Chapter 72 Caring For Clients With Dementia And Thought Disorders

Front 1

mental activity

Back 1

mentation

Front 2

short-term memory and learning ability

Back 2

Examples of cognitive functions

Front 3

-is a sudden, transient state of confusion.

Back 3

delirium

Front 4

Comparison of Dementia and Delirium

Onset

Back 4

Dementia -gradual

delirium--Sudden

Front 5

Comparison of dementia and delirium

presentation

Back 5

dementia--alert, attentive

delirium--blunted inattentive

Front 6

dementia vs delirium

course

Back 6

dementia--stable, progressive deterioration, extended

delirium--unstable, fluctuations in function, brief

Front 7

dementia vs delirium

duration

Back 7

dementia--permanent

delirium-temporary

Front 8

dementia vs delirium

treatment

Back 8

dementia--symptomatic or supportive

delirium--temporary specific

Front 9

dementia vs delirium

outcome

Back 9

dementia--incurable

delirium--curable

Front 10

dementia vs delirium

__can result from high fever, head trauma, brain tumor, drug intoxication or withdrawal disorders, or inflammatory disorders of the CNS.

Back 10

delirium

Front 11

__is more commonly in older adults, refers to conditions in which decline in memory, thinking, and reasoning is severe enough to affect daily life of an alert person.

Back 11

dementia

Front 12

__the most common cause of dementia, is a progressive, deteriorating brain disorder.

Back 12

Alzheimer's disease

Front 13

What are the two types of Alzheimer's Disease?

Back 13

early onset (btwn 30-60 yrs old)

late onset (after 60)

Front 14

Alzheimer's Disease

Early onset is believed to be caused by what?

Back 14

A mutated gene within specific chromosomes (1,14,21) that are responsible for making proteins that promote survival of nerve cells.

Front 15

The mutated genes in Early onset Alzheimer's are cause a disruption in the processing of a substance known as __

Back 15

amyloid precursor protein (APP)

Front 16

T or F

Having a first degree relative with Ad in late onset doubles the risk for acquiring the disease.

Back 16

False

Having a first degree relative in early-onset doubles your chances

Front 17

What causes AD in late-onset

Back 17

the etiology of late-onset is unclear, but a combination of genetic, environmental, and lifestyle factors may be a factor

Front 18

Late - onset AD

One risk factor for Ad is attributed to __, one of a pair of genes, occupying chromosome 19 that regulates the formation of apolipoprotein.

Back 18

allele

Front 19

The onset of Ad is __and symptoms may develop slowly over years.

Back 19

insidious

Front 20

What are the stages of AD?

Back 20

preclinical

mild cognitive impairment

Alzheimer's dementia

Front 21

What happens during the preclinical stage?

Back 21

a period when amyloid plaques are accumulating and nerve cell changes are occurring, but there are no clinical symptoms of AD

Front 22

What happens during the mild cognitive impairment stage?

Back 22

a time when memory problems are noticed but not serious enough to interfere with independent living

Front 23

What happens during the Alzheimer's dementia stage?

Back 23

the point at which there is significant cognitive decline, such as difficulty recalling words, trouble learning new information, difficulty recognizing familiar faces, impaired reasoning, judgment, and problem solving.

Front 24

What is the classic sign for AD?

Back 24

memory loss-it's confined at first to recent information and eventually long-term memory becomes impaired.

Front 25

aphasia

Back 25

problems with speaking

Front 26

alexia

Back 26

problems with reading

Front 27

agraphia

Back 27

problems with writing

Front 28

acalculia

Back 28

problems with calculating

Front 29

ataxia

Back 29

difficulty walking

Front 30

apraxia

Back 30

inability to accomplish ADLs

Front 31

biomarkers

Back 31

a measurable indicator of some biological state

Front 32

How does a patient get a diagnosed of AD?

Back 32

AD diagnosis currently relies on validating mental decline and by excluding other causes for client's symptoms

Front 33

What is the AD7C test?

Back 33

Test developed by Nymox Pharmaceutical

Uses human urine or cerebrospinal fluid to detect the presence of beta amyloid ad tau proteins.

Front 34

How can the early onset familial type of AD be identified?

Back 34

Genetic testing to identify the defective trait

Front 35

What test can help identify the late onset of AD?

Back 35

Blood test that can identify APOE 4

Front 36

T or F

There is a cure for AD.

Back 36

False

There is no cure for AD; treatment is supportive using on of various drugs currently available

Front 37

Until recently, AD could only be confirmed ___

Back 37

during a postmortem examination

Front 38

Diagnosing AD

__scan shows shrink of the cerebral cortex, but this wouldn't be apparent during the early stages.

Back 38

Computed Tomography (CT)

Front 39

Diagnosing AD

__and __ provide structural and metabolic information about the brain.

Back 39

Positron emission tomography (PET) and magnetic resonance imaging (MRI)

Front 40

Diagnosing AD

__detects slower-than-normal brain waves.

Back 40

Electroencephalography

Front 41

Current drugs approved for the treatment of dementia of Alzheimer's type include___(what class)

Back 41

cholinesterase inhibitors and N-Methyl-D-Aspartate (NMDA) Antagonist

Front 42

How do Cholinesterase inhibitors act on the body of AD clients?

Back 42

These drugs increase acetylcholine by inhibiting acetycholinesterase, the enzyme that degrades it.

Front 43

How do N-Methyl-D-Aspartate (NMDA) Antagonist act on the body of an AD client?

Back 43

By blocking NMDA receptors, the drug protects neurons from excessive stimulation by glutamate, an excitatory neurotransmitter responsible for neuronal death.

Front 44

What other class of drugs can be given to AD clients who are experiencing agitation or depression?

Back 44

antidepressants or tranquilizers

Front 45

What is the major focus of nursing management for an AD client?

Back 45

To help the client and caregiver maintain the highest possible quality of life by supporting mental and physical functions and ensuring safety.

Front 46

Gerontologic consideration

Because cognitive changes alter older adults' roles and relationships, impacting their self-worth and evoking fear of the progression of the disease, What can help the client feel a sense of self-worth if the they have little or no family members or significant other?

Back 46

photographs from younger years may help provide a sense of self

Front 47

Because of mental decline, an elderly client with AD may not be able to verbally express pain. How should the nurse assess for pain?

Back 47

Careful observation of facial expressions, body positioning, and by collaborating with caregivers and significant others

Front 48

When caring for an AD client that wonders, what is an important caregiver teaching?

Back 48

keep a means of identification on the client's person at all times

Front 49

What would be a good teaching to help the caregivers of dementia clients?

Back 49

Become involved with the local community mental health association; Join and attend meetings of a support group for caretakers of those who are cognitively impaired; investigate the services of a day care facility for occasional respite care.

Front 50

__is a thought disorder characterized by deterioration in mental functioning, disturbances in sensory perception, and changes in affect (emotion).

Back 50

Schizophrenia

Front 51

Many neurotransmitter imbalances are involved in schizophrenia, but __ is believed to be the major cause of the symptoms.

Back 51

dopamine excess

Front 52

T or F

Schizophrenia is known to have a familial or genetic component.

Back 52

True

Front 53

Other theories on the Etiology of schizophrenia (besides genetics) believe it may result from ___ during pregnancy.

Back 53

a viral infection experienced by the infected individual's mother

Front 54

disturbed thinking

Back 54

delusions

Front 55

sensory experiences only the client perceives

Back 55

hallucinations

Front 56

belief in one's importance

Back 56

grandiosity

Front 57

Schizophrenia

symptoms usually begin during ___

Back 57

late adolescence to early adulthood

Front 58

The Schizophrenic client will manifest a variety of symptoms that are categorized as positive or negative. What is the difference?

Back 58

-Positive symptoms include delusions, hallucinations, and fluent but disorganized speech.

-negative symptoms(defect symptoms) are marked by impoverished speech and an inability to enjoy relationships or express emotions.

Front 59

Schizophrenia

Which is symptoms are more easily controlled by drugs positive or negative?

Back 59

Positive

Front 60

How is schizophrenia diagnosed?

Back 60

Diagnosis is made primarily on the symptomatology and by ruling out other possible causes. CT and PET scans, MRIs, and brain mapping may show decreased brain size and activity, esp in the frontal and temporal lobe.