET, CT, or MRI of brain
- EEG
- Lumbar puncture
What are 7 common nursing diagnoses associated with NCD?
1) Risk for trauma
2) Disturbed/altered thought processes
3) Disturbed sensory perception
4) Risk for other directed violence
5) Impaired verbal communication
6) Self-care deficit
7) Situational low self-esteem or grieving
Name the nursing diagnosis:
Falls, wandering, confusion, poor coordination
Risk for trauma
Name the nursing diagnosis:
Disorientation, confusion, memory deficits, paranoia
Disturbed/altered thought processes
Name the nursing diagnosis:
Experiencing hallucinations
Disturbed sensory perception
Name the nursing diagnosis:
Aggressiveness
Risk for other directed violence
Name the nursing diagnosis:
Aphasia
Impaired verbal communication
Name the nursing diagnosis:
Inability to do ADLs
Self-care deficit
Name the nursing diagnosis:
Expressions of shame, social isolation
Situational low self-esteem or grieving
What is the most important intervention for someone with a NCD?
SAFETY!!!
What are common interventions with NCD?
1) Safety first and foremost!
2) Promote client self-esteem and life quality
3) Family education and support
4) Community referrals
5) Encourage and allow time to do ADLs, assisting as needed
What classes of meds are used to treat NCD?
- cholinisterase inhibitors
- NMDA receptor agonists
- antipsychotics
- SSRIs
- TCAs
- Benzoa
- Selective-hypnotics
- Antidepressants
- Tetracyclic antidepressants
Cholinisterase Inhibitor meds:
donepezil (Aricept)
rivastigmine
galantamine
NMDA Receptor Agonist meds:
memantine (Namenda)
Antipsychotic meds:
risperidone
olanzapine
quetiapine
haloperidol
SSRI meds:
sertraline
paroxetine
TRIcyclic Antidepressant (TCA) meds:
nortriptyline
Benzodiazepine meds:
lorazepam
oxazepam
temazepam
Selective-Hypnotic meds:
zolpidem
zaleplon
eszopicline
ramelteon
Antidepressant meds:
trazodone
TETRAcyclic Antidepressant med:
mirtazapine
Define aphasia:
- inability to speak or unable to express what they need
- forget meanings of word and names or use of things
Define apraxia:
(apraxia sounds like TAXI…MOTOR)
the inability to carry out motor activities and eventually unable to care for self
Define agnosia:
the inability to recognize familiar objects
Define executive functions:
- coordinated in the frontal lobe
- planning and organizing
- remembering details
- curbing inappropriate speech/behavior
- integrating past experiences with past action
- managing time for tasks
Define confabulation:
creating imaginary events to fill memory gaps to cover up/deny that memory problems exist
Define perseveration:
persistently repeating the same word or idea in response to different questions
How can we manage sundowning?
- controlling pain
- reducing stimulation
- turn on lights to minimize shadows
- distract with quiet simple activity
- daily physical activity
- short naps, not close to bedtime
- reduce caffeine
- not many (tiring) activities during the day
