week 6- Dementia Flashcards
(21 cards)
What are cognitive skills that may decline in an older adult?
verbal fluency,
logical analysis,
selective attention,
object naming,
complex visuospatial skills
T/F- declines in cognitive skills are considered a normal part of aging?
FALSE- if therfe are changes in relation to cognitive functioning they should be investigated in relation to a neuro degenerative contition like dementia
how can sensory changes effect or influence cognitive functioning?
-decreased visual acuity and accommodation, can result in decreased ability to process visual cues.
-Yellowing and flattening of the cornea can lead to difficulty distinguishing colors.
-Hearing loss affects what one hears in conversations
Out of the following list, which is associated with dementia and which is associated with delerium?
______ a. Gradual and insidious onset
______ b. Hallucinations or delusions
______ c. A sudden, acute onset of symptoms
______ d. Progressive functional impairment
______ e. Personality changes with emotional lability
______ f. Incoherent interactions with others
______ g. Possible wandering behavior
______ h. Lucid at times, but often worsens at night
DM–a. Gradual and insidious onset
DL–b. Hallucinations or delusions
DL– c. A sudden, acute onset of symptoms
DM– d. Progressive functional impairment
DM– e. Personality changes with emotional lability
DL– f. Incoherent interactions with others
DM– g. Possible wandering behavior
DL– h. Lucid at times, but often worsens at night
In dementia is onset usually sudden or gradual?
Gradual
List 3 types of dementia:
(This is just a list of the dementias)
Alzheimer’s disease,
Diffuse Lewy body dementia,
Frontotemporal dementia (FTD)
Posterior Corticoid Atrophy (PCA)
Progressive primary aphasia (PPA)
Young onset Alzheimer’s disease (YOAD)
Vascular dementia
What are 4 common cognitive assessments
-General Practitioner Assessment of -Cognition (GPCOG),
-Memory Impairment Screen,
-Mini-Cog, Mini-Mental State
-Examination (MMSE),
7-Minute Screen,
-Clinical Dementia Rating,
-Global Deterioration Scale,
-Brief Cognitive Rating Scale,
-MOCA- Montreal Cognitive
-Assessment
-CAM
What dx testing should be used to help diagnose dementia?
Toxicology screen
✓ Electrocardiogram
✓ Electroencephalogram
✓
Complete metabolic panel
✓ Complete blood count with differential
✓
Thyroid function tests
✓
Rapid plasma reagin (RPR) test
✓ Serum B12and folate levels
✓
Liver function tests
✓
Vision and hearing evaluation
✓ Magnetic resonance imaging (MRI)
✓ Urinalysis
What neuroanatomic changes are seen in person with AD?
Changes seen in the brain include destruction of the proteins of nerve cells of the cerebral cortex by diffuse infiltration with neurofibrillary tangles and plaques (nonfunctional tissue). These tangles and plaques are a result of the death of nerve cells within the brain.
What is AD?
a progressive degenerative disorder of the brain leading to dementia
what does AD cause?
irreversible loss of memory and loss of mental functions, particularly in tasks involving language, behavior and thinking
how long does it take for a patient to become mentally or physiclly disabled or incapacitated for AD?
3-15 years
What is developing Alzheimers disease a combination of?
Combination of genetic, lifestyle and environmental factors that affect brain over time
Is alzheimers disease a natural part of aging?
No
What is the most important factor to developing AD?
Age
What are some support issues related to people living with AD?
-Exclusion
-Rushed and task based approaches
-Poor communication
-Uncertainty (care partners)
-Caregiver as “hostage” (care partners)
-Lack of support for care partners
What is Donepezil?
Donepezil is indicated for the symptomatic treatment of mild to moderate Alzheimer’s disease. Donepezil may compensate for the loss of functioning cholinergic brain cells
What three domains of AD does the research support donepezils effect on?
functional ability
behavior
cognition
Why is donepezil a high risk medication for older adults?
increased rates of orthostatic hypotension and bradycardia within this population
What do you need to teach K.B. and his family about donepezil? Select all that apply:
A)“The best time to take donepezil is in the morning.”
B)“Swallow each tablet whole. Drink a glass of water afterward.”
“Notify the provider if you have trouble urinating or muscle weakness.”
C)“You may have some nausea. Taking the medication with food may help.”
D)“Keep the tablet in the blister pack until you are ready to take the medicine.”
A, C, D, E
The tablet should not be swallowed whole but allowed to dissolve on the tongue. After it dissolves completely, the patient should drink a glass of water. Taking donepezil in the morning lessens the common side effect of insomnia (but remember discussion in class!!!)
What are 6 things you should review with the patient and the family in regards to safety?
-Do not allow him to go out alone.
-Place locks on the doors and install a door alarm device that would provide warning if he opens the door.
-Register K.B. with a safe return program and obtain a wearable tracking device for K.B. to help with locating him if he wanders.
-Obtain a medical alert bracelet that has his name, address, and telephone number.
-Alert neighbors about K.B.’s wandering tendencies.
-He must stop driving.
-Do not allow him to do potentially dangerous activities, such as cooking, alone. Place locks on the stove dials.
-Ensure that the home has good lighting, install handrails in stairways and bathroom, and remove area rugs.
