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Nursing > Med Surg Ch 46 > Flashcards

Med Surg Ch 46 Flashcards

1
Q

The most common degenerative disease of the brain, with no known cause or cure. The disease causes loss of neurons in the frontal and temporal lobes and primarily affects people older than 65 years but can also occur in younger people

A

Alzheimer disease (AD)

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2
Q

A measurable substance that indicates the presence of disease, infection, or toxic exposure

A

biomarker

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3
Q

the mental processes of perception, memory, judgment, and reasoning

A

cognition

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4
Q

a behavioral reaction to memory loss in which the patient fills in memory gaps with made-up facts and experiences

A

confabulation

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5
Q

an altered state of consciousness that is usually acute and of short duration

A

delirium

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6
Q

a false, fixed belief that cannot be changed with rational explanation

A

delusion

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7
Q

a broad impairment of intellectual function that usually is progressive

A

dementia

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8
Q

irretrievable total loss of memory

A

global amnesia

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9
Q

a sensory perception (touching, tasting, feeling, hearing, seeing) that occurs without external stimulation

A

hallucination

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10
Q

a misperception of an actual sensory perception; misinterpretation of reality

A

illusion

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11
Q

the phenomenon of becoming confused and disoriented at night, although oriented during the day

A

sundowning (sundown syndrome)

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12
Q

a broad term used to describe any type of dementia caused by vessel disease. Hypertension is a leading factor that predisposes a person

A

vascular dementia

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13
Q

inability to remember the names of things

A

anomia

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14
Q

misuse of objects due to failure to identify them

A

apraxia

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15
Q

inability to recognize familiar objects, taste, sound and other sensations

A

agnosia

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16
Q

memory loss

A

amnesia

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17
Q

inability to express oneself through speech

A

aphasia

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18
Q

the types of things that can cause delirium

A

Cerebrovascular accident, drug overdose, toxicity, withdraw, tumors, systemic infections, anesthesia, fluid and electrolyte imbalances, malnutrition

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19
Q

the changes in delirium that occur

A

The patient may be alert or lethargic, depending on the cause of the delirium, or may appear very confused. The attention span changes, and overall awareness of the environment decreases. Orientation and recent and immediate memory are impaired. Speech may be incoherent, and overall thinking can be disorganized and distorted. The patient will not be able to communicate thoughts in a meaningful way. The patient may experience illusions, hallucinations, or delusions.

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20
Q

Know about the anticholinergic medications

A

Anticholinergic medications have potent central nervous system effects and can cause a sudden episode of confusion.

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21
Q

What do you need to consider with medication administration with older people?

A

Start low and go slow

22
Q

Know the medications that are common to cause substance induced delirium

A

Anesthetics, analgesics, sedative-hypnotics, any products with anticholinergic activity (tricyclic antidepressants, antihistamines, theophylline derivatives, antipsychotics, histamine receptor blockers, famotidine, cimetidine, ranitidine, beta blockers, NSAIDs

23
Q

different types of dementia

A

parkinson’s, alzheimers, lewy

24
Q

herbs with sedative effect

A

Chamomile, hops, valerian

25
Q

Alzheimers is the most common degenerative disease, what population is at greatest risk for it?

A

65 and older

26
Q

Risk factors of alzheimers

A

Age, family history, genetics, ethnicity, history of head injury, history of health

27
Q

diet related to cognitive disorders

A

Mediterranean diet. Fish and omega-3 polyunsaturated fats, fruits and vegetables

28
Q

Know about the exercise for the brain, what can keep your mind sharp

A

Playing brain games by using computerized apps can be an effective way of exercising the brain. Regular exercise and social interaction also can help maintain a healthy brain as well as crossword puzzles or anything of the sort.

29
Q

Know the different stages of alzheimers and what is characteristic to each stage

A

Mild, moderate, to severe

30
Q

Know the benefits of pet therapy

A

Helps improve memory, coordination, object identification, language, and attention

31
Q

Know how to diagnose alzheimers

A

Post Mortem Biopsy only true way to diagnose

32
Q

Know the neurotransmitters that are related to alzheimers

A

Serotonin, Acetylcholine

33
Q

Donepezil

A

Aricept

34
Q

Galantamine

A

Razadyne

35
Q

Memantine

A

namenda

36
Q

Rivastigmine

A

exelon; transdermal patch available.

37
Q

Know patient education for medication and the signs of overdose

A

Take with food. Signs of overdose include severe nausea and vomiting, bradycardia, hypotension, convulsions, or severe muscle weakness. Patch: first patch should be applied on the day after the last oral dose, then rotate sites; replace every 24 hours.

38
Q

Know the 10 early signs and symptoms of alzheimer’s

A

Memory loss that disrupts daily life. Challenges in planning or solving problems. DIfficulty completing familiar tasks at home, at work, or at leisure. Confusion with time or place. Trouble understanding visual images and spatial relationships. New problems with words in speaking or writing. Misplacing things with inability to retrace steps. Decreased or poor judgment. Withdrawal from work or social activities. Changes in mood or personality.

39
Q

When caring for confused patients, evidence-based practice supports the need for careful observation and documentation of patterns of behavior. This process, which is part of a systems approach to care, is called

A

dementia care mapping

40
Q

Know what you are going to do with an agitated patient

A

redirect and come back later

41
Q

You need to know about MMSE and what you are looking at

A

assessing orientation, memory, and ability to follow commands (1082)

42
Q

(know) When you are collecting data on patients and they have a cognitive disorder, the patient may not be the best source of information so you could ask the caregivers or nurses or possibly the person living with them

A

…

43
Q

Know about antipsychotic drugs in old people, what drugs would kill the geriatric

A

Olanzapine (Zyprexa), quetiapine (seroquel), and risperidone (risperdal)

44
Q

Know what reality orientation is and who is going to benefit from it and who’s not going to benefit from it

A

Reality orientation is a therapeutic program consistently implemented by all nursing staff to orient a patient to person, place, and time. Works great for people with dementia, does not work for global amnesia

45
Q

(1084) know the problems that occur from restraints

A

choked, strangulation, affixation

46
Q

What are you going to chart about restraints

A

All alternatives tried before restraint, the type of restraint, strict accounting for time in and out of restraints, and the assessment and care given to the patient while in restraints. Offer and document bathroom breaks, fluid and food, and skin care with each 1 to 2 hour chec. The total number of hours in restraints or seclusion must be noted, with supporting documentation

47
Q

Know about maintaining dignity

A

Nurses who care for patients with dementia need to be aware of the importance of maintaining the dignity of the patient and family. In the later stages of dementia, patients experience numerous deficits in self-care, such as grooming and toileting. It is very important to treat both patients and families with respect. Call the patient by name, provide privacy, and individualize your care for this patient based on culture and history.

48
Q

Know about elderspeak

A

When working with older adults, do not confuse clear and supportive communication with elderspeak. Elderspeak is a style of speech that includes baby talk, exaggerated tones and slow speed, elevated pitch and volume, and simplified vocabulary. Being overly nurturing, or overly controlling, is perceived as patronizing and demeaninging and does not promote communication

49
Q

Know the signs of exhaustion in caregivers (1085)

A

Denial, irritability, anxiety, sleeplessness, and anger

50
Q

Know suggestions for a safe environment and what you are going to recommend families to do

A

Make and keep a consistent schedule. Orient the person. Minimize guests. Simplify the environment. Schedule rest breaks. Change your expectations. Offer help. Always supervise. Always approach in the front. Use distraction if agitated. Apply many safeguards. Put protective caps on electrical outlets. Remove sharp objects. Remove throw rugs. Keep the house well lit. Attach safety grab bars in the bathroom. Protect windows and doors with plexiglas. Create a safe place to wander. Establish and maintain bedtime rituals.

51
Q

Know about respite care

A

It’s a break for caregivers or family members and they have 30 “free” days a year where they can put their family member in a nursing home temporarily.

52
Q

Know the benefits of early diagnosis

A

being able to still tell you what the patient wants done

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