Test 3 Alzheimer's Disease (CNS, Brain) Flashcards
What is Alzheimer’s Disease?
Alzheimer’s Disease:
Chronic progressive, non-reversible type of dementia
Structural changes in brain
- Neuritic plaques, granulovascular degeneration,
- Neurofibrillary tangles –> Found in autopsy
What are the 3 general stages of Alzheimer’s Disease?
Early or Mild
Middle or Moderate
Late or Severe
What are the key features of the EARLY (MILD) stage of Alzheimer’s Disease?
- Independent in ADLs
- No social impairment
- Denies presence of symptoms
- Forgets names, misplaces household items
- Short-term memory loss
- Subtle changes in personality and behavior
- Loss of initiative; less engaged in social relationships
- Mild impaired cognition, problems with judgement
- Decreased performance, especially when stressed
- Unable to travel alone to new destinations
- Decreased sense of smell
What are the key features of the MIDDLE (MODERATE) stage of Alzheimer’s Disease?
- Impairment of all cognitive functions
- Problems with handling or unable to handle finances
- Disorientation to time, place, and event
- Possible depression, agitation
- Increasingly dependent in ADLs
- Visuospatial deficits: Difficulty driving, get lost
- Speech language deficits: Less talkative, decrease in use of vocabulary, increasingly non-fluent, and eventually asphasic
What are the key features of the LATE (SEVERE) stage of Alzheimer’s Disease?
- Completely incapacitated; bedridden
- Totally dependent in ADLs
- Motor and verbal skills lost
- General and focal neurological deficits
- Agnosia (loss of facial recognition)
What symptoms of Alzheimer’s Disease?
- Gradual memory loss (SHORT-TERM FIRST)
- Problems with judgement
- Changes in behavior & personality
- Eventually, Motor Skills and Language Loss
What are the Risk factors for Alzheimer’s Disease?
Risk Factors:
- Gender: Women slightly higher
- Genetic predisposition, apolipoprotein E (ApoE)
- African Americans more than Euro-Americans
- Environmental agents: herpes virus, metal, toxic waste
- Head trauma
- Age is #1 known risk factor, occurs after 65 years old
Health promotion to prevent Alzheimer’s Disease?
Health Promotion to prevent Alzheimer’s Disease:
- Increase Walking, Swimming, Exercise daily
- Balanced diet
- Dark colored fruits & vegetables
- Folate, vitamins B12, C and E
Diagnostic testing
MMSE (Orientation, registration, attention & calculation, recall, speech-language)
CT scan, Lab studies, EEG
**These is no definitive diagnostic procedure, except brain tissue examination upon death.
Priority Nursing Care for Alzheimer’s Disease?
Priority of care:
- Interventions and support (patient and caregiver)
- Cognitive stimulation and memory training (Cross word puzzles)
- Structuring the environment (Safety)
- Reality Orientation (early stages)
- Validation therapy (later stages) –> Acknowledge feelings, don’t argue
- Promoting self-management (Assist ADLs as needed)
- Promoting bowel and bladder continence (Provide a routine toileting schedule)
- Promoting communication (Speak directly to the patient in short concise sentences)
- In last stage, wont be able to talk.
Medication Therapy:
What are the medications used to treat Alzheimer’s Disease?
Medication therapy:
Cholinesterase inhibitors
-Donepezil (Aricept); galantamine (Reminyl)
N-methyl-D-aspartate receptor antagonist
-Memantine (Namenda) –> Typically, Later stage drug!
Antidepressants
-SSRIs
What is the Alzheimer’s drug that prevents the breakdown of acetylcholine (ACh), which increases the amount of ACh available?
***This results in increased nerve impulses at the nerve sites.
Cholinesterase inhibitors (____) help slow this process of disease progression and may help improve behavior and daily functions.
Nursing considerations?
Use caution when administering this medication to which patients?
Donepezil (Aricept)
Cholinesterase inhibitors (Donepezil) help slow this process of disease progression and may help improve behavior and daily functions.
Nursing Considerations:
- Observe client for frequent stools or upset stomach
- Monitor for dizziness and/or headache. Patient may feel lightheaded or have an unsteady gait.
-Use caution when administering this medication to patients who have asthma or COPD
What is the inability to find words?
Anomia
What is the inability to use words or objects correctly?
Apraxia
What is the inability to speak or understand?
Aphasia
