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86 Cards in this Set
- Front
- Back
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Confusion |
Impairment of mental function, means poor judgement, impaired memory, and disorientation to time, place , situation or person. |
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AD |
Alzheimer's Disease. |
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Delerium |
a mental disturbance, usually temporary, marked by wandering speech, delusions, excitement, and at times, hallucinations
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Dementia |
Group of symptoms , not an official disease. organic loss of intellectual function, formerly referred to as organic brain syndrome or senility |
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MCI |
Mild Cognitive Impairment, transitional stage of mental impairment. More serious cognitive changes than are associated with normal aging, but not the serious memory losses of dementias such as in AD |
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amnestic MCI |
MCI that significantly affects memory |
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nonamnestic MCI |
MCI that does not affect memory |
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psudodementia |
term used to describe a condition in which a person has the appearance of dementia, but whose confusion results from depression. |
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FTD |
Frontotemporal Dementia:
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HD |
Huntington's Disease: |
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Agnosia |
inability to recognize objects or persons via auditory, visual, or tactile sensations |
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Akinesia |
difficulty moving; may be complete or partial loss of muscle movement |
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Aphagia |
difficulty with or unable to swallow |
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Apraxia |
inability to perform purposeful movements or to use objects properly |
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compulsions |
repetitive behaviors |
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confabulation |
fabricating details of events to cover up lack of memory |
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delusional |
fearful; has false beliefs |
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dysphagia |
difficulty swallowing or chewing |
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emotional liability |
sudden, unexplained, or unexpected mood shifts |
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paranoid |
Suspicions, depressed, not trusting others |
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paranoid |
suspicious, depressed, not trusting others |
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Beginning of Delerium |
confusion, sleep disturbances, restlessness |
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progression of delerium |
progresses to anxiety, delusions, hallucinations , and fear |
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Delerium is part of the normal aging process T/F |
False |
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Delerium can cause an altered LOC t/f |
True. Can change LOC to Drowsy or Hyperactive |
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Dementia is a normal part of aging T/F |
False |
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Risk Factors for AD |
Age Genetics Environment Decreased Training, or use of intellect Disease that effect cerebral blood flow (CVA, Heart disease, hypertension Low levels of Vitamin Folate |
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Physiological changes in brain with AD |
Cerebral Cortex atrophy Loss of neurons Changes in brain cells
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Brain cell changes for AD |
Abnormal Neurons arranged in filaments called (neurofibrilary tangles) threads of proteins
Senile (neuritic plaques) -clusters of destroyed synapses
Granulovacuolar degeneration - the inside of the cell is crowded with fluid-filled vacuoles and granular material |
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In AD the brain ability to make this vital neurotransmitter is decreased |
acetylcholine |
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Most Common symptoms of AD (7) |
Memory loss inability to learn and retain new information loss of judgement and planning skills personality and mood changes decreased abstract thinking skills and reasoning loss of language inability to care for self |
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Nursing intervention with AD (touch and eye contact) |
gentle touch and eye contact |
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Goal of medicine of AD |
prevent development for AD slow the onset of symptoms reduce symptoms
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Is Medication for AD palliative or curatative |
Palliative |
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4 common drugs used for AD |
donepezil (Aricept) rivastigmine (Exelon) galantamine (Razadyne) memantine (Namenda) |
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MID |
Multi-Infarct Dementia a.k.a. Vascular Dementia cause by several brain infarcts (loss of blood supply resulting in necrosis) |
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Most common causes of MID (2) |
Cerebrovascular disease Hypertension
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MID can be distinguished from AD these 2 ways |
It has a faster onset It progresses in a step-wise fashion It usually coexists with other conditions |
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25% of patients with Parkinson's have |
Dementia |
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Wernicke-Korsakoff Syndrome |
Alcohol-related dementia from long term alcohol use
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FTD |
Pick's disease Rare form of Dementia, mistaken for AD FTD involves the frontal and temporal lobes
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symptoms of Wernicke-Korsakoff Syndrome |
short term memory impaired poor judgement lack of insight slowed thinking belligerent behavior pattern |
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Symptoms of FTD |
unacceptable and dangerous behavior dysphasia early onset (40-50 years) strong genetic component progresses rapidly, 2-10 years |
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Creutzfeldt-Jakob disease (CJD)
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rare dementia caused by a slow virus incubation period is years Infectious and transmissible death occurs within 2 years of onset of dementia |
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AIDS dementia |
Not all AIDS patients develop dementia period of lucidity may remain until late in disease |
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Crack-related Dementia |
Irreversible can be violent confusion, memory loss, speech disordersoT |
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Toxic Dementia related to |
Drug Overdoses |
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Metabolic dementia can occur |
uremia (untreated end-stage renal disease) hypoglycemia hyperglycemia hypothyroidism hyperthyroidism hepatic failures head trauma
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Definite diagnoses of AD can only be made with
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autopsy , after death |
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To determine a diagnoses for Dementia a physician would do the following to collect data: |
Complete History from patient & family Physical and Neurological Exam Laboratory tests (blood & urine ) CT Scan, MRI, PET and EEG Phychometric testing (mental status) Functional assesment (ADL)
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Before diagnoses of dementia rule out possible causes |
Stroke or brain tumor Abnormal blood tests ( folate & Vit b12 level) Scan shows cerebral atrophy only Show of slow wave activity onlyA |
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Physcometric testing for dementia would |
done by psychologist standardized intelligence scale memory scale testing for judgement and planning abilities comprehensive language abilities
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The lab test for Dementia are done because |
to rule out and treat any reversible causes of cognitive impairment |
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Taking the History of client for dementia is because |
look for any specific mental or physical changes |
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The psychiatric assessment for dementia is important because |
important to determine underlying cause and to rule out depression |
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The neurological examination for dementia would include |
Mental statue, Motor, sensory function, reflexes, coordination |
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Stage 1 AD |
no symptoms |
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Stage 2 AD SOS |
intermittent symptoms may not be recognized uncomfortable in new situations memory lapses (may be mistaken for normal aging) |
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Stage 4 AD SOS |
Confabulation problem with numbers, language, handwriting repeated questions forgetting to turn off oven misplacing items money mismanagement |
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Stage 5 AD SOS |
Apraxia Aphasia Agnosia major gaps in memory neglect of personal hygiene most likely need assistance with some ADL
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Stage 6 AD SOS |
emotional liability paranoid compulsions wandering akinesia need assistance with ADL not remember names of family, maybe faces dysphasia
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Stage 7 AD SOS |
Individual loses ability to respond not in touch with personal environment incontinent unable to assist with ADL Aphagia semicomatose before death some remain in the fetal position |
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Stage 3 AD SOS |
Mild cognitive decline noticeable signs of memory lapses difficulty planning events may not function in a work environment may not comprehend reading materials may be diagnosed early in this stage
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Mild AD includes these stages |
1-3 |
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Moderate AD is described as these stages |
4-5 |
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Moderately severe AD is this stage |
6 |
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Severe AD is this stage |
7 |
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Nursing Consideration for Aggression AD |
Use a calm approach and keep environment and activities consistent and reliable to help relieve anxiety |
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Nursing consideration for Anxiety, paranoia AD |
Break activities in simple steps and short comments " I am going to wash your face now" ConsistencyH |
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During the early stages of AD ___________ is a risk |
Suicide, accidental or intentional |
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An important part of nursing care is determining a client's ability to |
Carry out basic daily tasks |
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The most common cause of burns for older adults is |
hot water |
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management for the person with dementia includes but is not limited to |
-caring for basic personal needs -basic understanding of communication & behavior management techniques
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Bathing client with Dementia |
-may use padding -bathe when rested not overtired so they are calm -give baths at preferred time -use low water levels, have supplies ready -use positive reinforcement -avoid noise confusion like shower or whirpool |
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Dressing client with Dementia |
lay out clean clothes offer clothing in sequence one at a time use simple clothing (Velcro & elastic) use cardigans or button downs (covering head may be frightening |
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Pain Control with Dementia |
-Give pain medication before performing care like bathing, dressing, ect |
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nutrition and Hydration with Dementia |
-offer small amounts often -offer a variety of liquids, soups, teas, gelatins, -avoid hot liquids -limit variety of foods to avoid confusion -sit clients near others they should mimic -cut in small portions -remind to chew and swallow if necessary -observe for choking
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Bladder and Bowel management dementia |
-regular toileting -label bathroom -give one-step instructions -document I & O |
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Balking |
refusing to do things |
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Agnosia |
Inability to recognize objects or persons via visual , auditory , or tactile sensations |
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Aphasia |
Difficulty in communicating in speech or writing |
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Apraxia |
Not able to do purposeful movement or use objects properly |
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Akinesia |
difficulty moving may be complete or partial loss of muscle movement |
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when persons with dementia's display catastophic reactions.... you should |
cease the activity and allow quiet time or time out |
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What should you do when a client with dementia is paranoid? |
-Keep environment calm and predictable -remove excess stimulation or items that contribute to misperceptions -do not try to reason with clients, but reassure they are safe
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What should you do if a client is aggressive (AD) |
-do not try to reason with client -try to identify trigger and remove trigger -use a soothing tone of voice -remove client from group if necessary |
