Delirium And Dementia

Front 1

Age does not equal....

Back 1

cognitive impairment

Front 2

Changes in cognitive ability should be...

Back 2

aggressively assessed and treated

Front 3

Abrupt-onset confusion state involving:

•Disturbance of consciousness

•Change in cognition

•Develops over a short period

•Fluctuates during the day

•Always secondary to another condition•Complete recovery can occurn

Back 3

Delirium (Acute Confusion)

Front 4

•Intoxications/withdrawals

•Infections

•Metabolic disorders—fluid& electrolyte imbalances, hypoxia, hypo/hyperglycemia

•Drugs—CNSdepressants, digitalis, lithium, steroids, benzodiazepines

•Neurologicaldiseases—headtrauma, seizures

•Cancer—primary or metastatic lesions

•Psychosocialstressors—sensorydeprivation/overload, relocation, pain, immobility, sleep deprivation

Back 4

Causes of delirium

Front 5

Causes of delirium?

Back 5

Drugs

Environment

Low O2

Infection

Intracranial (tumor)

Under hydration

Metabolic

Sleep deprivation

Front 6

•Specific for delirium

•Takes less than 5 minutes.

•Very helpful in noting change in cognition.

•Delay in Treatment can have serious consequences.

Back 6

CAM tool (Confusion Assessment Method)

Front 7

CAM tool

Feature 1 & feature 2 must be present as well as....

Back 7

Feature 3 or 4.

Front 8

RASS (Richmond Agitation-Sedation Scale) score identifies if patient is

Back 8

sedated or agitated

Front 9

Dementia is a _________ confusion. It is the __________ loss of function. Majority of which is irreversible. Most common cause is ___________ disease.

Back 9

Chronic

Progressive

Alzheimer's

Front 10

Brain damage caused by multiple strokes.

Back 10

Vascular dementia

Front 11

abnormal deposits of a protein called alpha-synuclein in the brain. These deposits, called Lewy bodies, affect chemicals in the brain whose changes, in turn, can lead to problems with thinking, movement, behavior, and mood.

Back 11

Lui Body dementia

Front 12

a group of disorders caused by progressive nerve cell loss in the brain's frontal lobes (the areas behind your forehead) or its temporal lobes (the regions behind your ears).

Back 12

Frontal temporal dementia

Front 13

The disease process is associated with plaques and tangles in the brain.

Back 13

Alzheimer's

Front 14

(mild)—forgetfulness; possible depression

Back 14

Stage 1

Front 15

(moderate)—

Confusion

Memory gaps

Self-care gaps

Apraxia (motor function)

Labile (easily altered) mood.

Back 15

Stage 2

Front 16

(moderate to severe)—

Can't identify objects/people

Agnosia (sensory perception)

Apraxia (Motor function)

Back 16

Stage 3

Front 17

(late)—end-stage:

Agraphia (writing)

Hyperorality (combo pica or overeating)

Hypermetamorphosis (touching everything)

Back 17

Stage 4

Front 18

Over time experiences difficulty remembering words

Loss of language ability

Back 18

Anomia

Aphasia

Front 19

Cardinal symptoms

Back 19

–Anomia (Name recall)

–Aphasia (Speak)

–Apraxia (Purposeful Action)

–Agnosia (Interpret sensations)

Front 20

Defensive behaviors

Back 20

–Denial

–Perserverationv (repetition of a particular response)

–Avoidance of questions

–Confabulation (fabricated stories without the conscious intention to deceive)

Front 21

Diagnosis is based on...

Back 21

history of symptoms.

(lab tests + imaging)

Front 22

Cholinesterase inhibitors

(↑acetylcholine to slow progression)

Back 22

–donepezil

–rivastigmine

–galantamine

Front 23

NMDA receptor antagonist

(↓effectsof glutamate, CNS excitation)

Back 23

–Memantine

Front 24

SSRI’s for depression

Back 24

–paroxetine

–sertraline

Front 25

Sleep aids and antipsychotics are used ___________ with patients who have dementia.

Back 25

sparingly

Front 26

Never say “No” or “You can’t”

___________ may cause agitation – depends on stage of disease

Back 26

Orientation