Psychiatric Nursing-The Elderly-Slides

Front 1

Cognition

Back 1

the process by which the person knows the world and interacts with it

Front 2

confusion
decontructed

Back 2

-intoxication
-psychosis
-depression
-dementia
-delirim

Front 3

depression
overview

Back 3

-most common psych illness in elders
-overlooked and nder diagnoses
-inc morbidity and mortality
-miltiple losses
-person may not c/o feeling depressed
-inc risk for suicide
-most common misconception;weakness
-most common complaint; constipation

Front 4

assessing depression

Back 4

-most common s/s are vague physical complaints and preoccupationwith boily functions
less guilt
-more paranoid thinking
-moreapaty
-moreagitation
-fewer feelings of being depressed
-physical assessment

Front 5

depression clues in older adults

Back 5

-unexplained or agrivated aches
-hopelessness
-helplessness
-anxiety and worries
-memory problems
-loss of feeling of pleasure-slowed movemtn
-irrritability
-lack of interest in personal care

Front 6

Depression with psychotic features

Back 6

-hallucinations or delusions congruent with mood

Front 7

pseudodemenai

Back 7

-despressed mood may be less prominent than other symptoms
-especially in older adults depression can mascerade as dementia
-apathy

Front 8

non-pharmicaological nursing strtegies

Back 8

-saftey needs
-relationship needs
-adls
-tears
-irriability
-family teaching and support

Front 9

saftey strategies

Back 9

-dealing with risk to self
-dealing with risks of apathy-neglect
-disconections
-compliance
-falls frm disuse syndrome

Front 10

the therapeutic realtionship

Back 10

depression shuts down the limbice circuits

Front 11

Pharmacology

Back 11

start slow go slow
-antidepresseansts
-vitamin d
-omega 3 fatty acids
-antianxiety meds
-stimulant use
-use of antipsycholtics

Front 12

dementai
criteria

Back 12

-memory impairment
-at least one:
--aphasia
--apraxia
-agnosia
--distrbances in executuive functioning

Front 13

alzheaimers ds

Back 13

-a signifigant percentage of dementias
-an age rlated progressive, disorder of the CNS characterized b y by chronic gonitive dysfunction
-prevelance increases with age
-four A's
--amnesia
--agnosia
--aphasia
--apraxia

Front 14

Vascular dementia

Back 14

-multiple large and small cerebral infarctions
risk factors:
HN
-hyperlipidemia
-a fib
-DM
-smoking
-sedentary lifestyle
-TIA's

Front 15

Dementia with lewy bodies

Back 15

-marked fluctuation of cognitive function
-persistant hallucinations
-mild parkinsonianism

Front 16

Other demntia etiologies

Back 16

-radiation inducesd-wernickeskarsakoff
-HIV
-parkinsons
-huntingtons
-picks ds
-chronic hypoglycemia

Front 17

Dementai
Nonpharachologc strategies

Back 17

-saftey needs
-psychossocal spiritual needs
-delusions and illusions
-physiological needs
-agitation
-family teaching and support

Front 18

Demntai
saftey strategies

Back 18

-dealing with risks to pt and others
-falls
-spacial issues
-use strong paint colors

Front 19

Pharm in alzheimers

Back 19

-cholinesterase inhibiters(aricept, exelon, reminyl) rxed first
-slows breakdown of acetylcholine
-Namenda

Front 20

Dementia pharm
may augment with

Back 20

-antidepressents
-antipsychotics(usually atypical (black box warning for elders)
-meds to help with insomnia

Front 21

delerium
vulnerable pts

Back 21

-elderly
-cognitive dysfunction
-sensory impairment
-dehydration
-infection
-poor nutrition
-polyphamr
-post op
-severe or multiple illness
-post op lower limb
-length of surgery

Front 22

Delerium:
Cardinal comonents

Back 22

-disturbaces of consiousness
-change in cognition
-acute onset
-fluctuating course

Front 23

Subtypes of delerium

Back 23

-hyperactive
-hypoactive(most common)
lethargy, withdrawel, slow speeach
-mixed

Front 24

Delerium prevention

Back 24

-orienting communication
-family, friends, kind strangers
-familiarthings
-nutrtion and hydration
-sensory corrections
-anxiety reduction
-ambulation

Front 25

delerium
nonpharmachological strategies

Back 25

-know what your dealing with-saftey needs
-figure out whats causing it and stop whatever it is
-supportive inteventions
-agitation
-family teaching and support

Front 26

Depression vs dementia
DEPRESSION

Back 26

Depression
-trouble concentrating
-oriented x 3
-exert little effort in cognitve tasks but report incapcity
-do not have sig signs of cortical dysfunction
-

Front 27

Depression vs Dementia
DEMENTIA

Back 27

-has troble storing new information
-may be oriented x 1-2
-do not complain of cognitive problems becas they have little insight
-exhbit aphasia, apraxia, agnosia
-confabulation

Front 28

Delerium vs Dementia
DELERIUM

Back 28

-acute illness
-usually reversable, often completly
-marked psychomotor changes
-altered and changing level of consiousness
-short attention span

Front 29

Deleriumvs dementia
-DEMENTAI

Back 29

-chronic illness
-generally irreversable and prgressive
-psychomotor changes occur late in the illness unless depression or apathy develops
-consiousness is not clouded until terminal stages
-attention span is not characteristacallyreduced