Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
16 Cards in this Set
- Front
- Back
|
Delerium definition |
Organic brain syndrome SECONDARY to underlying cause |
|
|
Delirium characteristics |
-4 cardinal signs: acute/fluctuating, inattention, disorganized thinking,change in LOC -Cognitive/perceptual disturbances: illusions and hallucinations -Autonomic hyperactivity (increase in VS) -Hypervigilance, labile mood, anger/agitation -Can be life-threatening |
|
|
Delerium mgmt |
-Reorient, keep comfortable, safe -Keep hemodynamic stability -Keep hydrated -Eventually AAOx3 |
|
|
Dementia definition |
Gradual irreversible impairment in cognitive fx, decline in social and occupational fx, no change in LOC |
|
|
Dementia risk factors |
-Advanced age and family hx! -Low SES and poor medical care |
|
|
Dementia patho |
-Theories: cerebral atrophy, neuritic plaques, tangles -Neuronal death in hippocampus causes decrease in Ach -4 A's: amnesia, aphasia, apraxia, agnosia -Primary or secondary (ex: AIDS) |
|
|
Dementia dx |
-PET, CT, MRI, decrease in brain weight -Only confirmed after autopsy |
|
|
Dementia pharm: goals |
-Improve sx and reverse cognitive decline (ideally) -Actually to slow memory loss |
|
|
Dementia pharm: Memantine |
-Neuronal receptor blockerr -NMDA antagonist -Moderate-severe AD -Regulates glutamate -Better tolerated than cholinesterase inhibitors |
|
|
Dementia pharm: Cholinesterase inhibitors |
-For mild to moderate, except aricept -Do not delay disease progression -Improvements modest and short -Start low, go slow! -AE: bronchoconstriction (COPD/asthma) -Avoid antihistamines, TCAs, conventional antipschotics |
|
|
Dementia pharm: Aricept |
-1x dosing, extended release -Less peripheral AE -FOR SEVERE AD -Don't discontinue abruptly |
|
|
Dementia: initial sx |
Short term memory loss, language problems, disorientation, decrease in judgment, decrease in abstract thinking, changes in mood and personality, misplacing things |
|
|
Dementia: Progressive sx |
Dysphasia (inability to communicate), apraxia (loss of motor coordination), visual agnosia (can't recognize things), dysgraphia, wandering |
|
|
Dementia dx |
Mini mental status exam, H&P, imaging is not dx, just shows progression |
|
|
Dementia: late sx |
Long term memory loss, unable to communicate, incontinence, no ADLs |
|
|
Communication strategies with dementia |
Identify yourself, maintain face-to-face, encourage reminiscing, talk about familiar things, be 1-2 arms lengths, use visuals, engage in activities |
