Test 2: Blueprint (1) Flashcards

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1
Q

What is a mental state characterized by a disturbance of cognition, which is manifested as confusion, excitement, disorientation, and a clouding of consciousness.

A

delirium

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2
Q

Is delirium acute or chronic?

A

acute

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3
Q

What is meant by “sundowning”?

A

symptoms become worse in late afternoon and evening

ex/ pts will wander around

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4
Q

What are some predisposing factors of delirium?

A
  • systemic infections
  • febrile illness
  • metabolic disorders (hypoxia, hypercarbia, hypoglycemia)
  • hepatic encephalopathy
  • head trauma
  • seizures
  • migraines
  • brain abscess
  • stroke
  • postoperative states
  • electrolyte imbalance
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5
Q

How should delirium be managed?

A

1) determine and correct the cause

2) Medications

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6
Q

What meds are commonly used to relieve delirium symptoms?

A
  • benzos for substance withdrawal

- neuroleptics (antipsychotics) for agitation, aggression, hallucinations, illusions

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7
Q

What is a syndrome of chronic and possibly progressive intellectual and functional impairment involving memory, language, emotion, cognition, and changes in the personality?.

A

neurocognitive disorder

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8
Q

Is neurocognitive disorder associated with alzheimer’s primary or secondary?

A

Primary

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9
Q

Is neurocognitive disorder associated with HIV, depression, or nutritional deficiency primary or secondary.

A

Secondary

These things CAUSE NCD.

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10
Q

How is neurocognitive disorder assessed?

A
  • History
  • Physical and cognitive assessments
  • Blood and urine lab work
  • Chest x-ray
  • PET, CT, or MRI of brain
  • EEG
  • Lumbar puncture
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11
Q

What are 7 common nursing diagnoses associated with NCD?

A

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

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12
Q

Name the nursing diagnosis:

Falls, wandering, confusion, poor coordination

A

Risk for trauma

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13
Q

Name the nursing diagnosis:

Disorientation, confusion, memory deficits, paranoia

A

Disturbed/altered thought processes

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14
Q

Name the nursing diagnosis:

Experiencing hallucinations

A

Disturbed sensory perception

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15
Q

Name the nursing diagnosis:

Aggressiveness

A

Risk for other directed violence

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16
Q

Name the nursing diagnosis:

Aphasia

A

Impaired verbal communication

17
Q

Name the nursing diagnosis:

Inability to do ADLs

A

Self-care deficit

18
Q

Name the nursing diagnosis:

Expressions of shame, social isolation

A

Situational low self-esteem or grieving

19
Q

What is the most important intervention for someone with a NCD?

A

SAFETY!!!

20
Q

What are common interventions with NCD?

A

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

21
Q

What classes of meds are used to treat NCD?

A
  • cholinisterase inhibitors
  • NMDA receptor agonists
  • antipsychotics
  • SSRIs
  • TCAs
  • Benzoa
  • Selective-hypnotics
  • Antidepressants
  • Tetracyclic antidepressants
22
Q

Cholinisterase Inhibitor meds:

A

donepezil (Aricept)
rivastigmine
galantamine

23
Q

NMDA Receptor Agonist meds:

A

memantine (Namenda)

24
Q

Antipsychotic meds:

A

risperidone
olanzapine
quetiapine
haloperidol

25
Q

SSRI meds:

A

sertraline

paroxetine

26
Q

TRIcyclic Antidepressant (TCA) meds:

A

nortriptyline

27
Q

Benzodiazepine meds:

A

lorazepam
oxazepam
temazepam

28
Q

Selective-Hypnotic meds:

A

zolpidem
zaleplon
eszopicline
ramelteon

29
Q

Antidepressant meds:

A

trazodone

30
Q

TETRAcyclic Antidepressant med:

A

mirtazapine

31
Q

Define aphasia:

A
  • inability to speak or unable to express what they need

- forget meanings of word and names or use of things

32
Q

Define apraxia:

A

(apraxia sounds like TAXI…MOTOR)

the inability to carry out motor activities and eventually unable to care for self

33
Q

Define agnosia:

A

the inability to recognize familiar objects

34
Q

Define executive functions:

A
  • coordinated in the frontal lobe
  • planning and organizing
  • remembering details
  • curbing inappropriate speech/behavior
  • integrating past experiences with past action
  • managing time for tasks
35
Q

Define confabulation:

A

creating imaginary events to fill memory gaps to cover up/deny that memory problems exist

36
Q

Define perseveration:

A

persistently repeating the same word or idea in response to different questions

37
Q

How can we manage sundowning?

A
  • 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